Fighting for Medicaid is a Feminist Issue

Did you know that 1 in 5 American women in their reproductive years receive health insurance through the Medicaid program? In fact, Medicaid is a lifeline for nearly half of women in that age group who are below the federal poverty line, and nearly a third of Black women in that group (compared with 16% of white peers). Did you also know that LGBTQ+ people disproportionally experience poverty compared to heterosexual and cisgender people, making them more reliant on Medicaid for health care? Did you know that the Medicaid program covers care expenses for 51% of all births in the United States?

In this political moment, one of the country’s largest health care programs—designed to improve access and quality of life for low income people and those with disabilities—is under attack on both federal and state levels. Last month, the proposed American Health Care Act (AHCA) passed a vote in the House and stands to go up for a vote in the Senate. One of the many dangerous components of the AHCA is its targeting of the Medicaid program, which is an essential health care safety net for low income people, as well as a key facet of our nation’s family planning effort. Medicaid allows coverage for family planning services without copays, or penalties and red tape for choosing one type of contraceptive over another. The AHCA’s proposals to shift to a block grant or per capita cap structure for Medicaid would shift more costs to states, which would end up putting more costs on poor patients as well as their providers.

Unfortunately, Maine is also experiencing more localized attacks on our state Medicaid program, known as MaineCare. Maine is one of 19 states that have yet to expand Medicaid under the Affordable Care Act (ACA or Obamacare), due to Governor LePage’s multiple vetoes of this effort. Now, through a waiver application process, the Maine Department of Health & Human Services (DHHS) is attempting to enact rule changes that would place even more barriers to health care before poor and disabled Mainers, and result in potentially thousands more losing MaineCare coverage. Luckily, Maine’s “state plan amendment” has allowed for Maine Family Planning clinics to extend free reproductive health care services to low-income Mainers who are otherwise not eligible for MaineCare. However, the DHHS proposal to eliminate retroactive coverage would have negative effects on our ability to continue offering this service to people who fall through the cracks of our current health care system.

Opponents of these changes spoke passionately at a public hearing in Portland yesterday. One advocate with Homeless Voices for Justice—Dee Clarke—asked blatantly, “Why are you trying to hurt us?” Several mothers, including Clarke, spoke about raising their children on MaineCare, which allowed them to care for their families in the best way possible while facing the daily challenges of living in poverty. A nurse midwife spoke against the proposed $5,000 asset test as one change that would punish many women seeking prenatal care whose families operate small businesses. As she so poignantly put it, “You can’t sell off your small business or farm to afford prenatal care.”

Both the data and human stories make it clear:  Defending and expanding Medicaid is a feminist issue with major implications for women and LGBTQ+ health. The political attacks on Medicaid are fueled by classist stereotyping and stigmatizing of poor people, and the harm disproportionately falls on poor women. Cutting Medicaid means rolling back access to reproductive health care as well. It means more unplanned pregnancies, less healthy pregnancies, and more sick mothers and babies. Progressive Maine organizations are fighting to expand MaineCare this year, and Maine Family Planning is joining them. We continue to fight every day for the well-being of Maine women, teens, and LGBTQ+ people.

If you’d like to learn more about how to get involved in this effort, contact Community Organizer Cait Vaughan at 207-480-3518 or at cvaughan@mainefamilyplanning.org.

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