President-elect Donald Trump isn’t set to take office until noon on January 20, 2017, so it’s impossible to say exactly what changes a Trump presidency will bring. But he’s already made some announcements that have the potential to affect women’s lives, particularly when it comes to health care and reproductive rights.
Issue number one on the table: the Affordable Care Act (ACA), also known as Obamacare, which was signed into law in 2010. While the ACA changed many aspects of health care, of particular interest to women is the preventative services provision that requires, among other things, that insurers cover birth control, annual checkups, and screenings at no cost to women. And women have definitely taken advantage of these benefits. Over 55 million women now get birth control and other preventative services with no out-of-pocket costs, for a yearly savings of $1.4 billion, according to a report issued by the National Women’s Law Center.
It cannot be overstated how significant this provision of the ACA has been for women, says Janel George, director of federal reproductive rights and health at the National Women’s Law Center. “The ability to determine the number and spacing of children is critical to a woman’s health, financial stability, education, and career,” she explains. “Take that away, and we’ll go back to having to pay huge amounts out of pocket for services and things only women use. It’s discriminating against women simply for being women.” (Heal your whole body with Rodale’s 12-day power plan for better health.)
There is a real possibility that this could happen. On the campaign trail, Trump was adamant about repealing the ACA, saying in an interview with ABC’s Martha Raddatz, “The one thing we have to do is repeal and replace ObamaCare. It is a disaster.” He later clarified in the Republican debates that he was OK with keeping pieces of the ACA, including provisions allowing adults under 26 to stay on their parents’ health insurance and barring insurance companies from excluding people based on pre-existing conditions.
However, those promises might not be fulfilled, judging by a recent late-night vote in the Senate. In the process of passing a legislative measure that would help eventually overturn the ACA on Wednesday night, the Republican majority voted down several proposed amendments to protect key provisions of the law, including coverage for contraception and continued access to coverage for people with pre-existing conditions. The ACA has not yet been repealed, but this does not look very promising for those who support the law.
But when it comes to the coverage for birth control, his position may be best summed up by Senator Tom Price, the man Trump picked to head the Department of Health and Human Services. Prior to being chosen, Price headed legislation designed to remove the birth control provision, and in a 2012 interview he expressed doubt that these preventative services were even something women needed. “Bring me one woman who has been left behind,” he said. “Bring me one. There’s not one.”
Neither Trump nor Price have announced their specific policies or their plans for repealing and replacing the ACA. But just because there are no real answers from Trump yet doesn’t mean women don’t have questions. So we asked George to walk us through what might possibly happen to women’s health care under a Trump presidency and what you can do to protect yourself.
Will I still get free birth control?
If the ACA is repealed in its entirety, no. Unless Trump introduces new legislation that would provide this, things would revert to the way they were pre-ACA, says George.
Will birth control get more expensive or harder to get?
The cost of birth control varies widely. A generic form of the pill may only cost a few dollars a month, while an IUD can cost around $800. But right now, all FDA-approved contraceptive methods are covered by the law at no cost to the woman. Unfortunately, that may change, with women again having to pay for contraception themselves, says George. That’s likely why so many women declared plans to get an IUD immediately post-election day. Whether or not these prices will increase from pre-ACA rates remains to be seen, though.
What about other women’s reproductive health services?
One of the things that makes the preventative services provision great is that it not only requires insurers to cover birth control, but it also covers the cost of annual well-woman check-ups, STI screenings, breastfeeding support, counseling, and support for victims of domestic violence, among other things. (You can find a full list at HHS.gov.) Without the ACA or a similar law, women will revert back to having varying levels of coverage with significant out-of-pocket copays, says George. Women who have great (read: expensive) insurance will be covered, while poorer women on high deductible plans or those with no insurance at all will see their costs for routine care go up.
Will emergency contraception (Plan B) still be available without prescription?
The ACA doesn’t cover non-prescription medications and services, so existing laws for Plan B should remain as they are, says George. However, that doesn’t mean it won’t be harder to get. The FDA’s decision to allow sales of emergency contraception over-the-counter was a controversial one and could be overturned, an idea that Trump’s pro-life adviser Marjorie Dannenfelser has championed, according to the The Washington Post.
Could Trump get rid of Roe v. Wade and ban abortion?
Trump ran on a pro-life platform and earlier this year sent a letter saying he would sign into law the Pain-Capable Unborn Child Protection Act, which would ban abortions after 20 weeks. How this would play out with current legal precedent remains to be seen. “Roe v. Wade has decades of precedent supporting it and was reaffirmed by the Supreme Court this past summer,” says George. “So even if Trump wanted to overturn it, that’s not something he could do unilaterally.” That said, Trump will be able to appoint Supreme Court justices, should any openings arise, and if they’re all pro-life, it could make it possible to legally change Roe v. Wade in the future.
Could Trump shut down Planned Parenthood or stop funding it?
Planned Parenthood provides comprehensive health care services to millions of women and men, mostly those who are poor or otherwise vulnerable. Yet in the same letter he sent regarding the Pain-Capable Unborn Child Protection Act, Trump stated his desire to “defund Planned Parenthood as long as they continue to perform abortions, and reallocate their funding to community health centers that provide comprehensive healthcare for women.” Trump doesn’t have the power to unilaterally get rid of the institution, says George, but he could significantly undermine it through administrative actions and legal changes.
What can I do to protect myself and my reproductive rights?
Many women are understandably nervous for the upcoming changes, and Trump’s lack of specificity is both comforting (maybe it will all work out fine!) and terrifying (we’re going back to the dark ages!). But even though we don’t have a ton of information, yet there are things you can do now. “Raise your voices: go on social media, talk to your friends, write your representatives, and tell them how important women’s reproductive rights are to you,” says George. In the meantime, stay in touch with your insurance provider and your doctor about any changes in your coverage. And bookmark this page, as we’ll be updating it regularly with any and all news.