Across parties, politicians are showing increased interest in developing policies around paid family and medical leave, especially for new parents.  The latest creative example is Republican Senator Marco Rubio’s Economic Security for New Parents Act, backed by the Independent Women’s Forum, a politically conservative US non-profit advocacy organization. The bill would allow households with a new child (biological or adopted) to access Social Security benefits to cover their parental leave, in exchange for delaying receipt at retirement. The proposal has received little support from Democrats or the public, yet it is noteworthy that Republicans are offering new ideas for addressing the changing nature of and needs of modern families – for instance, the mother is the sole or primary earner in 40% of families with children under age 18 (2013 Pew report) – for paid leave after the arrival of a child. The United States is an outlier, late to the recognition that economic instability during family formation is a public problem worthy of a public response. Research shows the benefits of such paid leave for mothers, fathers, children, and employers.  The dominant policy around the globe and in seven US states is publicly run social insurance, under which workers and/or employers contribute to a fund accessed by workers during their leave.

The perfect mother is a ubiquitous, if impossible, part of American life. We see her in spandex at the gym, working out—self-care!—a week after delivering twins. She’s at center-stage when internet experts opine about how mothers can prevent teenagers’ opioid addictions. In the shadow of this unattainable, idealized vision of a mother as a virtual guarantor of their children’s health and happiness, actual mothers berate themselves for falling short of perfection, feeling ashamed and inadequate. In the American legal system, the pervasive stereotype of the perfect mother can lead to serious consequences, dramatically distorting the judgments of police, prosecutors, judges, and jurors.

Title X of the Public Health Service Act is the only federal program devoted exclusively to family planning and reproductive health care. Title X is symbolic of the mid-20th century’s widespread and bipartisan support for policies aimed at increasing access to affordable contraception. More recently, the once-separate politics of abortion and contraception have converged. Just as we see a growing number of “abortion-free zones,” we are witnessing the growth of contraception deserts, or geographic areas with inequitable access to affordable family planning due to states’ broad discretion in Title X implementation. New and proposed reforms to Title X at the state and federal levels may expand contraception deserts. This inequality isn’t trivial. Two-thirds of reproductive age women in the U.S. use contraception, and more than 20 million women require the assistance of public programs to afford that contraception.

Prior to the Patient Protection and Affordable Care Act (also known as ObamaCare or ACA), in states without protections for nursing mothers, many women were forced to nurse or express breastmilk in bathroom stalls—if they were even given adequate break time. Women without break time and/or access to a private space often stopped breastfeeding upon return to work. Even with the ACA in place, some women lose their jobs for trying to work and pump (numerous stories demonstrate these and other challenges).  Now, as Congress and the White House again debate healthcare, mothers working in the formal economy have reason to worry.

Two characteristics are central to this administration’s and the 115th Congress’ approach to health care policy in its first 100 days: individualization and androcentrism. Both characteristics are bad news for gender equity – and ultimately, families and the economy.

As Congress and the President deliberate on the future of the Affordable Care Act, what do women and LGBT individuals stand to lose? Here’s what you need to know.