Repeal. Replace. Repair. Whatever shape the next iteration of policy change takes in health, it will affect every American. Health is an everyday experience, and the trials of accessing health care services and the importance of health insurance coverage touches every American life. Another reality of health care in America is that it is experienced differently by women and men. Sex differences in health care utilization are well documented. These differences are driven by a range of factors that may also influence how health care policies applied broadly affect men and women differently.
On his third day in office, President Donald Trump issued an executive order that prohibits reproductive health NGOs that receive US family planning assistance from providing abortion services, information, or referrals, or participating in advocacy to liberalize abortion laws. Since its introduction by President Reagan’s administration in 1984 at the United Nations Conference on Population and Development in Mexico City, this policy been reinstated by Republican presidents (George H. Bush and George W. Bush) and rescinded by Democratic presidents (Bill Clinton and Barack Obama). In other words, it represents a way of signaling, during the earliest days of each new administration, the government’s stance on global and domestic abortion politics.
In considering the potential impact of the repeal of the Affordable Care Act, efforts to defund Planned Parenthood, and other actions that may affect women’s health, most of the discussion has appropriately been on the impact on individual women. Indeed, Texas demonstrates the risks. In 2011, the state legislation cut family planning grants by 66%, and tried to redirect federal funds from Planned Parenthood to more general county-based programs. Although litigation initially prevented the switch, Texas eventually succeeded in replacing the federal funds with state money, and moving such funding away from family planning providers.
Many groups in the US face uncertainties about what the future holds for their health, given the health policy priorities of newly inaugurated President Donald Trump and the 115th Congress. Women, LGBTQ communities, refugees, undocumented communities, and the elderly are among those who may be most affected by the federal government’s health policy initiatives, including those impacting whether these groups will continue to have access to health care and if so, whether that care will be affordable and appropriate.
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