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What’s at stake for minority women’s healthcare after Barrett’s Supreme Court confirmation

This past Tuesday, Amy Coney Barrett was sworn in as the newest Supreme Court Justice, filling the place left by the late Ruth Bader Ginsburg. Her confirmation to the Supreme Court brings a lot of uncertainty for the future of women, especially Latinas and other minority women in terms of rights, access to education, equal pay, and affordable healthcare. 

Amy Coney Barrett taking oath. Lucy.Sanders.999, CC BY-SA 4.0, via Wikimedia Commons

Upon her nomination in September, Barrett said that should she be confirmed, she would be “mindful” of who came before her. “The flag of the United States is still flying at half-staff in memory of Justice Ruth Bader Ginsburg to mark the end of a great American life,” said Barrett. “Justice Ginsburg began her career at a time when women were not welcome in the legal profession.  But she not only broke glass ceilings, she smashed them.  For that, she has won the admiration of women across the country and, indeed, all over the world.”

Indeed, Ginsburg’s legacy will not be forgotten. Ginsburg paved the way for so many women, championing for equal rights, fair pay, and women’s right to healthcare and bodily agency. It is important now that we keep Barrett accountable and hold her to her word to be mindful of Ginsburg’s legacy and life’s work. 

The primary issue at present that we should all be concerned about is the potential threat Barrett poses to equal and affordable healthcare for women, specifically minority women. 

You might be interested: The threat to women’s rights is of our own making

The threat to healthcare access for minority women 

With Judge Barrett’s confirmation, the Court is now poised to overturn the Affordable Care Act (ACA). The ACA has been crucial to minimizing the gap in health disparities for women of color in recent years. Prior to the ACA, 23 million women were uninsured in 2011.

women's healthcare

Sinsi Hernández-Cancio, vice president at the National Partnership for Women & Families

According to a report from National Partnership for Women and Families, for that year, women of color made up 37 percent of the U.S. female population, yet they were 56 percent of uninsured women.

Since the ACA, the uninsured rates among Black women, Asian American and Pacific Islander (AAPI) women, and Latinas have declined significantly, and have declined for all women by nearly half. Barrett has repeatedly indicated that she would support lawsuits to overturn the ACA and has criticized both major Supreme Court rulings that upheld the ACA (NFIB v. Sebelius (2012) and King v. Burwell (2015)). 

On the topic of healthcare access for minority women, we spoke to Sinsi Hernández-Cancio, vice president at the National Partnership for Women & Families and expert in minority women’s healthcare.

Sinsi  is a national health and health care equity policy and advocacy thought leader with 25 years of experience advancing equal opportunity for women and families of color, and almost 20 years advocating for increased health care access and improved quality of care for underserved communities.

She has extensive experience in health and health equity policy and advocacy spans the state government, labor and non-profit arenas and has also worked for the Service Employees International Union (SEIU) as a senior health policy analyst and national campaign coordinator for their Healthcare Equality Project campaign to enact the Affordable Care Act.

As an expert, we asked Sinsi what really Barrett’s confirmation to the Supreme Court could mean for minority women, their lives, their health. and for their families. 

“We must understand the great danger posed by Judge Amy Coney Barrett’s confirmation to the Supreme Court for women of color’s health and well-being for our families and communities,” Sinsi said.

She continues, “Having repeatedly indicated that she would approve the dismissal of the Affordable Care Act, our concern is that a case, Texas v. California, will be argued just seven days after the November election. If Barrett delivers the vote that overturns the ACA, we stand to lose a lot,” said Sinsi. “To start, millions of women of color will lose their health insurance. Insurers can discriminate against people with pre-existing conditions. There are 67 million women with pre-existing conditions.”

minority Women health

Photo credit National Cancer Institute – Unsplash.com

Sinsi also reminds us that we could also lose access to prenatal and maternal care since health insurance providers would no longer be required to offer it. Affordable, preventive services, from preventive checkups, vaccines, cancer tests, and mammograms, would all be on the chopping block if the ACA is struck down.

Losing the ACA will severely impact the lives of minority women and women living in underserved communities as health services will become increasingly inaccessible. Not only will they become unaffordable, but women are likely to also face discrimination based on racial baises, gender identity, reproductive history, and even their ability to speak English.

Previously, women were protected from discrimination in health care by non-discrimination provisions of the Affordable Care Act, known as Section 1557. However, in June 2020, the present Administration finalized a rule that would eliminate these provisions.

This rule puts women in danger, especially those who exist at the intersection of multiple communities and promotes misogyny, racism, and ableism in healthcare. Currently there are many lawsuits in the lower courts challenging this rule, and if brought to the Supreme Court in its actual composition, it would likely to be confirmed. 

Greater health disparities during the pandemic 

Photo by CDC on Unsplash

In the post-COVID world we are living in today, it has become all the more apparent how important our health is and how crucial it is that we have access to healthcare. If the Affordable Care Act gets overturned, millions of Americans will be left vulnerable during the pandemic.  And undoubtedly, people of color and underserved communities will be hit the hardest as they have already suffered disproportionately with more COVID-19 cases and deaths than non-Hispanic white populations. 

“Today, more than ever, Latinas and women of color are living this dystopian reality with the Coronavirus pandemic. Those who ever doubted the importance of access to health care or our community’s vulnerability can no longer deny it. The pandemic has shown to great, painful, and tragic effect the devaluation of our lives,” said Sinsi Hernández-Cancio. “Although there are more than three times as many non-Hispanic white people in this country as Latinos, we suffered the highest number of COVID deaths among people under 65. The largest number, not a portion or percentage.” 

To put that into context, for every white baby that has died, Latinos have lost two. For every white child or young person between the ages of 5 and 24 who has died from the virus, Latinos have lost three. 

“These are the future not only of our race but of the nation,” said Sinsi. “Latinos between the ages of 35 and 44 have died at a rate three and a half times higher than whites. These are fathers and mothers, uncles and aunts, sisters and brothers who are no longer here.” 

The repeal of the ACA would be dire and health disparities would worsen for minority women. At a time when over 236,000 people have died in the U.S. due to COVID-19, and while thousands are experiencing severe symptoms, the loss of health care coverage during the COVID-19 public health crisis would be devastating. 

The future of women and girls in our country 

Like most of life during this past year, the future is uncertain, but Barrett’s confirmation to the Supreme Court poses a potential but significant threat to limiting the rights of women and girls in the U.S., from personal autonomy to education and economic equity, healthcare access, and equal rights under the law. 

minority women's healthcare, empowerment

Photo by Natalie Hua on Unsplash

“Barrett will assuredly join the majority of justices who oppose allowing women to make their own decisions on whether, when and how to parent. Her ascension is part of a concerted plan to marginalize women and communities of color,” said Sinsi. “It has strong roots in racism, sexism, xenophobia, homophobia, and transphobia. But the attacks on our access to health care are central to it all. As my granny used to say, ‘If you have no health, you have nothing.’”

Ruth Bader Ginsburg paved the path forward for women and girls in the U.S. to have equal rights under the law. Her legacy is based on a foundation that values the rights of women and their right to agency and autonomy in their lives. This includes equal pay, access to education, and access to healthcare without discrimination. Judge Barrett promised to be mindful of the legacy that came before her, and it is our duty now to hold her accountable to this and to upholding the rights of women in this country. The future may be uncertain, but the path forward is not. 

You might be interested: Latina Equal Pay Day is a call to action

“Despite these genuine threats, I do believe that communities of color will resist these efforts,” said Sinsi. “We know that Latinos are the fastest-growing minority group, and we’re on track to become 30 percent of the total U.S. population. I think we’ll continue to organize and elevate our voices–and ultimately, I think public opinion will be on our side.” 

Smiley pregnant

Women of childbearing age gain health coverage in ACA expanded states

Smiley pregnant

On the eve of the 2016 Open Enrollment period for Marketplace coverage, the March of Dimes and Urban Institute released a new study documenting gains in insurance coverage among women of childbearing age in the early stages of implementation of the Patient Protection and Affordable Care Act of 2010 (ACA).

Why is this study important? Here are some findings previous to the implementation of the ACA:

  • In 2013, more than one in five women of childbearing age was uninsured (Cohen and Martinez 2014).
  • Women who do not have health insurance coverage are more likely to forgo necessary medical care because of cost and have lower rates of preventive screenings, such as Pap Smears and mammography (Kaiser Family Foundation 2013).
  • Studies have also shown that access to preconception and interconception care can improve the health of women and their future children by addressing chronic health conditions and risk behaviors associated with adverse pregnancy outcomes (Atrash 2006; Moos and Cefalo 1987).
  • Adequate preconception care for women of childbearing age can also reduce disparities in adverse pregnancy outcomes (Johnson et al. 2006).
  • Health insurance coverage facilitates access to care because women who are uninsured before becoming pregnant are less likely to receive preconception counseling (Williams et al. 2012).

The study, Changes in Insurance Coverage, Access to Care, and Health Care Affordability for Women of Childbearing Age, showed that 5.5 million women of childbearing age gained coverage between summer 2013 (prior to ACA implementation) and winter 2014-15 (after one year of enrollment), reducing the uninsurance rate for this group from 19.6% to 13.3%.  However, states’ decisions whether to expand Medicaid were a key determining factor; low-income women in Medicaid non-expansion states did not experience the same gains as low-income women in expansion states.

“The large declines in uninsurance among women of childbearing age, particularly low-income women, are an encouraging sign,” said Adele Shartzer, a research associate at the Urban Institute’s Health Policy Center and the study’s lead author.  “While there is still more to be done to further reduce uninsurance, the ACA appears to be reaching women during a critical period for their own and their family’s health.”

The brief also examined reports of access to and affordability of care. Affordability of care improved, particularly for low-income women in Medicaid expansion states, who reported a 10.4 percentage-point decrease in unmet need for care because of cost.  Access to care held steady between summer 2013 and winter 2014–15, with no change in the share of women who reported a usual source of care or recent routine checkup.

“If we can help women be healthy before they become pregnant, they will have healthier pregnancies and healthier babies,” said Cynthia Pellegrini, Senior Vice President for Public Policy and Government Affairs at the March of Dimes, which funded the study.  “This study offers critical insights into the impact of the ACA on coverage, access to care, and affordability indicating that the law is indeed enabling more women of childbearing age to obtain coverage.  We now must continue working to determine whether that coverage is translating into better health and health outcomes, especially in areas like pregnancy and childbirth.”

The full study, which may be found online,  used data from the Urban Institute’s Health Reform Monitoring Survey (HRMS) to examine changes in uninsurance and health care access and affordability for women of childbearing age (ages 18 to 44).  Funding for the core HRMS is provided by the Robert Wood Johnson Foundation and the Urban Institute. The March of Dimes intends to continue tracking key indicators of maternal and child health as 2016 open enrollment begins and Marketplace coverage evolves.

Small Business Majority answers your questions on Obamacare

Small Business Majority webinars on Affordable Care Act

Small Business Majority webinars on Affordable Care Act

Small Business Majority (SBM) New Jersey Outreach Manager Aixa Acevedo will conduct a series of webinars on “What the Healthcare Law Means for your NJ Small Business.”

This webinar will focus on what the new healthcare law, the Affordable Care Act –also known as Obamacare– means for New Jersey small businesses. It will focus on both federal and state provisions to help local small business owners understand how the law will affect them. Topics being discussed include:

  • Small business tax credits (available to businesses and tax-exempt non-profits)- who’s eligible and how to claim them
  • New Jersey marketplace update
  • Shared responsibility
  • Cost containment
  • Tools and resources available for small businesses interested in learning more about the law

Aixa will also answer questions to all participants during the session. This webinar will be repeated on the following dates. Please click the date you’d like to register.

Aixa Acevedo, NJ Outreach Manager SBM, at Rutgers/Newark event

Aixa Acevedo, NJ Outreach Manager SBM, at Rutgers/Newark event

Thursday, December 4, 2014 – 12pm

Thursday, December 11th – 12pm

Tuesday, December 16th – 12pm

You can go to the Small Business Majority website to use the small business tax credit calculator.

Calculator property of Small Business Majority and its subsidiary website California Health Coverage Guide

About Small Business Majority

Small Business Majority was founded and is run by small business owners to focus on solving the biggest problems facing small businesses today. Since 2005, we have actively engaged small business owners and policymakers in support of public policy solutions that promote small business growth and drive a strong economy. We are a team of 31 working from our offices in California, Washington, D.C., Colorado, Missouri, Ohio, New York, New Jersey, Virginia, Oregon and Washington state. We deploy our network of 25,000+ small business owners and 6,500 business organizations, along with a strategic partnership program including more than 100 business organizations, to reach more than 400,000 small business owners. Our extensive scientific polling, focus groups and economic research helps us educate and inform policymakers, the media and other stakeholders about issues including healthcare, energy, immigration, taxes, access to capital, financial reform and workforce development.