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Senator Elizabeth Warren: Attacks on Birth Control Access Are Attacks on Women's Freedom


If anyone told a young woman today that she was expected to quit school after eighth grade or leave her job once she got married, most Americans would be outraged. Not fair! Women should have the same range of economic choices as men.

Through the years, one door after another has opened, as women have become astronauts and neurosurgeons, run Fortune 500 companies and nonprofit organizations, and started their own businesses. Sure, there’s still a lot of ground to make up, but the country has headed in the direction of greater equality for decades now.

Despite this progress, near-constant attacks on safe and cost-effective women’s health care have become a regular part of our political debates. The latest front in this battle? Access to contraception. The Affordable Care Act required employer-sponsored health insurance policies to cover birth control without additional costs. On October 6, in one of his series of reckless attacks on health insurance in America, President Trump ended that protection.

These fights are often framed as ideological discussions. But for millions of women, access to health care isn’t about ideology at all—it’s about economics.

Americans, at least in private, agree that using birth control is a no-brainer. The vast majority have used it, including ninety-nine percent of women (and by extension, their partners) who have had sex between the ages of 15 and 44.

Some of the reasons for this are obvious. Contraception prevents unintended pregnancy and reduces the abortion rate. Certain forms of birth control prevent sexually transmitted infections, and others help control debilitating health conditions. But contraception is not only about health; it is about economic security as well.

Americans, at least in private, agree that using birth control is a no-brainer.

As every parent knows, the decision to have children is momentous—and carries massive economic consequences. Because the United States does not ensure that parents have access to paid family leave or affordable childcare, new costs add up quickly. The totals are striking: middle-income parents with two kids will spend an estimated $230,000 to raise a child born in 2015 from birth through age 17, amounting to roughly $13,000 per year. Starting a family is a big commitment, and millions of people use contraception until they decide to do so.

But the out-of-pocket costs for baby cribs and car seats are only the tip of the iceberg. A mother experiences a measurable decline in earnings immediately after having a child—a decline that continues throughout her lifetime. And women don’t have to be mothers to benefit economically from contraception—just ask college students, or women with crippling endometriosis, how contraception helps them land and hold down jobs.

The arrival of the birth control pill in 1960, later joined by other effective contraceptives, gave Americans more control over if, when, and how they chose to grow their families. That control, in turn, helped fuel economic opportunity for American women, American families, and the American economy. After the widespread introduction of birth control, the number of women in professions once closed to them increased dramatically. And without the movement of women into the workforce since 1970—a trend partly enabled by the availability of effective birth control – our country’s GDP would only be three-quarters the size it is today.

Contraception helps level the economic playing field for women.

Contraception helps level the economic playing field for women. With birth control available, women have more chances to go to school, get jobs, create businesses, and grow our economy. They can more reliably plan their economic futures. But birth control offers these benefits only when women can access it—and when their bosses can’t dictate what types of birth control it’s appropriate for them to use.

While 99% of women have used birth control at least once, cost is a big factor restricting consistent access. Prior to the ACA, one in three women struggled to afford the out-of-pocket costs of prescription birth control. These costs put additional strain on the finances of workers already struggling to make ends meet—and also reduced contraceptive use. According to a 2010 Centers for Disease Control report, hundreds of thousands of women who tried various forms of contraception gave up because the methods were “too expensive,” “insurance did not cover it,” or because contraception was “too difficult to obtain.” The ACA’s birth control protections helped level the playing field: women in America saved an average of $255 a year on birth control pills and saw cost reductions for other contraceptive methods.

For millions of women, President Trump’s edict isn’t some abstract, ideological debate. For a working couple with modest wages and piles of student loan debt, the ability to decide when to have children is an economic issue. For a student working towards her college degree and financial independence, access to birth control is an economic issue. For a woman working two jobs with two kids in daycare, affordable contraception is an economic issue.

This isn’t the Trump Administration’s first attack on women’s health. Efforts to defund Planned Parenthood, repeal the ACA and Medicaid, and block access to safe, legal abortions have put women on the economic defensive. But those efforts require Congress—and so far, despite the best efforts of Mitch McConnell and Paul Ryan, they have failed. Now, President Trump has turned to a decision he can make without Congress: make it harder to access birth control. With the stroke of a pen, the President shrunk the economic futures of millions of women. He should reverse this decision—and if he won’t, Congress should force him to.



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Take it From a New Mom: Universal Health Care Would Mean Freedom, Especially for Women


Since my baby was born a year and a half ago, my husband and I have watched the majority of our recent employers in the media industry either shut down, get sold, or drastically decrease their staff. We have switched back and forth to each others’ health insurance a few times, trying to maintain stability for our family.

Still, I go to bed every night worrying about insurance, especially that I am now a C-section mom, which means I have a pre-existing condition.

For women—and for all parents and primary caretakers—having the freedom to move careers or locations without losing our health care means something really big: we can choose when, if and how to start families—in ways we might not be able to imagine otherwise. And that’s something we should be talking about more.

These days when we talk about health care, we hear a lot about what is wrong (and scary, and terrible) about the status quo. We listen to frightening stories of sickness and tragedy, stories that don’t seem to melt any powerful hearts or change any influential minds—the Affordable Care Act repeal efforts are a zombie that won’t die. It’s critical that we have those conversations and shine a light on the people who need the most help.

But we’re so busy defending our position, that we don’t talk enough about what a different world could look like. Sometimes it feels impossible to even think that way. But it’s worth trying, for the glimmer of hope and the shot of positive energy it can give us.

But when I think about the concept of universal health care, I see a doorway to more freedom. It feels like a ray of sunshine has suddenly descended on my family’s future, and all of ours.

Bernie Sanders’ Medicare for All bill, introduced this month, and which is getting support from all the major Democratic contenders for the 2020 race, offers us all this chance—a moment to think expansively, to imagine something radically different.

It allows us to ask the big questions: If you had guaranteed access to decent health care, what would you do differently with your life? Would you become an entrepreneur? An artist? Go live on a farm? Have a baby sooner, or later? Work on that rock opera or science experiment you’ve been dreaming about?

Or just do exactly what you do now, but with a little less anxiety?

Medicare for All, as it’s called by Sanders, is really what’s known as a single-payer plan. As NPR explains‑it would phase in a single system by lowering the eligibility for an expanded version of Medicare every few years until everyone is covered. The plan as proposed isn’t expected to pass—and the question of how it will be paid for remains a big one—but at least it’s offering us something we need: a vision that could really change our lives.

If you had guaranteed access to decent health care, what would you do differently with your life?

Think about the major shift that happened for the generation who lived during the legalization of birth control, and then of abortion: they were suddenly able to pursue careers and adventures and plan for a family at the time that felt right to them. That revolution in reproductive health care made the same kind of sea-change for them that universal health coverage could do for women now. New ways to join the workforce. New chances for equal partnerships at home. The ability to really consider when and how and in what order they wanted to have kids.

Medicare for All would give a new generation a whole new level of freedom and opportunity; last time I checked, those are two ideas that are part of a very American ethos of taking charge of your destiny.

Health care untethered from or employers would give America’s women a chance to follow their dreams. Maybe that’s why it’s so threatening to some men in power—like the congressmen who questioned why men should have prenatal care included in their insurance plans.

Today, most of us rely on employer-based health care, which was fought for and won when a government-run health care proposal faltered in the 1940s—when many women were still expected to be totally dependent on their husbands. If you think about it, it makes no sense. Why should the suits who judge the quality of, say, your spreadsheets, your lesson plans, your PowerPoint presentations or your carpentry skills have power over whether or not you have health care? There is no really logical connection between these two things. It puts us all at the mercy of the companies that employ us, and that’s not exactly comforting in these volatile times.

The status quo is bad for our souls, as well as our bodies. In my busy, over-scheduled life as a fairly new mom, I’ve started look at self-help book titles and be tempted by them: They all exhort me to “Live the life you’ve always wanted! Be the CEO of your future!” and “Choose to Succeed!” It’s so appealing. I mean, I’d love to kill my inner fears and eat them for breakfast every morning. I’m sure we all would. But then I look around me.

Many modern fears are not the kind you can vanquish with a new outlook on life. It’s rational—wise, even—to leave your daring, awesome, magical dream-project in a drawer, if doing so means your kid can go to the doctor instead of the E.R.. No mantra can change that. That’s why it’s crazy to me when people act like government involvement in health care would mean less freedom. It could mean so much more, for all of us—especially for lower-income women, who already receive huge benefits from Medicaid during their childbearing years, from family planning to postnatal checkups.

I mean, I’d love to kill my inner fears and eat them for breakfast every morning. I’m sure we all would. But then I look around me.

We’ve seen in the past decade the sense of freedom that comes from the idea of expanded health coverage. I remember the sigh of relief that ran through my group of friends when Obamacare passed. My peers, then in their 20s and beginning to think about families, began to relax, to freelance, go back to school—because their health care was no longer tied to one job. They had more than a single path forward. But as the options under the ACA got pricier and coverage slimmer, and as politicians played ping-pong with our health care this summer, a nagging voice has come back into all of our lives: what about insurance, what about insurance?

It’s amazing how this affects me. Every time I hear that a new health care repeal effort has failed, I feel tension leave my body. I try not to make it feel personal, but of course it is personal; I’m a mom who had a pregnancy complication and a C-section, a walking pre-existing condition with a little person to protect and provide for—and in 2017, providing for means health insurance.

This is what life is like for so many of us. We are exhausted and sore from living in defensive mode, struggling to anticipate the next disaster: job loss or a health problem, a relative getting sick, steeply rising rents in our neighborhood, a scary diagnosis for our kid—some unexpected twist that could push us to the edge.

But it doesn’t have to be this way. So next time the health care debate comes up in your life, ask the people around you this question: If we knew that losing our jobs didn’t mean having to settle for pricey insurance or no insurance at all, would we behave differently? Would we come up with more bold ideas? You know, think outside the proverbial box? Would we speak up about sexual harassment? Complain about equal pay? Unionize? Use the craziest fonts ever on our slideshows? Start our own company like Jerry Maguire? Take more time off to care for our kids? Breathe a sigh of relief to know that our babysitters and other caregivers have their own care, too?

And ask yourself what you would do if you knew health care was a guarantee for everyone. What dreams would you chase?

Sarah Seltzer is a writer in New York City. She edits the parenting website Kveller.com.



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