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The Romney-Ryan Budget: Taking Aim at Women's Health Care

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This is Part 2 in a series. Read Part 1 here.

The leaders of the Republican Party claim to be on a mission to reduce this nation's "crushing burden of debt." The centerpiece of this effort is Rep. Paul Ryan's 99-page 2013 budget proposal. Because GOP presidential candidate Mitt Romney has embraced it wholeheartedly, I call it the Romney-Ryan budget plan. From the very beginning, the plan states that a federal budget "also serves as an expression of Congress's principles, vision, and philosophy of governing."

You can say that again. And the federal budget's vision isn't just a lofty collection of ideals -- it has real-world implications for real-life people. The Romney-Ryan budget plan does not have the support of the Senate, so at this point it is only an expression of the values of the conservative-led House and its cronies. But many of these folks are asking for our votes this November. That's why I'm writing this series of posts on the Romney-Ryan budget plan. Women, in particular, must take a careful look at the economic proposals emerging from our nation's increasingly radical right wing. Just how do Romney and Ryan think they can help the people of this country "build a prosperous future for themselves" while "safeguarding America from the perils of debt, doubt and decline"?

The first thing women should know about the Romney-Ryan budget is that it has been called the single largest transfer of wealth from middle- and low-income earners to millionaires and billionaires in our country's history. Since women are over-represented in the ranks of middle- and low-income earners, not to mention drastically under-represented among billionaires, it's fair to say the Romney-Ryan budget disproportionately takes from women to give, overwhelmingly, to people who look (and have bank accounts) like Mitt Romney.

Of the many ways in which Mitt Romney and Paul Ryan's economic vision is bad for women, a good place to start is with women's health care. The Romney-Ryan budget repeals the Patient Protection and Affordable Care Act (known as the ACA or "Obamacare") in its entirety, thereby snatching away from millions of women the health care services that the law is just now beginning to make affordable.

For women, repealing the ACA goes in exactly the wrong direction. By the time it is fully implemented, the law will have opened up access to comprehensive health coverage to nearly all of the 19 million women in the United States who were uninsured when it was signed into law in 2010. Moreover, at the time the law was passed, the Congressional Budget Office (CBO) concluded that it would produce "a net reduction in federal deficits of $143 billion over the 2010-2019 period."

The reality is that the ACA is a good first step toward getting the nation's health care costs under control. Women especially need this to happen because, throughout a lifetime of unequal pay, in jobs that frequently don't offer health benefits, women don't have a lot of savings to fall back on to pay for sky-high medical expenses.

The National Partnership for Women & Families calls the ACA "the greatest advance for women's health in a generation." Unquestionably, the law helps women in five key ways by:

  • Requiring insurers to cover a range of preventive reproductive health care services, including contraception, mammograms, pap tests and STD / HIV screening without co-pays or deductibles;
  • Prohibiting insurers from charging higher rates for women than men for the same coverage;
  • Stopping the insidious practice of refusing coverage due to pre-existing conditions, which insurers have used to refuse prenatal care -- and we know that without prenatal care women are two to three times more likely to die in childbirth, and have babies who are six times more likely to die in infancy;
  • Expanding Medicaid coverage to low-wage workers (disproportionately women) who earn below 133 percent of the federal poverty level; and
  • Subsidizing other low- and middle-income earners (again, disproportionately women) so they can afford quality health insurance for themselves and their families.

Healthier women with more money in their pockets sounds like a win-win to me.

But the Romney-Ryan budget plan would put an end to all that. It promises to repeal the ACA and replace it with ... well, they don't say. They claim an intention to "move toward patient-centered reform." Please note that whenever a conservative offers up a "patient-centered" or "consumer-centered" approach, that means they're passing more of the cost on to you. What would really happen after repeal of the ACA is that we would go right back to where we were during the Bush years, with health care costs spiraling out of control, patients denied coverage of lifesaving health care by profit-hungry insurers, and the worst overall health outcomes in the entire industrialized world.

And it gets worse, as Romney has promised to "get rid of" Planned Parenthood and fully supports Ryan's votes to zero out funding for all Title X family planning clinics. Now, the advantages of family planning funding couldn't be more clear. The ability to plan one's family, to choose whether and when to have children, is both a matter of women's reproductive freedom and a public health issue. Unplanned pregnancies, sexually transmitted diseases, breast and cervical cancer -- these are issues that have an economic impact on this country, and we can't turn away from them because of outdated, sexist notions about women's reproduction.

Contraception helps young women postpone getting pregnant until they finish school or job training. The typical U.S. woman wants only two children; to achieve that goal, she will need to use contraception for about 30 years. Yet, the cost of contraception often deters women from choosing the method what would work best for them. This is especially true of methods with high up-front costs, like long-acting IUDs and implants. Consider these twin facts: According to Planned Parenthood, "34 percent of women voters report having struggled to afford prescription birth control at some point in their lives and, as a result, used birth control inconsistently;" meanwhile, according to the Guttmacher Institute, women who use birth control consistently and correctly account for only five percent of unplanned pregnancies each year.

For many women, Planned Parenthood centers and other government-funded family planning clinics are their only source of health care. Planned Parenthood alone serves 2.9 million clients in the U.S. each year, 72 percent of whom have incomes at or below 150 percent of the federal poverty level. These clinics provide preventive, primary care that includes testing and treatment for sexually transmitted infections, cancer screening and prevention, as well as contraceptive services.

According to the National Center for Health Statistics, one out of seven women age 18-64 has no usual source of health care. The ACA changes that. Without health care reform or family planning clinics, where exactly should these women go?

So let's review. Obamacare -- and incidentally, I'm willing to embrace that term because President Obama does care about women's health -- helps millions of women gain access to affordable contraception, mammograms, cervical cancer screenings and other health services. That's right, millions. Fully funding Title X family planning clinics helps many more. By contrast, instead of thinking responsibly about the women who would love to have health insurance if only they could afford it, the Romney-Ryan budget would send us back to where we were in the Bush era, except this time there would be no federally-funded family planning clinics, leaving millions of women more vulnerable to illness and financial hardship than they are today.

On that basis alone, voters should reject the Romney-Ryan budget and its standard-bearer, presidential contender Mitt Romney. But there are many more things wrong with the Romney-Ryan budget, which I'll explore in future posts. Stay tuned.

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