I have to be honest. I am outraged by the president's federal budget proposal and its commitment to passing the American Health Care Act (AHCA), which is currently with the Senate.
The president’s budget is a terrifying glimpse into the callous values that guide this administration’s policies, including its support for massive cuts to social programs, education, community development, and health care. Both the president’s budget and the AHCA would drastically cut the Medicaid program and block patients with low incomes from accessing care at Planned Parenthood — coverage and providers that many women of color depend on for essential health services like birth control, STD tests, and lifesaving cancer screenings.
I am a Black woman. I am the aunt of a wonderful special-needs kid who's on Medicaid. And when I was an uninsured law school student, I had the benefit of accessing care at Planned Parenthood. The policies in this budget and the AHCA would harm people like me, and the people I love.
Medicaid & Women of Color
Women of color in the United States already have less access to quality health care due to the intersections of structural racism, inequality, sexism, classism, xenophobia, and other systemic barriers. The AHCA would make it even worse, especially for women of color on Medicaid.
The president’s budget proposes to cut Medicaid by at least $600 billion — and that’s on top of AHCA Medicaid cuts of over $800 billion. The AHCA also ends Medicaid expansion. Across the next decade, these changes would kick approximately 14 million people off the program, including many women of color. Here’s why that’s a big deal:
Systemic economic barriers make Latinas and Black women more reliant on Medicaid than white women. Approximately 31% of African American women and 27% of Hispanic women aged 15 to 44 are enrolled in Medicaid, compared to 14% of white women.
In states that expanded Medicaid under the Affordable Care Act (ACA), the uninsured rate of women of reproductive age was nearly cut in half between 2013 and 2015. It just so happens that high populations of Black women live in the states that chose not to expand Medicaid.
Taking away Medicaid coverage would leave millions of women of color without affordable health insurance. That begs the question: Where will these women go for health care — if at all?
Blocking Women on Medicaid from Planned Parenthood
Both the president’s budget and the AHCA seek to “defund” Planned Parenthood. Let me be clear: “Defunding” Planned Parenthood means blocking low-income Medicaid patients from preventive care at its health centers. This would be devastating to some Black and Latino communities — especially the women. If they were prevented from accessing care at Planned Parenthood, current patients would have no other place to go for the critical services Planned Parenthood provides. The result would be disastrous. Consider this:
Of the 2.4 million people who rely on Planned Parenthood for health care every year, more than half use Medicaid.
About 360,000 of Planned Parenthood’s annual patients identify as African American or Black.
Around 500,000 Latinos come to Planned Parenthood health centers annually (nearly a quarter of Planned Parenthood’s patients).
Very often Planned Parenthood is the only health provider option for many patients. Many health care providers do not even accept Medicaid patients, and studies show that most states face Medicaid provider shortages.
An Issue of Health Equity
All people need and deserve equal access to reproductive health care. And yet women of color, immigrant women, and LGBTQ people are disproportionately impacted by restrictions on that care — especially those whose identities intersect (e.g., an immigrant person who identifies as LGBTQ). For many, access to cancer screenings; birth control; and safe, legal abortion are out of reach because of their income or where they live.
We cannot allow this administration to run roughshod over historically marginalized communities who may already be struggling to make ends meet. Though the path toward health equity may be a long one, we must remain vigilant in protecting and promoting the health and wellbeing of women of color.
Originally hailing from Phoenix, Arizona, Mimi Spalding is a Black reproductive justice activist and Medicaid Policy Analyst at Planned Parenthood Federation of America.