The Ryan/Trump—I’m calling it Rump—“health care” plan would result in no health care at all for hundreds of thousands of people in my state, with as many as 24 million people across the country losing access to health care. Instead of addressing some of the challenges of the Affordable Care Act, Republicans want to burn it in a dumpster fire, and redirect health care funds into tax breaks for the most wealthy and giveaways to insurance companies. A vote on the Ryan/Trump plan has been delayed, with both the far right Freedom Caucus and more moderate Republicans fighting hard to stop the bill in its tracks.
While the Republicans fight among themselves over short-sighted goals of repealing the ACA but with no clear plan in place, it’s important to stay focused on who is really vulnerable.
Women are the big losers in this scheme, particularly women who depend on Planned Parenthood providers to meet their reproductive health care needs. Planned Parenthood is an easy punching bag for the right, and President Trump has joined in the brawl.
Planned Parenthood of Wisconsin (PPWI) is one of our state’s safety net providers, and 50,000 out of their 60,000 patients is Medicaid eligible, with 6,000 of these patients residing in Speaker Ryan’s own district. In 2016 alone they provided 122,258 patient visits, conducted 21,705 patient exams and prescribed 204,754 units of birth control.
This all would change under the Rump proposal, which kicks Planned Parenthood out of the Medicaid program, leaving millions of women without a health care provider.
Here in Wisconsin, Governor Scott Walker and legislative Republicans have waged a dangerous partisan fight over women’s health care needs since 2011. Because of their efforts, abortion is hard to access for Wisconsin women, even in dire circumstances. State Republicans have also tossed Wisconsin’s gold-standard comprehensive sex education law out the window and blocked Planned Parenthood of Wisconsin from receiving millions in state funds for cervical and breast cancer screens and birth control.
In 73 percent of the counties that Planned Parenthood of Wisconsin serves, there is now no provider who has the capacity to absorb Planned Parenthood of Wisconsin’s patients. Republican assurances that other providers would step in to fill the void are flat-out false. Such providers certainly never materialized in Wisconsin when five Planned Parenthood rural health centers were forced to shut down because of Republican efforts. Shawano, a county that lost a Planned Parenthood center, has since seen increases in cases of gonorrhea and chlamydia. Chippewa County, which housed another now closed health center, has no place for women to be tested for sexually transmitted infections. Low-income women from Johnson Creek, where a third center closed, have to be referred to another county just to access birth control.
The situation is punishing and degrading to women, especially in low-income communities where women need the health care services provided by Planned Parenthood the most.
As the Jefferson County Director of Health Gail Scott recently told the Guardian, “They’ve never replaced the services of Planned Parenthood. I’m not pro-abortion or anything. But I can tell you nothing has ever replaced those services for uninsured people.”
More barriers to health care decrease a woman’s ability to access the care she needs. In the end, women suffer. Wisconsin already has acute health-care provider shortages in rural areas, thwarting health-care access in general, particularly for low-income people, and resulting in higher health-care costs. The Rump proposal compounds these problems for rural women. Over 54 percent of Planned Parenthood of Wisconsin health centers are in health professional shortage areas, which are rural or medically underserved. Without these health centers, women will have to drive hours or wait months to receive basic health services like a breast exam, cervical cancer screen or physical. As one of the few charity health care providers to underserved populations, Planned Parenthood of Wisconsin loses money on every single Medicaid patient they serve but do so knowing that often these men and women, of all ages, races and education levels, have nowhere else to go. How many other providers are going to be willing to lose money on almost every patient they see?
Because the elimination of Planned Parenthood from the Medicaid program is the only provision in the Rump health care bill that has nothing to do with repealing and replacing the Affordable Care Act, its fate is uncertain.
Planned Parenthood of Wisconsin recently celebrated its eightieth anniversary. It has survived constant political battles waged by a vocal few to shut it down. From the middle-aged, rural white woman whose breast cancer was detected to the African American college student in Milwaukee who is a patient, Planned Parenthood health centers have kept people healthy, helping them to pursue their dreams. We must resist efforts by politicians to make our personal, private health-care decisions, and to take our dreams away. Our health, and lives, hang in the balance.