Comprehensive health care reform should give all Americans
affordable access to care and prevention.
But will health reform give women access
to the services we need, including reproductive health care? Only if we’re on
the front lines helping shape health reform policy.
This summer, women’s health and reproductive justice
advocates are working hard to ensure that health reform is a top issue in this election
year. From grassroots efforts and rallies in state capitals to big-budget
national media campaigns, women are making our voices heard.
"If we want health reform to meet our needs, we’ve got to
speak up, get involved and make sure we have a place at the table," says Byllye
Avery, co-founder of Raising Women’s Voices and founder of the Black Women’s Health Imperative and the
Avery Institute for Social Change.
Women’s Voices for the Health Care We Need has launched a national action
campaign aimed at mobilizing grassroots women to speak out at Congressional
town hall meetings and candidate forums about problems in the current health
system and the need for health reform. The campaign emphasizes women’s roles as health
decision-makers and coordinators of care for entire families, positioning
women as sources of "kitchen table wisdom" about what’s wrong with the health
system and how it might be fixed.
Meanwhile, in Washington, a number of women’s health organizations have become
actively involved in broad-based progressive health reform coalitions, even
though these coalitions have not explicitly endorsed access to comprehensive reproductive
health services. The National Women’s Law Center
and the Planned Parenthood Federation of America have joined the steering
committee of Health Care for America
Now, a coalition of progressive organizations and unions that is mounting a
$40 million media campaign to promote what it calls an "American solution that
provides quality, affordable health care for everyone." That American solution? To allow Americans to keep
the health insurance they have, pick a new insurance plan or join a public
health insurance plan.
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A $500,000 commitment per steering committee member, along with a $10 million grant from The Atlantic Philanthropies, kicked
off HCAN, which represents the mainstream progressive push for health
care reform heading into a new national administration in 2009. Other steering
committee members include ACORN, Americans United for Change, Campaign for America’s
Future, Center for American Progress Action Fund, Center for Community Change,
MoveOn.org, USAction and several big unions.
Not represented in HCAN are the major organizations advocating a
"single-payer" national health insurance system administered by the government,
such as the 15,000-member Physicians for a National Health Program (though some smaller single-payer groups have joined). Also
absent from the HCAN coalition is the high-profile Washington, D.C- based consumer health organization Families
USA, which recently announced "a
brand new action project called Stand
Up for Health Care — with the goal of persuading our elected leaders to
provide quality and affordable health care for all." And yet another organization — the Universal Health Care
Action Network — is concentrating its efforts on "building
active unity" among the various health reform campaigns, so that leaders of the
progressive community don’t squander an historic opportunity to make change by fighting each other.
Will Reproductive Health Care Services Be Included in Health Reform?
There are no guarantees. But the presence of PPFA and NWLC on the steering committee of
HCAN ensures that women’s concerns and reproductive health issues will be
raised in the inner circles of the high-visibility health reform campaign. NWLC
Co-President Marcia Greenberger and PPFA President Cecile Richards spoke at the
D.C., HCAN launch event, and women
representing affiliates of PPFA had speaking roles at some of the rallies HCAN
sponsored in 38 state capitols.
While HCAN’s "Statement of Common Purpose" does not
explicitly advocate for comprehensive reproductive health services, it does
call for "a standard for health benefits that covers what people need to keep
healthy and to be treated when they are ill" and explains that health benefits
"should cover all necessary care including preventive services…" While those benefits have not been defined, women’s health leaders are expecting that their presence at the table will make a difference in whether reproductive health services are explicitly included.
equally important to note which organizations are not in the HCAN coalition: the powerful anti-choice faith-based
organizations like the U.S. Conference of Catholic Bishops and the major
Catholic health systems. In recent years, some progressive health reform groups
have sought "common ground" with these religious organizations by deciding to
stay silent on reproductive rights and instead emphasizing such noncontroversial
issues as children’s health care.
strategy has alarmed reproductive justice advocates because religious
conservatives’ view of health reform does not include abortion or contraception
(or even referrals for these services), but does
include explicit protections for doctors and hospitals who refuse to provide
reproductive health services.
The Raising Women’s Voices Vision
Raising Women’s Voices, while participating in HCAN as a
member, has issued its own vision of health reform that explicitly calls for "provision
of the full range of women’s health and reproductive health services," including, at a minimum, maternity care, pre and post-natal care,
contraception, abortion, treatment and prevention of sexually transmitted
diseases and infertility treatment. RWV also
calls for the provision of comprehensive sex education as part of health care,
not just in schools.
"Reproductive health care is not the only issue we address,
but it is an important feature of our vision of quality, affordable health care
for all," says Eesha Pandit of The MergerWatch Project, one of the three organizations
that co-founded RWV. "We are placing reproductive health just where it should
be – as an integral part of primary and preventive health care for women."
Choosing Issues and Strategies
"Americans know that the last people we can trust to fix the
health care mess are insurance companies," HCAN National Campaign Manager
Richard Kirsch says. HCAN’s website declares war on the insurance
companies: "Taking on a multi-billion
dollar industry means TV advertising and massive organizing. We’ll need serious
money to take these guys on." The group is also using Internet outreach (such
as by HCAN member MoveOn.org and through an on-line petition drive on the HCAN
website) and old-fashioned community organizing through HCAN members’ chapters and affiliates around the country. And HCAN is employing organizers in
45 states to ensure lots of activity as the election nears.
Where HCAN is guided by a high-profile steering committee
and has the resources to make large media buys, RWV’s
emphasis is on building support for health reform from the grassroots up and
ensuring that individual women’s voices are heard. The Raising Women’s Voices
campaign held listening sessions with small groups of grassroots women and
girls of all ages and from diverse racial, ethnic and income groups. Participants have voiced concerns about such issues as the high price of
birth control, the refusal by some health insurers to cover midwifery services,
the pressure on pregnant women to have cesarean sections, the desperate need
for support services for family caregivers (often women) and the impact of the
Hyde amendment ban on access to abortion services for Medicaid recipients. The
RWV vision statement, as a result, encompasses the health needs of women and
their families across the lifespan.
Like HCAN, the RWV 2008 Action Campaign is also focusing, in
part, on insurance company practices – but specifically from a woman’s
perspective. One of the campaign’s three key focuses is the fact
that women are being denied individual insurance policies (or charged more for
them) because of pre-existing conditions that can include breast cancer, pregnancy
and even having had a cesarean section.
"When women find out they can be denied health coverage
because they are pregnant, or because they had breast cancer, they are just
outraged," says pollster Celinda
Lake, who helped brief
RWV advocates on the issue of pre-existing conditions.
RWV’s campaign also addresses two other issues:
Making health coverage affordable for women and
families. "Women are being hurt badly by the high cost of health insurance —
many can’t afford to buy health insurance any longer. And even women who have insurance are going
without the health care they need because insurance companies are finding more
and more ways to shift costs to consumers," says RWV’s Cindy Pearson, Director
of the National Women’s Health Network, the third RWV founding organization.
that health reform plans must actively work to end health disparities. "Getting
health coverage for underserved women is definitely the first step toward
eliminating disparities, but it can’t be the only step," RWV’s Byllye Avery
says. "We know that even when people have the exact same health coverage, such
as Medicare, some of the people still get second-class health care."
The group has prepared fact sheets and talking points on all the campaign issues and is recruiting regional
coordinators in locations across the country. RWV’s 26 advisory board members, ranging from
the Black Women’s Health Imperative, the National Latina Institute for
Reproductive Health and the National Asian Pacific American Women’s Forum to
Our Bodies, Ourselves and the National Coalition for LGBT Health, are leading
outreach to women of color, lesbians and other groups of women often left out
of health policy debates.
Both Raising Women’s Voices and the National Women’s Law Center
have been working to inform women about health reform plans and to prepare them to
actively participate in debates and legislative struggles over expanding access
to health care. In 2009, when health reform hits state legislatures and, let’s hope, Capitol Hill in Washington, women’s health advocates will know whether their efforts to work with consumer health groups this election year
will pave the way for health reform that meets all of women’s health needs.