What Will Women’s Health Care Look Like Now?

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Photo: Angela Wyant/Getty Images

Many of us are still processing the results of the election, but it’s worth looking to the future to see what women’s health care would look like in a Trump administration. The short answer: It’s not going to be good.

Donald Trump, president-elect, says he wants to repeal and replace the Affordable Care Act, which says insurers cannot deny coverage if you have a preexisting condition, that young adults can stay on their parent’s insurance until 26, and annual well-woman gyno visits and birth control must be covered without a copay. Even if Trumpcare does include these preventive services, as medical experts recommend, about 22 million people could lose their health insurance after a two-year, post-repeal transition period. These would mostly be people who have insurance through Medicaid or the insurance exchanges — in other words, low-income people.

Trump has also said that while Planned Parenthood helps “millions and millions of women” when it comes to breast and cervical cancers, he would still defund it “because of the abortion factor.” Of course, Planned Parenthood also does loads of STD screening and treatment, something our country still desperately needs if record STD rates are any indication. He’s also insisted that he would nominate pro-life judges who would overturn Roe v. Wade, a statement that was echoed by his running mate, Mike Pence, who himself has a horrific record on women’s health and reproductive rights. (Pence’s war on Planned Parenthood closed the only clinic in rural Scott County, Indiana, which was also the county’s only HIV testing center. Pence had to declare a public-health emergency after an HIV outbreak thought to be caused mostly by intravenous drug use.)

What if Roe is “consigned to the ash heap of history,” as Pence put it? Trump said during the final debate that the question of abortion legality would “go back to the individual states.” It’s scary to think about what that might look like, given the targeted restrictions on abortion providers, a.k.a. TRAP laws, that states like Texas and Mississippi have passed. Though the Supreme Court ruled in July that such regulations are unconstitutional, it would be a whole different ballgame if Roe were overturned.

Yet it seems Trump wouldn’t leave things entirely to the states. In a September letter to anti-abortion leaders, Trump wrote that he would sign into law the Pain-Capable Unborn Child Protection Act, which would ban abortions after 20 weeks, and before many fetal anomalies are detected. Trump also wrote that he was committed to ensuring that the Hyde Amendment — a rider which bars federal funds including Medicaid from being used to pay for abortion — into permanent law. This legislation disproportionately impacts low-income women and women of color who rely on Medicaid for insurance.

The missive was released by the anti-abortion nonprofit Susan B. Anthony List. Trump declared SBA List president Marjorie Dannenfelser, the leader of his “Pro-Life Coalition.” SBA List opposes the use of emergency contraception, a.k.a. the morning-after pill, and the copper IUD ParaGardbecause the group believes that they cause “early abortions” when in fact they simply prevent ovulation and fertilization, respectively. The copper IUD can prevent the implantation of a fertilized egg, but the Guttmacher Institute says this isn’t considered abortion under medical or legal definitions. So if you were thinking about getting a copper IUD — or any IUD while it’s still covered by the Affordable Care Act — you might want to make that appointment now.

If a Trump administration does what he promised anti-choice leaders he would do, it would set women back a good 40 years. As Rebecca Traister wrote in September, “those things would return women, in a very real way — in a way that is already happening in state and local jurisdictions around the country — to their secondary status: unable to exert full control over their bodies; barred from making choices about whether or when to bear children based on their health, their economic, or familial status, or the condition of the fetuses they carry.”

It’s ironic, though, that anti-choice politicians would restrict abortion access or disavow certain forms of birth control because neither reduces the number of abortions women have. What does lower the abortion rate? Giving women unfettered access to effective birth-control methods, including long-acting ones like IUDs, which let them prevent unintended pregnancies. In fact, restricting terminations can lead to women self-inducing or attempting to self-induce an abortion, per a Texas study. Google data shows that women living in states like Mississippi, where it’s difficult to get an abortion, were more likely to search for the phrase “how to have a miscarriage.” Women look for information on where to buy the medication-abortion drug misoprostol online, which herbs can induce abortion, and, yes, how to do a coat-hanger abortion.

So if you were planning to make any major reproductive-health decisions in the next year, best to get that over with before January 20.