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"Inside the Brutal Fight to Include Women in the Affordable Care Act
Cecile Richards reveals how abortion coverage and free birth control became part of Obamacare, in an exclusive excerpt from her upcoming book.
"Get ready, women, we are going to war!” Barbara Mikulski, a senator from Maryland and the longest serving woman in Congress, shouted into the microphone. Then she pulled out her bright red lipstick and smeared it on.
These were the early days of the fight for health care reform in 2009, and I’d accompanied Barbara to a press conference in the Capitol Visitor Center to announce Planned Parenthood’s support for Obamacare.
Back then, the uninsured rate in America was at its highest point in a generation. At Planned Parenthood we saw every day how the lack of health insurance affected our patients. This was an opportunity to take a big leap forward.
The passing of Obamacare was long and arduous, and most people remember the fights over drug pricing or cracking down on insurance premiums.
But neither of those were the most controversial pieces of the Affordable Care Act. Instead, nearly every knock-down, drag-out fight had to do with women’s health.
A proposal, known as the Stupak Amendment, had been introduced at the last minute— with support from the US Conference of Catholic Bishops—that would prevent insurance plans from covering abortion services under the new health care law.
The amendment went against everything we stood for at Planned Parenthood.
For help, I turned to Laurie Rubiner. Laurie had come on to run our government relations office in Washington, and she was smart and savvy. She had worked on health care policy on both sides of the aisle, including for then Senator Hillary Clinton...
We tried to beat back the Stupak Amendment, but we just didn’t have the votes, and it was included in the bill passed by the US House of Representatives.
If it passed the Senate and became law, it would be a done deal: we’d lose abortion coverage for women and never get it back.
I was devastated.
That was my lowest point in a long time.
Early the next morning I was in a hotel room when my cell phone rang. It was my old boss, Nancy Pelosi.
“I know this is terrible, and I’m as mad as you are,” she said.
“This was a last-minute attack and just know this:
I am committed to getting the Stupak Amendment out of the final bill. I don’t know how, but that’s my word.”
(Emphasis is mine.)
I thanked her, but I wasn’t hopeful.
... “This is it,” I told them, bracing for a tough conversation.
“I am asking you to give me the authority to tell the White House and our congressional leaders that if the bill bans abortion coverage, as it does in its current version, we will lobby against final passage.”
There was an uneasy silence...All this work, for nothing?
The board went back and forth,
recognizing that if Planned Parenthood opposed Obamacare over abortion, the entire bill might go down, hurting the millions of Americans in desperate need of affordable health care.
... In the middle of their deliberations Reverend Kelvin Sauls...cleared his throat.
“The Bible says, ‘And I sought for a man among them, that should stand in the breach before me,’” he said.
“The question we must answer is, Who will stand in the breach?
Who will stand for the women we care for, at a moment of need for moral leadership?
I believe this is one of those times when we are called to be in solidarity with women who may have no one else to stand in the breach.”
The room erupted with applause ...
It was my job to call the White House, knowing that they would be furious.
... Our only real hope was Speaker Pelosi, and though I remembered her pledge to me weeks earlier, her opposing this bill, here at the final hour, seemed nearly impossible.
I knew how important health care reform was to her, and to millions of Americans. Our position wasn’t popular enough to upend the entire bill. But I needed to tell her where Planned Parenthood stood.
Waiting at the Capitol for my appointment with Nancy, I knew I had to be crystal clear on our position, take it or leave it.
“Thanks for coming in today,” Nancy began.
“I know you understand we are within only a handful of votes to get this bill passed, and I’m not sure we can get it done. But we are working hard.”
But before I could respond, she continued,
“You know how much this bill means to me.
I’ve worked for health care reform my entire career.
But I want you to know: if there is an abortion ban in the Affordable Care Act, there won’t be an Affordable Care Act.
I won’t pass it.”
(Emphasis is mine.)
Her members were already hard at work whipping the votes, she said, and soon we would know whether the abortion ban had made it into the final bill—not to mention whether the bill could even pass.
We had Planned Parenthood supporters calling every member of Congress, either to buck them up or urge them to support only a bill that protected abortion rights. I was in Washington all week with the Planned Parenthood leadership, holed up in a conference room where we were getting reports from organizers out in the states.
Late Friday night the phone rang in my hotel room. It was Congresswoman Rosa DeLauro from Connecticut, a key lieutenant to Speaker Pelosi ...
“Cecile, we did it! We backed them down.
They threatened us over and over,” Rosa said. “And it won’t surprise you—several of the Democratic men were ready to sell us out.
But Nancy didn’t blink.
None of the women blinked.
The Stupak abortion ban is out of the bill!” ...
Two days later, the Affordable Care Act passed, and we made history. Without the women in the House and the Senate, it would have been a different story. For the first time, insurance companies could no longer charge women more than men for the same health care coverage—something that routinely happened before Obamacare. ...
Protecting coverage for abortion was a major victory, but certainly not our last battle in the fight for women’s health care.
Part of the promise of Obamacare was that under the new law, preventive care would be covered for everyone with no out-of-pocket cost.
We thought if we could make a case for contraception as preventive care, maybe women could actually have their birth control covered by insurance, like every other prescription medication in America. ...
But we were fresh off a fight against laws that would let pharmacists refuse to fill a woman’s birth control prescription, and we weren’t about to take anything for granted. ...
We had supporters in the White House, but we also had some very high-ranking opponents. The most organized force against us was, again, the Conference of Catholic Bishops ...
Members of the US Senate, led by Patty Murray and Richard Blumenthal, demanded to talk to the White House. Activists flooded the administration with letters ...
Then, one afternoon in February 2012, my phone rang. The woman on the other end said, “Would you please hold for the president of the United States?”
(Emphasis is mine.)
“I can definitely do that,” I said. A minute later President Obama—who is notorious for being on time—came to the phone.
“Hey, Cecile, how’s it going?” he asked in a cheerful voice.
“Well, hello, Mr. President. It’s going just fine, thanks.”
“Cecile, I wanted to call you because I’m making three phone calls today: the Catholic Bishops, the Catholic Hospital Association, and you.
Suffice it to say, I think yours is going to be the happiest phone call I’m going to make.” He paused. “I’m going to tell them the same thing I’m telling you: later today, I’m going to announce at the White House that, from here on out, birth control is going to be covered for all women under their insurance plans with no copay.
I know you’ve worked hard for this, and I think it’s going to be a huge advance for women.”
I took a deep breath. “Well, Mr. President, thank you for calling me yourself, and for understanding what a difference this is going to make. ...
In the first year alone, women saved $1.4 billion on birth control pills. Today we’re at a 30-year low for unintended pregnancy, a historic low in teen pregnancy, and the lowest abortion rate since Roe v. Wade.
These facts are too often overlooked, even though this is one of the biggest public health success stories of the last century. It didn’t happen on its own—it happened in large part due to better and more affordable access to birth control.
But of course elections have consequences. Since President Obama left office, women’s health has come under fire by the Trump administration, which believes insurance companies shouldn’t have to cover birth control. ...
Taking on controversial issues is hard.
... Any time you’re trying to change the way things are or challenge the powers that be, it’s going to be controversial.
Often the work that’s most worthwhile seems the most intractable and impossible. But just because someone else hasn’t figured it out yet doesn’t mean you can’t.
... And in the meantime, at least I’m enjoying fighting the good fight.
The best and worst part about being a professional troublemaker is that the trouble never ends."
You can read more here
You can find much more about the release of the book, including, but not limited to, brief comments on the book and a book tour schedule to date here
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Eleanor Roosevelt with female reporters
at her first White House press conference
on March 6, 1933.
“ … At first Eleanor Roosevelt adhered to her own...political topics. She told about her daily schedules, discussed the prints on the White House Walls, and shared low-cost menus for Depression-era households. But reporters pressed the First Lady for more news on public policy, and the press conference sessions soon broadened their scope. As early as April 1933 Eleanor Roosevelt provided a political scoop; she announced that beer would be served in the White House once Prohibition ended. By the end of 1933, according to UP reporter Ruby Black, the First Lady had defended low cost housing, the subsistence homestead program, equal pay for equal work, old age pensions, and the minimum wage. “Tea Pouring Items Give Way to Big News,” Black declared. “No newspaperwoman could have asked for better luck,” reporter Bess Furman recalled. The First Lady, she wrote, “conducts classes on scores of subjects, always seeing beyond her immediate hearers to ‘the women of the country.’” … “ ( You can read more here )
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