05/23/2010 05:12 am ET Updated May 25, 2011

Health Insurance Reform: Bittersweet for Women's History

The morning after the passage of health insurance reform in the United States feels a lot like the morning of November 5, 2008 in California.

I want to celebrate the successes of the Democratic Party. Our President and our Congress have worked diligently and tirelessly to advance legislation that will create lasting change for Americans who suffer the consequences of a broken health insurance system. I want to applaud the regulation and reform that will be placed upon our private health insurance system for the benefit of many of America's most vulnerable citizens. I want to see the faces of Americans who will now be able to afford insurance, no longer having to choose between their mortgage or education payments and their health. In particular, I want to rejoice in requiring coverage for maternity, especially given Amnesty International's recent report on maternal mortality in the United States.

I want to be proud of the progress that was made, but I cannot ignore that it is Women's History Month.

For decades, our foremothers in the women's movement have fought to protect women's health. Today, women are still expected to be the primary caregivers for both our youth and our aging communities, and thus carry a large part of the burden of health care in our country. Making less money for equal work, and often providing care that is not considered worthy of payment in our society, women know firsthand the impacts of our broken health insurance system. Thus, women have quite an investment in the many and varied outcomes of health insurance reform.

However, Congress voted for a health insurance reform bill that codifies Hyde Amendment language through the Nelson restrictions; permits gender- and age-rating for small businesses; omits LGBT-specific provisions; allows discrimination against immigrant workers; and lacks a public option. They did not place a value on the unpaid care-giving women routinely provide in their families and communities. To provide further certainty of his commitment to limiting reproductive health care access, the President announced his proposed executive order to include Stupak-Pitts language to the bill. Instead of ensuring protections for women's comprehensive health care, insurance reform has suggested that progress is only possible at women's expense and has made clear that women's rights are negotiable in the United States.

While the President and Congress will argue that employers can still offer insurance plans that cover the spectrum of reproductive health care services through additional riders, the truth is that an extra administrative step for insurance companies and employers -- to ensure that no federal money contributes to a woman receiving an abortion -- is an extra step to discourage the availability of comprehensive services. Even people who desire to purchase this additional coverage with their own money will not be permitted to do so if their insurance providers receive ANY federal funds. Furthermore, it is not practical to think that every woman who chooses to discontinue unintended, forced, and sometimes-lethal pregnancies will be able to afford the additional coverage. Ultimately, American women will disproportionately suffer the effects of the unwillingness of our federal elected leaders to stand on their side.

Additionally, our federal leaders have touted the elimination of gender-rating practices as a result of health insurance reform. The truth is that a loophole still exists -- for companies that cover fewer than 100 employees who participate in exchanges -- regarding equal coverage for women. Women who work in small businesses will not be protected from gender-rating practices. Women who work in large businesses that have fewer than 100 employees participating in exchanges will not be protected from gender-rating practices. To me, it is unconscionable for any woman to pay higher insurance rates simply because she is a woman -- but not according to our federal government.

The implications of the health insurance reform vote go far beyond the content of the executive order or loophole language. The President did not issue an executive order to ensure prohibition of federal spending on erectile dysfunction. Congress did not allow provisions for small businesses in order to protect higher cost coverage for men. Women are the targets of gender-based compromises on health insurance coverage. Thus, feminist objections to health insurance reform are objections to women's rights being put on the negotiating table in the name of progress.

Feminist leaders will continue the fight for comprehensive health coverage for women. However, with only 17 women in the Senate and 76 women in the House -- record numbers this year in Congressional representation -- it is no surprise that women have found difficulty in achieving their desired health care protections. It is an unfair characterization that women who did not whole-heartedly support health insurance reform because of its gender-based discrimination are selfish, or that we fail to see the bigger picture. We are simply rejecting the false choice between protecting our own health or the health of our male family and community members.

Without pro-choice elected leaders voting for reform, we would not have anything to celebrate at all. However, the health insurance reform bill is another example of legislation that allows women to be the object of discriminatory practices for the sake of progress. Even with Speaker Pelosi's leadership, health insurance reform is an achievement in women's history with several asterisks. I think it is time for ratification of the Equal Rights Amendment once and for all.