The first major improvement was the passage of the Affordable Care Act (ACA) during President Barack Obama’s first term. Before the ACA, one-third of women who attempted to buy a health insurance plan themselves were either turned down, charged a higher premium, or had specific health issues — like pregnancy — excluded from their plans. Insurance companies sold plans to young women that didn’t cover birth control or pay for maternity care, the most common reasons a young woman is most likely to seek medical care.
Just being a woman was a requirement and the insurance companies didn’t want to pay for it. Because of these barriers, at least 1 in 5 women in America did not have health insurance.
The ACA changed all that, ensuring that more women could get health insurance, that it was more affordable, and that they could not be denied coverage for basic health care like pregnancy and birth control. The law also ensured that the necessary preventive care services for women — your yearly physical, Pap and pelvic floor exam, birth control, breastfeeding support — all had to be provided free of charge. It was a good start.
This year, the Inflation Reduction Act (IRA) built on the momentum of the ACA by going further. Prescription drug costs will be lower, especially for seniors on Medicare, and people who get their health insurance on the ACA exchange will see lower premiums for at least the next three years.
Unfortunately, those two massive steps forward that ensured access to and affordability of quality health care only managed to win a single Republican vote. You read that right. One Republican voted for the Affordable Care Act, none for the Inflation Reduction Act. Almost every Republican has voted twice against your ability to access quality, affordable health care. Without the Democrats in Congress and in the White House, women would not have made the progress that we have made over the past 12 years.
But now all those advances seem irrelevant as we helplessly backtrack on an issue central to the health of women and families around the world — abortion. Abortion is health care, not a binary choice that some politicians want you to make either “for” or “against.” Abortion care is part of the spectrum of pregnancy care, from fertility treatment to miscarriage management to caring for women with complicated pregnancies and since Dobbs overturn decision Roe v. Calf, Abortion treatment is not available to women in Wisconsin.
Instead, our bodies are governed by a law that dates back to 1849, enacted 70 years before women were even allowed to vote. This law makes no exceptions for rape. There are no exceptions for incest. The only exception is the mother’s life. But pregnant women don’t have a warning light that lights up when they’ve crossed that threshold. Physicians must use our clinical judgment – developed through years of formal training, experience and dedication – to make complicated, sensitive, individual decisions in partnership with our patients and their families.
The ramifications of this criminal ban are terrifying, and not just for the 1 in 4 women who will have an abortion in their lifetime. People in our state are being denied medication to treat miscarriages. Wisconsin women are denied treatment in emergency rooms while actively bleeding.
Already before DobbsOur maternal mortality rates were among the worst in the developed world, particularly for black mothers, who in Wisconsin were five times more likely to die from complications during pregnancy than white mothers. This rate will increase dramatically as women with physical and mental health conditions are forced to take significant risks of unwanted pregnancy because they have lost access to life-saving healthcare.
It’s about a lot. We are in the midst of a health crisis, an economic crisis and a moral crisis. But our Republican leaders don’t seem to care. These so-called leaders make their own decisions: they duplicate politics, control, and fear instead of working together to solve problems and save lives.
As a doctor, I have taken an oath, a promise, to take care of my patients and their families. I hear them and understand that only they can make decisions about their bodies in the context of their lives. For me, this is the most personal, most effective and most important choice in this election. And it has never been more important than now.
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