Caring about Obamacare

I’ve had the government shutdown on my mind for the last couple of weeks (like many of you, I’m sure). As I’m writing this, it looks like there is an agreement in the works, and just in the nick of time because it was about to get even uglier for women. But I don’t want to get into that. Let’s think happy thoughts…thoughts of Obamacare.obamacare-logo

What?

Obamacare doesn’t stir warm fuzzy feelings in your heart? It’s actually called the Affordable Care Act (ACA). Better? No? OK, full disclosure; I have mixed feelings about it as well. But something that does warm my heart is to know that many folks who were unable to afford health insurance before will be able to get it now. This will undoubtedly include people who are dealing with abuse in their lives. Access to healthcare for survivors of domestic violence is key to getting and staying healthy, healing from the physical and emotional wounds of abuse, keeping a job and income flowing…I could go on.

It’s part of my job to think about the implementation of Obamacare and how it affects those who are experiencing abuse. Here’s what I know:

  • Washington State, after a rocky opening day, has one of the best working systems for implementing the ACA in the country right now.
  • The ACA gives financial incentives for health care professionals to screen patients for domestic violence and refer them to local supportive services.

This is all really good news for survivors of abuse in Washington. But, there is still a lot we don’t know about the system and how it will (or won’t) work for those dealing with abuse, like:

  • Tax credits are awesome, when you can get them. To get this one you have to file jointly if you are married. That’s going to be a problem for many married survivors.
  • What exactly happens to the information entered into the Health Benefits Exchange, the marketplace for those purchasing private coverage? As an advocate, I know how important it can be to keep information confidential if someone’s abuser is stalking them.
  • How safe is this system for undocumented mothers trying to get healthcare for their children? Can the feds access and use information from this process to track immigration status?
  • Who is teaching medical professionals how to screen for domestic violence? Are they considering a person’s safety when asking these questions (like not asking in front of their partner)?

Sigh. So many questions and only 24 hours in the day. There is still a lot that remains to be seen about how Obamacare will ultimately fare, but I’m optimistic. And overwhelmed. But mostly, optimistic.

Why aren’t they restricting condoms?

Not exactly on point, but I got what my teenager was asking. Even she gets the double-standard of the Obama administration’s position on emergency contraception. She asked, “If they think that making it easy for girls to get emergency contraception means that they are going to have more sex, then why do boys get to buy condoms without any problems?” This is mind-boggling coming after President Obama’s speech at the Planned Parenthood Conference: “When it comes to a woman’s health, no politician should get to decide what’s best for you.”condoms

Why do I have a problem with the government policy? Because of all the barriers: you must be 15, you must have a government-issued or photo id (not something all schools provide), you must purchase it in a store that has a stand-alone pharmacy (rare in rural and remote communities), and it is expensive—even though Medicaid covers other over-the-counter medicines like condoms.

We have plenty of evidence-based scientific studies proving that emergency contraception is safe, prevents ovulation, and cannot terminate an existing pregnancy. We have research that shows the dramatic decline in unintended teen pregnancy and abortion rates when teens learn how to use contraception more effectively.

We also know that teens who are abused experience birth control sabotage, pressure to get pregnant, and significantly higher rates of unintended pregnancy. Emergency contraception is important because negotiating birth control methods is awkward in any relationship, but it’s nearly impossible if you’ve got an abusive partner who wants control.