For many RJ advocates, the Affordable Care Act was a mixed bag. On the one hand, it covers 95% of Americans by 2014, with all sorts of improved quality measures. On the other hand, the Nelson Amendment dealt a severe blow to advocates who felt that this was a real chance to provide comprehensive reproductive health services to women.
But the politics don’t end when the President signs a bill into law. Federal agencies, in this case the Department of Health and Human Services, exercise power in implementing legislation by issuing regulations. The issue confronting HHS now is whether regulations implementing Sec. 2713 of the Affordable Care Act (the Women’s Health Amendment) should include family planning and birth control in the definition of mandated “preventive care.” Advocates are fighting for and against a comprehensive definition, but the decision belongs to HHS Secretary Kathleen Sebelius.
Birth control is preventive care. First, as a medication or device that literally prevents pregnancy, birth control is preventive medical care. But birth control also fits into the RJ framework. I believe that because birth control enables a woman to control her fertility, it empowers her to decide whether and when to have children. Without access to birth control, RJ becomes unworkable because a woman’s fertility has the capacity to control her decision making. It should be the other way around: women should be able to choose whether and when to parent in the context of all their other life circumstances. Without affordable birth control, RJ becomes a big question mark.
Secretary Sebelius has the power to make contraception affordable for all women. If we take RJ seriously, we should demand that she do so. Do you agree?
The views that this writer expresses are her own and should not be construed to reflect those of her past, present, or future employers.