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The Health Care Bill: Women’s Gains and Losses

Last night’s congressional debate and votes on health care reform was riveting TV, from the shouts and hollers in the crowd to impassioned speeches on both sides to the final, triumphant arrival of Nancy Pelosi, the first female Speaker of the House, who had just achieved what no other speaker in decades of trying had done: passing a comprehensive health care reform bill.

Liberal-leaning Jewish and women’s groups cheered. “The National Jewish Democratic Council congratulates the U.S. House of Representatives on the passage of a historic health care reform package that represents a giant step forward in improving the welfare of the citizens of the United States,” NJDC Chair Marc Stanley said in a statement to Reuters. “This bill also reflects the clear groundswell of support in the American Jewish community — both among individuals and organizations — for the change in our health care system that’s so desperately needed today.”

Visually, the night couldn’t have been better for women. Between the pundits’ assertion that Pelosi’s will to get things done had been the driving force behind this accomplishment — over the hemming and hawing of various male politicians — and her declaration on the House floor that “being a woman will no longer be a pre-existing condition,” and the numerous female representatives who spoke passionately and loudly alongside their male colleagues, it was clear we were in a new era.

For many feminist Jewish activists, though, the night was less triumphant than, to borrow a word used by the National Council of Jewish Women’s twitter feed, “bittersweet” due to the abortion restrictions it contained — even if they fell short of the restrictions some conservative legislators sought. In perhaps the most bizarre twist of the saga, abortion rights opponent Democrat Bart Stupak, who has delayed this process repeatedly with his demands to further restrict aboriton funding, was called a “baby killer” by an angry congressman when he stood up to defend the bill he ultimately decided to support. Stupak even mentioned prenatal care and maternal health in his remarks, which was shocking in an evening where abortion foes acted as if the procedure happens in a vacuum rather than in the body of a living, breathing woman.

But what will the actual contents of the bill accomplish for women? Do the gains represented by the bill offset some of the losses for reproductive rights?

Well, the bill will be helpful in several ways, most noticeably by ending the disparately high premiums women pay (thus womanhood no longer being a pre-existing condition). It will also mandate the coverage of maternity care for women, which is a huge gain considering the U.S.’s dismal record on maternal health. Finally, it will ban companies from discriminating against all patients for pre-existing conditions — which will go into effect immediately for children, eventually for adults. It will expand coverage to a larger percentage of low-income Americans, which is a huge victory, and will allow young people up until the age of 26 to stay covered on their parents’ plans, which is particularly timely given the poor economy and the larger number of young people freelancing. Here’s a good round-up of pros and cons from Feministing. and a more detailed breakdown from Reuters.

But practically speaking, the ramifications of this bill in terms of reproductive rights remain depressing. First of all, many are predicting that private companies will simply drop abortion care because keeping separate pools of funding for such procedures isn’t worth the hassle. Secondly, the unfortunate message has been sent that it’s acceptable to compromise abortion rights for broader goals.

Perhaps, as Katha Pollit in The Nation suggests, the Democratic establishment should give women some payback for taking this blow for the greater good.


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