Obamacare. It’s the signature legislation of the Obama Administration, the pivot on which President Obama and his surrogates have repeatedly asserted his legacy will rest. Yet while enrollment at healthcare.gov will end on March 31, the problems surrounding Obamacare will persist long after and the people it was supposed to help most–women–could be the ones left shafted in the end, with many not getting full coverage or not getting coverage at all.
In addition, gay political statistician Nate Silver has rendered his verdict on how Obamacare will play out in the November 2014 mid-term elections: Democrats will lose the Senate. Among the most vulnerable seats are many held by women, who only comprise 20 percent of the Senate as it is.
How could health care reform that was supposed to help the 50 million Americans who were uninsured when the bill passed, now pose a threat for women and likely gay men as well?
The Patient Protection and Affordable Care Act or ACA (or Obamacare as it is now popularly known) was signed into law four years ago on March 23, 2010. The law was intended to ensure all Americans had health insurance coverage and that no health care provider could rescind or deny coverage to anyone, child or adult, with a pre-existing condition. The ACA also allowed parents to keep children up to age 26 on their family plans, thereby ensuring that college students and a host of millennials still living at home had coverage.
Health care reform was long in coming. It had been proposed by Franklin D. Roosevelt’s administration and the idea was floated again throughout the 1960s. It was revived in 1993 by Hillary Clinton, who attempted to make it her signature effort as First Lady. But three years of battling with Congress left her attacked and vilified by both Republicans and her own Democratic Party and "Hillarycare" was scrapped.
In 2008, Clinton revived the debate over health care during her run for president, making a health care mandate one of her signal concerns.
President Obama pushed Hillary Clinton’s version of health care reform in 2009, and in 2010, with Democrats in charge of the White House and both Houses of Congress, the ACA was passed.
Yet, just like in 1993, health care reform was never without controversy. The same issues that plagued Hillary Clinton in 1993 beset the Democrats in 2010–including attacks not just from the Republicans, but from within their own party. Blue Dog Democrats like then-Sen. Max Baucus put women at the center of the "perils" of Obamacare. At issue: abortion and contraception. Pro-life Democrats teamed with Republicans to change the language of the initial bill so that abortion was never covered and contraception was, well, iffy. Religious organizations got an automatic opt-out, so nationwide Catholic and other religiously based businesses like universities and hospitals were allowed an exemption from following the ACA.
Fast forward to October 2013 when the countdown to coverage began and women again became the "problem" of Obamacare. Businesses, to whom President Obama had already given an extra year’s extension to cover employees and had already allowed numerous other concessions, still had issues. What about the right to life?
Ever since former vice-presidential candidate and Tea Party leader Sarah Palin had accused the ACA of creating "death panels" to apportion care in 2010, the specter of Obamacare being somehow pro-death had been repeated as a meme by conservatives, and congressional Tea Partiers like Sen. Ted Cruz (R-TX) have made it their focus. More than two-thirds of Americans oppose Obamacare, with many citing the imaginary death panels as their reason.
On March 25, the U.S. Supreme Court case of Sibelius v. Hobby Lobby brought some of these issues center-stage, yet again. And now women are truly imperiled, not by Obamacare, but by the attacks against it.
Hobby Lobby, a nationwide chain of stores, is a private for-profit corporation with 15,000 employees. The owners, the Green family, are devout Christians and run the company according to their beliefs. Like Chick-fil-A, which came under fire in 2012 for anti-gay policies, Hobby Lobby’s owners close their stores on Sundays and have Bible readings for their employees.
The Greens don’t believe in abortion and they don’t want to pay for it. They will pay for some birth control, but don’t want to pay for the morning after pills and IUDs, which they and many other conservatives consider abortifacients, even though they’re not. So in September 2012 Hobby Lobby filed a lawsuit against the Department of Health and Human Services, which manages Obamacare.
What SCOTUS will decide–their ruling not likely before the end of the term in late June–could not only determine whether corporations pay for women’s health care needs, but also whether corporations can choose to ignore other aspects of the ACA as well.
What if a corporation decides HIV testing or pre-natal testing is against their religious beliefs? What if a corporation is against all forms of birth control, which many women use not just as birth control, but to regulate irregular menses from which one in four women suffer or for treatment of menopausal symptoms or other hormonal imbalance? And what about women who are forced to have therapeutic late-term abortions–which are always done in hospitals–due to a life-threatening complication?
As it is, women have faced more hardship under the ACA than was ever expected. Of the several million plans that were cancelled by the ACA (my own among them) single women were disproportionately victimized. Nearly all individually held plans were cancelled nationwide, leaving self-employed people who were not on a group plan suddenly without health insurance.
The ACA also hasn’t been as affordable as its moniker suggests. While healthcare.gov ads tout affordability of monthly premiums, they don’t address the bottom line of those plans: huge deductibles, often over $10,000. The plan healthcare.gov suggested for me to be in line with the premium I previously paid had a $15,000 deductible. The plan I chose–the exact same plan I’d had prior to the ACA canceling it–costs triple what my previous plan did, yet is point-for-point the same plan, with no deductible. But it still means I must now pay close to $2,000 a month for the same plan that until Dec. 31, 2013 cost me $525 a month.
Since women make disproportionately less money than men and more women are self-employed than men, these hidden costs will affect them more. Also, if the Hobby Lobby case is decided in favor of corporations over women, every woman in America will have to pay out of pocket for birth control and any other related procedure that can be fitted under the rubric of this case.
Story after story of women battling cancer and having their plans cancelled have made their way to the media everywhere from Huffington Post to Fox News. My own story is not the only one.
So what will be done to fix Obamacare and protect women? While much rests on the Supreme Court, more rests on the Administration and the HHS.
When the ACA was passed, 42 million people were uninsured and another eight to 20 million were under-insured. Yet only five million have signed up since Oct. 2013, despite numerous extensions proffered by President Obama, the latest of which happened yesterday. How many of those who have signed up are women like myself whose plans ("If you like your plan, you can keep your plan"–and I really liked my plan) were cancelled by ACA?
Women’s health care needs are different from men’s. Everyone knows this, yet this was not only not addressed by the ACA, every attempt was made from the outset by male members of Congress to excise health care needs that only women have from the ACA.
The U.S. Supreme Court may decide again that corporations are people as they did in the now-infamous Citizens United case and decide people–that is, women–are not as important. That upside-down logic got some attention from the three female members of the court when the oral arguments were heard March 25, but court watchers know this case likely rests on one justice, Anthony Kennedy, who is the court’s only true swing voter.
Over the next four months women will remain on tenterhooks, wondering whether–or if–they will be covered or not. And come October, when the annual numbers come in for Obamacare right before the mid-term elections, women may also get shunted from Congress in record numbers.
President Obama could proffer more extensions to protect women under Obamacare until after the November election, but that seems unlikely. So for now the picture is grim: corporations versus women, with our future health hanging, once again, in the balance, putting the lives of women at risk–the very thing the ACA was supposed to not only prevent, but cure.
Victoria A. Brownworth is an award-winning journalist, editor and writer. She has won the NLGJA and the Society of Professional Journalists awards, the Lambda Literary Award and has been nominated for the Pulitzer Prize. She is a regular contributor to The Advocate and SheWired, a blogger for Huffington Postand a contributing editor for Curvemagazine, Curve digital and Lambda Literary Review. She is the author and editor of nearly 30 books including Coming Out of Cancer: Writings from the Lesbian Cancer Epidemic and Restricted Access: Lesbians on Disability. Her collection, From Where We Sit: Black Writers Write Black Youth won the 2012 Moonbeam Award for Cultural/Historical Fiction. Her Y/A novel, Cutting will be published in fall 2014. @VABVOX
