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Health Care: The Remix

March 24, 2010

Photo via NYT

Sometimes you want to be excited for something, especially when people you care about it are excited.  And sometimes it just ain’t happening, and the best you can muster is something like “oh hey, well, I guess that’s not quite as terrible as it could have been.”  That’s where I am today on the newly-passed-and-signed U.S. Healthcare Reform law.  I could duck controversy and say that this is because, though I’m an American, I live in Canada, so it’s not like it’s my pre-existing condition at stake, but there’s a little more to it than that.  Part of it’s that I’m not wild about how much this law benefits the massive insurance corporations whose profits I am not interested in protecting.  But there are a few other things that really get my blood pressure up–and for that reason, I’m not going to call this Reform, but the Health Care Remix: same hook, but with a juiced-up beat.

By now I’m sure you’ve heard about the Executive Order the President signed in order to get Bart Stupak et al. to sign onto the damn thing–which, surprise, surprise, contains language that’s eerily similar to the amendment Stupak wanted.  That’s because it essentially repeats the language of the Nelson Amendment, the Stupak-of-the-Senate.  Here’s the money shot:

…it is necessary to establish an adequate enforcement mechanism to ensure that Federal funds are not used for abortion services (except in cases of rape or incest, or when the life of the woman would be endangered), consistent with a longstanding Federal statutory restriction that is commonly known as the Hyde Amendment. The purpose of this Executive Order is to establish a comprehensive, government-wide set of policies and procedures to achieve this goal and to make certain that all relevant actors–Federal officials, state officials (including insurance regulators) and health care providers–are aware of their responsibilities, new and old.

The Act maintains current Hyde Amendment restrictions governing abortion policy and extends those restrictions to the newly-created health insurance exchanges.

[...]

The Act specifically prohibits the use of tax credits and cost-sharing reduction payments to pay for abortion services (except in cases of rape or incest, or when the life of the woman would be endangered) in the health insurance exchanges that will be operational in 2014. The Act also imposes strict payment and accounting requirements to ensure that Federal funds are not used for abortion services in exchange plans (except in cases of rape or incest, or when the life of the woman would be endangered)…

So, basically, not only has the President–who is supposed to be pro-choice, mind you–conferred legitimacy on the Hyde Amendment (which decrees that no public money can be used to pay for a legal and legitimate medical procedure), he has also agreed that we should extend this decree to the new health insurance exchanges, which will make it more difficult to buy abortion coverage as well.  I’m not going to go into more details here, but if you’re looking for well-articulated accounts of what this means, the Reproductive Health Reality Check blog is a good place to start. Oh, and that’s not even to mention the fact that, despite some claims to the contrary, the bill doesn’t actually prohibit insurance-premium-discrimination on the basis of age or gender in most cases.  Or that the entire thing throws undocumented workers under the bus, again.

Melissa at Shakesville says it well:

Laying aside the practical realities of withholding federal funds from women who need them for a legal medical procedure, the symbolism of this maneuver is horrendously illiberal and, frankly, un-American. The Hyde Amendment has been more deeply entrenched by presidential fiat, and the bodily autonomy of half the population of this country has been once again treated like a bargaining chip by the one party who claims to defend their equality.

The profundity of my contempt is cavernous.

Though, actually, it’s far more than half, when we consider that the Bill also uses the denial of access to healthcare to millions of immigrants as a means to score passage/political points.  But hey, we’re used to doing that, right?

Ugh.

So what’s a feminist to do?  Don’t get me wrong, I’m pleased that one of my oldest friends who was dropped from her insurance because she got sick–and thus became un-insurable, having a pre-existing condition–will have an easier time of getting insurance now, just as I am that many millions of others in the same situation will.  But frankly, I’m pretty pissed that whatever she (or I, or any other woman who isn’t undocumented) could buy would seriously restrict her ability to get comprehensive reproductive health care.  And that millions of other women–who work and pay taxes, by the way, but don’t have the right paperwork–are prohibited from purchasing any insurance on the exchanges at all.

In some ways, none of this is surprising.  Kate Harding pointed out in December that the U.S. Democratic party isn’t exactly the most progressive game in town, typically assuming that those of us who care about lady-related, Queer or racial-justice issues will fall in line with their crap because, what are you gonna do? Let the Republicans take over?? The way she put our situation is worth quoting at length:

Some of us panic about losing a Democratic majority and start hollering at others to quit being so picky and oversensitive about our “single issues” and take one for the team. (Again. Still. Always.) If we can work together as a bona fide progressive movement, rather than a bunch of competing groups who will all ultimately settle for holding our noses and blocking the worst Republicans, we might actually force the Democrats to give us more than empty shout-outs on the campaign trail. But if some of us will sacrifice gay rights for a chance at advancing our own agendas, and others will sacrifice reproductive rights for a chance at advancing theirs, and a ludicrous number of self-identified progressives will sacrifice pretty much everything they claim to believe in, just because the words “Democratic majority” sound so much better than the alternative, then nothing will change.

So the wise, objective, pragmatic mansplainers can go ahead and tell us little ladies How This All Works one more time, but now we’re telling you: We’ve not only heard it, we’ve tried it. We’ve tried electing “moderate” Democrats who would be obvious conservatives in any era marked less by far-right lunacy. We’ve tried compromising our values in hopes of taking baby steps forward. We’ve tried sacrificing the rights of women and every minority group under the sun, so as not to look unreasonable or oversensitive to those who resent having to share this country at all with people they find undesirable. And we’ve seen where it leads: “We choose to play nice, our party trades on our freedoms. We choose to object, our party resents and blames us for failure.”

Really, when those are the options, there’s only one logical conclusion: This is not our party. We’ve known that for too long, and yet the Democrats have known too well that they could bank on our money and our votes as long as the GOP remained even more not our party.

But what do we do when we refuse to stand for it anymore?  Frances Kissling at Salon suggests that we refuse to fund politicians and organizations who don’t make repeal of the Hyde Amendment itself a priority–and while she doesn’t name names here, it’s clear she has her sights set not only on the Democrats, but Planned Parenthood and NARAL, who, as Megan Carpentier points out, aren’t doing so well either.

Pro-choice women rely on (and donate to) groups like Planned Parenthood and NARAL Pro-Choice America to stand up and advocate for their access to abortion, first and foremost, and to hold the feet of supposedly pro-choice politicians to the fire on abortion access even when the going gets tough (and the tough go shopping for healthcare reform votes among rabidly anti-choice Democrats).

But, this time, at least, pro-choice advocates were not as willing as their pro-life counterparts to be the skunks at the garden party “just” to save access to abortion, or perhaps because they feared losing their own access to Democratic politicians who, unfortunately, too easily sacrificed the pro-choice movement for a political victory without putting up much of a fight on behalf of the pro-choice women who elected them.

So it’s not just Democrats using women’s health as a bargaining chip, unfortunately.  But is Kissling right about the answer here?  I have to admit that, while I think it’s legitimate for feminists to vote with our (lack of) donations, I shudder to think of the effects of withholding contributions to Planned Parenthood, which is, after all, exactly the sort of organization that needs to be available to women who are denied coverage for reproductive health by the Health Care Remix.  I think it’s crucial that we keep donating to Planned Parenthood, because I think it’s crucial that women have a place to go to get the medical care that is their Constitutional right to choose–and, as QueenGeorge pointed out, this is getting more and more difficult.

But I do think it’s worth refusing to vote for and contribute to the campaigns of Democrats, and I’m done letting other so-called progressives (especially progressive dudes) tell me that by doing so, I’ve made myself responsible for whatever shit the conservatives in the U.S. manage to pass.  Saying as much suggests that women, including queer women and women who are undocumented workers, are obligated to put our own concerns aside when they’re inconvenient or distasteful to others.  I’m done buying into that crap, and I’m done being held hostage by a Democratic Party that all but threatens us with the overturning of Roe v. Wade when we protest their deference to the Stupaks and Nelsons of the world.

So yeah, I’m glad that some more people are going to have health insurance, and I’m hopeful that this will mean better things in the future.  But you’ll have to forgive me for not being blown away by the Health Care Remix: I’ve heard this track before.

2 Comments leave one →
  1. March 24, 2010 10:53 pm

    “I’m done letting other so-called progressives (especially progressive dudes) tell me that by doing so, I’ve made myself responsible for whatever shit the conservatives in the U.S. manage to pass. Saying as much suggests that women, including queer women and women who are undocumented workers, are obligated to put our own concerns aside when they’re inconvenient or distasteful to others. I’m done buying into that crap, and I’m done being held hostage by a Democratic Party that all but threatens us with the overturning of Roe v. Wade when we protest their deference to the Stupaks and Nelsons of the world.”

    I really needed to hear/read this right now. I’ve been in a sorry state of depression ever since the Remix passed, and I’ve been having trouble identifying the reasons. At first (as I’ve told you) I blamed it on having to watch conservative FB friends, family members, and co-workers lambast “Obamacare” and the “socialist downfall of the country.” But when I read your piece tonight, I realized that what I’m really angry about is that I feel like I’m being forced to defend as “mine” something that doesn’t even vaguely represent the changes I fought for in the first place. What I wanted was REAL public health care. But because I live in a very conservative place, I often feel like I HAVE TO stand up for the Remix against the haters just to prove that I don’t agree with them. But I get exhausted defending something that didn’t give me what I wanted, that doesn’t really change things all that much. And I’m tired of feeling like I have to tow the party line just to be a representative. I don’t WANT to be a representative for my Democratic congresspeople anymore if they’re going to refuse to be true representatives for ME.

    So thanks. I feel at least a little better.

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