Claire Decoteau and Kim D. Ricardo: Donald Trump's bill further erodes access to reproductive health care
The entire Medicaid system is next on the chopping block now that the Senate has passed tax cuts for the mega-rich in President Donald Trump's One Big Beautiful Bill Act. The majority of Americans oppose Medicaid cuts because it helps the most vulnerable among us — individuals with limited incomes, middle-class older adults and those with disabilities — through a joint federal and state program that provides free or low-cost health care coverage for 71 million Americans.
As researchers concerned with health care access for pregnant people, we interviewed 189 women over the last year to better understand barriers to abortion access since the Supreme Court overruled Roe v. Wade in 2022. Most of the women we interviewed live in conditions of sustained financial instability and, like most abortion seekers nationwide, already have children. These women are reliant on Medicaid or other forms of state assistance, such as the federal supplemental nutrition program for women, infants and children, known as WIC; school lunches; and housing vouchers. Our study confirms that Medicaid plays a critical role in guaranteeing access to reproductive health care and other essential services crucial to women's ability to sustain their families.
Ten states that have tried to ban or restrict abortion also never expanded Medicaid under the Affordable Care Act. That means it's harder to get birth control in these states, and when women experience unwanted pregnancies, they can't get abortions. Maria, one of our study participants, faced this exact dilemma. Maria is a dental hygienist and a single mother of three. She explained: 'I've looked into getting birth control (at a clinic with a sliding scale) … but … it's still too high of a cost for me.' When she found out she was pregnant, she said, 'I honestly knew I could not afford to have a fourth child. I'm already tight as is.'
If Congress passes the bill, more women will face the same catch-22. Maria ended up using abortion pills she received in the mail.
When the federal government restricts social assistance programs, women won't be able to support the children they already have. Therefore, getting abortions for unwanted pregnancies isn't exactly a 'choice,' as sociologist Katrina Kimport explains. As Eva, a 22-year-old Latina single mom from Indiana, summarized, 'If you aren't going to provide certain health care benefits or … food stamps or … housing, you shouldn't have a say on if somebody should have a baby.'
Abortion bans have reverberating effects. Pregnant people living in states with bans are twice as likely to die during childbirth as in states without bans. The risk is greatest for Black women — they are three times more likely to die during childbirth. Further, OB/GYNs don't want to train or practice in states with abortion bans, where their decisions around reproductive health care would be constantly under state surveillance. As a result, women in ban states already experience reduced reproductive health care access.
Now that the bill has passed, women in all states will likely face reproductive risks because cuts also affect women living in states where abortion is legal. Illinois has used Medicaid to effect immediate decreases in direct patient costs and increases in abortion care by removing federal restrictions for abortion coverage and raising Medicaid reimbursement rates for abortion services by 20%. Medicaid coverage for abortions improves outcomes by allowing people to seek medical care earlier in pregnancy. Early access to abortion is positively associated with improved physical and mental health outcomes. When abortion care is not covered by Medicaid, people wait longer to get an appointment for care, and their pregnancies are more advanced and abortions more complicated and expensive.
The bill would erase these state-led gains for women's reproductive health care while increasing federal spending. Barring Planned Parenthood from participating in Medicaid at a national level because it happens to provide abortions will raise federal spending by $300 million, the result of decreased contraception provision and a corollary increase in Medicaid-funded births. We know this because Texas implemented a similar plan in 2013 with these results.
Our leaders should be working to increase access to health care, not rationing it out to only those who can afford it.
Claire Decoteau is professor of sociology and Kim D. Ricardo is the Lucy Sprague professor in public interest at the University of Illinois at Chicago. Both are Society of Family Planning grantees.
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The Hill
7 minutes ago
- The Hill
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The Hill
7 minutes ago
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Trump deserves the Nobel Peace Prize, but the left will never admit it
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Billionaire businessman Mark Cuban recently laid into Democrats for having no policy or strategy beyond 'Trump sucks.' 'We picked the wrong pressure points,' said Cuban on 'Pod Save America.' 'It's just 'Trump sucks.' That's the underlying thought of everything the Democrats do. 'Trump sucks.' Trump says the sky is blue. 'Trump sucks.' That's not the way to win! It's just not! Because it's not about Trump — it's about the people of the United States of America — and what's good for them! And how do you get them to a place where they're in a better position, and it's less stressful for them.' Cuban — who a growing number of Democrats believe might make a credible presidential candidate in 2028 — is correct. When will it be peak 'theater of the absurd' for that echo chamber? When do working-class and disenfranchised Americans once again matter to it? When does national security once again matter to it? When does the performance art — aimed at literally just a few thousand entrenched elites living in bubbles — stop? If you only got yours information from that echo chamber, you would believe that Trump never accomplished anything; never built anything; was never successful; never made a correct decision; and never had a worthwhile instinct. Ever. And that was before he became president. Since Trump became president, inhabitants of that echo chamber have seemingly been in a constant state of rage. One of the issues that has most made them apoplectic is Trump being nominated for the Nobel Peace Prize. Over the last three decades or longer, the Nobel Prize Committee has become for many the poster child for a 'woke,' in-the-tank for the left organization. Especially when it comes to the Peace Prize. On the surface, there is nothing wrong with that, if the committee members admit that they have morphed into a propaganda arm for the far left and its causes. But they won't. Instead, they — like the Pulitzer Prize Committee — proclaim their nonpartisanship while actively discriminating against conservatives or those they perceive to be on the right. In 2015, one of its members, Geir Lundestad — possibly suffering a pang of guilt — had the good grace to admit to a mistake. That mistake being the laughable and sycophantic decision to award President Barack Obama the Nobel Peace Prize in 2009 for literally doing nothing. Obama had been in office for less than nine months when he got the award. Liberal New York Times columnist Nicholas Kristof called it 'premature.' Obama himself felt so self-conscious about getting the award that he gave serious thought to skipping the ceremony. Years later, while giving that 2015 interview, Lundestad said, 'Even many of Obama's supporters believed that the prize was a mistake. In that sense, the committee didn't achieve what it had hoped for.' Well, the committee did achieve what it set out to do, which was to fawn over a far-left president by giving him an award he never earned. It just didn't anticipate the immense blowback and ridicule. Again, it seems that, for the left, Trump should never be given any credit for anything. No matter how patently obvious that he deserves it. Even about keeping the peace and saving lives. For years prior to him becoming president — when many powerful Democrats courted his friendship and money — Trump spoke out against the war in Iraq and the needless waste of lives, something he continued to do as president. Just as he has done about the war in Ukraine. Did those calls against war and to save hundreds of thousands of lives ever register with the Nobel Committee? What about in 2020 when Trump created the Abraham Accords, an agreement that normalized relations between Israel and Arab countries? Again, in 2009, the committee awarded Obama the award for 'his extraordinary efforts to strengthen international diplomacy and cooperation between peoples.' Except, that is not what he did — and yet, he still got the award. Trump established the Abraham Accords — and was ignored by the committee. In 1998, the committee awarded the Peace Prize to John Hume and David Trimble for 'their efforts to find a peaceful solution to the conflict in Northern Ireland.' Okay, let's compare. Just recently, Trump was instrumental in preventing all-out war between India and Pakistan. Two nuclear-armed nations. Is that more valuable to the world than finding a 'peaceful solution to the conflict in Northern Ireland?' Apparently not to the committee. In 2019, the committee awarded the Peace Prize to Abiy Ahmed 'for his efforts to achieve peace and international cooperation, and in particular for his decisive initiative to resolve the border conflict with neighboring Eritrea.' Again, earlier this year, Trump brokered a peace agreement between the Democratic Republic of the Congo and Rwanda. While much of the mainstream media sought to bury the accomplishment, surely the committee knew of it. Mark Cuban was correct to call out the Democrats for only having one failed campaign policy. Trump is correct to call out the Nobel Prize Committee for its obvious and shameful bias. Brokering peace and saving lives should always be recognized — no matter if you are a Democrat or a Republican.
