Many women have voiced concern online that when Donald Trump takes office, he will keep his campaign promise of repealing the Affordable Care Act, which so many women rely upon for basic health services, including reproductive care coverage.
Currently, the Affordable Care Act covers contraceptives prescribed by a woman’s doctor. Those birth control methods include barriers (diaphragms and sponges), hormonal methods such as the pill and vaginal rings, IUDs and other implant devices, emergency contraception such as Plan B and Ella, and sterilization procedures.
The Affordable Care Act is NOT required to cover drugs that induce abortions or reproductive services for males, such as vasectomies.
Trump ran for president on a pro-life platform and chose a vice presidential candidate who has a long record of limiting women’s health care as the governor of Indiana.
In September while campaigning, Trump promised that he would work to defund Planned Parenthood, ban abortions after 20 weeks, and make a law banning use of public funds to pay for women’s health when it comes to abortion. He even enlisted Marjorie Dannenfelser, the president of the Susan B. Anthony List, to head up his campaign’s pro-life coalition. If you're not familiar with the Susan B. Anthony List, it's an organization which opposes abortion under any circumstance, including rape and incest, and also opposes several forms of contraception—including emergency contraception and IUDs.
So what does all this mean for women who rely on the Affordable Care Act for health care coverage? It could actually have far-reaching consequences, experts say.
And some women (and men) are advising other women to opt for an IUD that can outlast a Trump presidency in preparation of the possibility that they may lose coverage, access and even the right to govern their own bodies when it comes to reproductive health.
Even young women who are not close to becoming moms are speaking out on social media about making the decision to get an IUD.
You might be asking what a possible scenario would look like. Well, we've already seen a glimpse in Texas, and the facts are indisputable. (The Supreme Court struck down abortion clinic restrictions in Texas earlier this year.) A study published in the New England Journal of Medicine in February by researchers at the University of Texas at Austin showed that low-income women were most affected by cuts and closures of clinics across Texas since they reduced state-funded family-planning grants by two-thirds in 2011.
The result? Medicaid has had to pick up the cost because women who no longer have access to affordable, effective birth control are having more babies. Repealing the Affordable Care Act could make it even tougher to get access to reproductive health care services.
Over the last decade, IUD and implant usage to prevent pregnancy has increased nearly five-fold in young women, according to a 2015 report from the CDC, and just more than 7 percent of women ages 15 to 44 rely on long-term contraceptive devices to prevent unwanted pregnancies. Data published in 2013 showed that nearly 50 percent of all births in the U.S. are covered by Medicaid.
The Kaiser Family Foundation tracks more recent state data that's available on Medicaid births, with some states reporting as recently as 2015 and the numbers to date for 2016. States with the highest rates of Medicaid-financed births tracked by the foundation include New Mexico (72 percent in 2015), Arkansas (67 percent in 2013), Louisiana (65 percent in 2015), Mississippi (64 percent in 2014) and Nevada (64 percent in 2016, for the previous 12 months). Of those top five states, New Mexico and Nevada are the only two that went blue in the 2016 presidential election, according to the New York Times.
In 2016, about 12.7 million Americans were insured through the Affordable Care Act marketplace alone—and 6.8 million of them are women and girls. According to the U.S. Department of Health and Human Services, an estimated 8.7 million women with individual insurance coverage were able to also gain coverage for maternity services, and as many as 65 million women with pre-existing conditions were able to obtain coverage they would not otherwise have had if the Affordable Care Act didn't exist. It has literally changed women's lives by giving them access to health care.
But it's not just about access to abortion services. Many health benefits under the Affordable Care Act are also crucial to moms. The legislation currently covers "breastfeeding support, counseling and equipment such as breast pumps for the duration of breastfeeding," as well as services for pregnant women or women who may become pregnant—including screenings for diseases and disorders, gestational diabetes testing, folic acid supplements, tobacco intervention and counseling, HIV screening, and many other preventive-care services that are directly or tangentially related to reproductive health.
Women's reproductive freedom and privacy are protected by the U.S. Constitution, as affirmed by the Supreme Court in the landmark 1973 Roe v. Wade decision and other cases—but if Trump appoints a new Supreme Court justice to fill the vacancy left by the death of Justice Antonin Scalia, it's likely that it will be a conservative voice that doesn't side with the justices who have voted to uphold Roe v. Wade.
In June, when the Supreme Court declared that restrictions on abortion clinics in Texas were unconstitutional, legal experts considered it "the most significant decision on abortion rights in a generation." However, shortly after the court's decision, the Washington Post reported that Trump said, "If Scalia was replaced by me, you wouldn't have had that. OK? It would've been the opposite," during a radio interview.
Trump could feasibly nominate as many as four new justices to the Supreme Court during his presidency, which could potentially upend the balance of the current court. And, he has publicly criticized Chief Justice John G. Roberts, Jr. for voting with the court's liberal justices on cases related to the Affordable Care Act.
Trump has previously said any Supreme Court nominee he chooses will be from a list compiled with the help of the Heritage Foundation, a conservative think tank, and the Federalist Society, a conservative legal nonprofit organization, and would be someone who would seek to overturn Roe v. Wade and be a "strong supporter of the Second Amendment."