Any Republican worth his reelection bid will reassure American women that no, the GOP is not in fact “coming for their birth control.” How ridiculous! Of course the Republican-controlled government isn’t going to send henchmen (or women! But probably men!) creeping into the bathrooms of unsuspecting citizens in order to seize pill packets. Nobody’s going to force anybody to yank out their IUD’s. That’s absurd.
What isn’t absurd is a different, and more insidious, tack that the powers-that-be have assumed. Rather than overtly banning hormonal contraception, which would be terribly unpopular considering that most American women rely on hormonal contraception at some point during their fertile years, they’re chipping away at it slowly. Eventually, to some women who benefit most from birth control, it won’t even matter whether or not it’s legal anymore, in the same way it doesn’t matter to most people whether or not caviar is legal—we can’t afford it, and even if we could, we have to go a long way to get it. Eggs can get expensive.
Conservatives at all levels of government have set their sights on defunding Planned Parenthood. While it’s not the only shop in town that offers women birth control, it’s one of the largest providers of low-cost reproductive and women’s health care in the country. Cutting its funding means that its millions of patients would need to get contraception elsewhere. In places like New York City, that “elsewhere” might be another non-subsidized women’s health care provider a few blocks away. In places like West Texas, that might an hours-long round trip in a hot car.
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Just last week, a federal judge ruled that Texas couldn’t cut off Medicaid funding to Planned Parenthood providers. Texas Attorney General Ken Paxton had claimed, in the absence of evidence, that the health care provider was allegedly violating the law by selling fetal body parts, based on a secretly recorded video captured by anti-abortion activists. During the ensuing legal proceedings, it was the video’s makers who got slapped with criminal charges (later dropped), not Planned Parenthood, but that hasn’t stopped the state of Texas from running with their preferred more fictional set of facts. Paxton has vowed that he will appeal the court’s ruling. If the court battle advances far enough, it’ll reach the Fifth Circuit, which is notoriously conservative.
Which brings us to the Supreme Court. With Colorado judge Neil Gorsuch poised for confirmation, court watchers are examining his judicial record. And proponents of birth control access aren’t liking what’s there. As a federal judge, Gorsuch supported Utah’s attempt to defund Planned Parenthood. He also supported employers who wished to omit birth control coverage for female employees on religious grounds. If and when he’s installed on the court, it’s a safe bet to assume Gorsuch probably won’t be a champion of women’s health. Gorsuch isn’t going to go door-to-door and take people’s birth control away, but if a Supreme Court ruling makes it legal for more companies to interfere with what a woman can and cannot purchase with insurance (part of her compensation), contraception is about to get much more expensive.
Both the President and Republicans in Congress have promised that they’re going to repeal Obamacare, and that they’ve got an even better replacement just waiting in their drafts folders. Well, Republicans have had control of Congress for almost two months now, and they haven’t repealed the law as they’ve promised. Part of this might be because many of their constituents are very angry about this. Another part might be that they might not have a replacement and have been spending the last several years being the hype man to a band that would never take the stage.
Despite the quibbling about what exactly Republicans will do with the promises they’ve made, one thing seems to be at a near consensus: a dial-back of the Affordable Care Act’s provision that classifies birth control as “preventative care.” This means that health care benefits women once enjoyed, like copay-free birth control, would be on the chopping block. According to one report, that provision saved insured American women $1.4 billion in out-of-pocket costs. Many of the ACA’s beneficiaries were poor women and women of color.
Eliminating that provision wouldn’t make birth control illegal, but it would make it significantly more expensive for people who use it, placing women’s health in its own category separate from other health care. All under the banner of “personal responsibility,” of course, according to House Speaker and assumed Obamacare replacement architect Paul Ryan.
We’re going to be hearing a lot about “personal responsibility” in the coming months. It’s a seductive idea for both the fortunate and unfortunate. “Personal responsibility” allows the fortunate to celebrate their success as something of their own design. The unfortunate are able to focus their ire on themselves rather than confront the overwhelming unfairness of systems, both social and biological, that sometimes just stack things against people. For both winners and losers, more responsibility means more control, and that’s a nice idea. Nobody wants to imagine their life being subject to the whims of randomness.
When it comes to health care, touting oneself as a champion of “personal responsibility” always sounded like a bit of an insidious brag to me, and one favored by people who seem to have it pretty good, a way for a person to take credit for things they could not possibly have facilitated for themselves. For example: being born to extremely wealthy parents or not having to deal with the maintenance costs of having a uterus.
Nobody is coming to take your birth control away. Not all at once. But if the conservatives in power stack the Supreme Court with Gorsuch-like judges, defund Planned Parenthood, and roll back the ACA in the name of “personal responsibility,” one day, American women will wake up in a world where it’ll sure seem like they did.
