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Can you picture a health care system where every single person is insured? It’s called “universal coverage” — and members of Congress and other public officials have offered numerous proposals aimed at making that goal a reality.

We’re thrilled that policymakers, health care organizations, health care providers, and the public are discussing how the United States can achieve universal coverage — because Planned Parenthood has always been committed to ensuring everyone has access to quality, affordable health care.

But despite progress, vast health disparities continue to exist between people who have easier access to health care and those who encounter more barriers. What’s worse, access to sexual and reproductive health care services are becoming more out-of-reach for millions of people in this country. 

That’s why universal coverage proposals MUST ensure equitable access to the full range of sexual and reproductive health care services. 

Here’s what you need to know — and what you can do — to help make that happen.

Access to Health Care a Decade After the Affordable Care Act

The Patient Protection and Affordable Care Act (ACA, also known as Obamacare) was a big step toward universal coverage in America. When it became law nearly 10 years ago, on March 23, 2010, it made significant improvements to the existing health care system, including protecting and expanding access to preventive care such as birth control, annual wellness exams, and STI screenings at no out-of-pocket cost to you. 

And Congress can do more to build on those advances. 

The Dark Side

Through attempting to roll back provisions such as the birth control mandate — which guarantees birth control coverage with no copay for patients — and several failed attempts to repeal the law, the Trump-Pence administration deliberately sabotaged the ACA

Its efforts have resulted in less insurance coverage and weakened consumer protections that the ACA established. And far too many people — particularly women, people of color, people who are undocumented, and LGBTQ people — lack access to necessary preventive services.

The Bright Side

Advocates for affordable and accessible health care have fought back. They’ve fended off the administration’s efforts to roll back key ACA benefits — including birth control coverage with no out-of-pocket costs, the ability to stay on a parent’s insurance until reaching the age of 26, prohibiting insurers from discriminating against women, and protections for people with pre-existing conditions.

Pro-health care members of Congress also are working to improve the system by: 

  1. lowering the costs of prescription drugs

  2. reducing out-of-pocket costs for essential and emergency services 

  3. supporting innovations to increase the quality of care and delivery

The Secret to Expanding Sexual and Reproductive Health Care Access Through Universal Coverage

To revolutionize health care access and outcomes in America, it’s critical that every universal coverage proposal do the following:

Center Health Equity

  • Elected officials have a responsibility to prioritize communities that face the most barriers in accessing health care due to structural and systemic inequities. This includes communities of color, LGTBQ individuals, women, people who are undocumented, and people living with disabilities. 

  • Reforms must hold the health care system accountable for improving the quality of care for these groups, in order to close existing disparities — such as the disproportionate rates of maternal death for Black women in this country. 

Lower Health Care Costs

  • In 2018, Americans spent an estimated $3.65 trillion on health care, and this number is expected to continue to rise. People in the United States spend more on their health care than people in any other developed country, and individuals have to pay more out-of-pocket for care every year. 

  • Universal health care proposals should address every fundamental cause of America’s high cost of health care. 

  • High costs include (but are not limited to) excessive costs for prescription drugs, surprise hospital billing, and administrative costs for running our current system.


Universal coverage proposals must ensure equitable access to the full range of sexual and reproductive health care services. 

Support Community-Based Providers

  • Community-based providers, such as Planned Parenthood health centers, are well-positioned to meet the demand for a lower-cost system of care, while also reducing health inequities. 

  • With more than 600 health centers located across the country, Planned Parenthood is deeply committed to offering health care services — such as critical, life-saving screenings and preventive care — at a lower cost to the patient without sacrificing quality of care. Patients at Planned Parenthood often pay less for their prescriptions, as well. 

  • Research indicates that greater access to affordable, preventive care can significantly reduce costs to patients and payers, especially with timely diagnosis and treatment for certain health conditions.

Prioritize Sexual and Reproductive Health Care — INCLUDING Abortion

  • Under the Trump-Pence administration, access to sexual and reproductive health care has been radically undermined. The health and welfare of millions of patients have been put at risk based on a racist, xenophobic, misogynistic agenda. Any proposal for universal coverage must reverse the Trump-Pence administration’s harmful policies, including: 

  • Numerous attempts to repeal the ACA and “defund” Planned Parenthood; 

  • Forcing Planned Parenthood out of the Title X program, the nation’s program for affordable birth control and other reproductive health care, through a damaging gag rule;

  • Undermining the ACA birth control benefit by allowing employers to deny their employees access to birth control;

  • Allowing health care workers to deny care that they have a moral objection to; and 

  • Restricting access to health care and other public benefits to thousands of people who are undocumented.

In short, policymakers must prioritize:

  1. Advancing health equity;

  2. Lowering the costs of health care; 

  3. Expanding coverage for everyone in this country regardless of race, ethnicity, gender identity, sexual orientation, or immigration status; 

  4. Protecting the right of patients to see the provider of their choice; and 

  5. Ensuring access to providers who provide expert, lifesaving, evidence-based care through federal programs that are critical and essential to the health and wellbeing of the people in this country. 

Keeping Up the Drumbeat for Sexual and Reproductive Health-Inclusive Universal Coverage Proposals

At Planned Parenthood, we applaud policymakers who are addressing the needs and gaps in our current system. Health care is a human right — and everyone should have access to the highest standards of care at a truly affordable cost. 

Planned Parenthood will monitor and review developments in the universal coverage conversation as it continues. And we’ll continue to fight for an equitable, affordable health care system that places the patient front and center, no matter what. 

Find Out Where the Candidates Stand

Learn where the presidential candidates stand on sexual and reproductive health and rights.

Get the Facts

Tags: Affordable Care Act, Health Equity, Access to Health Care, Universal Coverage

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Learn about abortion access changes in your state.

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Planned Parenthood Action Fund Will NEVER Back Down

Know this: our right to abortion is not debatable. We will rebuild and reclaim the freedom that is ours.


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