Women have always considered many factors when voting, but this election, health care is top of mind. “I say it all the time now: ‘Vote health care, vote health care, vote health care,’” says Cindy Pearson, executive director of the National Women’s Health Network (NWHN), a nonprofit advocacy group in Washington, DC. So much of our health is affected by what our elected officials do: Getting affordable insurance, contraception, and screenings depends on this, as does having access to doctors who understand the unique ways in which conditions like heart disease affect women. Reproductive rights and racial disparities in the system are likewise on the ballot. “It’s more important than ever that women support people who prioritize women’s health,” says Congresswoman Nita Lowey, a rep from New York who is retiring after more than 30 years. “We cannot take that for granted.”
Legislating for Women’s Health
In some ways, the link between government and well-being is clear. Medicare and Medicaid are federal programs that help millions of women, and we know that the Affordable Care Act (ACA, a.k.a. Obamacare) expanded insurance coverage. “The ACA was particularly transformational for women,” says Congresswoman Rosa DeLauro, who represents the area around New Haven, CT. The law eliminated co-pays for birth control, mammograms, and annual visits; made it illegal to charge women higher premiums (as had been standard practice); and forced companies to cover preexisting conditions. “Those ‘conditions’ had included pregnancy, breast and ovarian cancer, osteoporosis, and more,” she says.
But a lot more is going on in government that concerns women’s bodies. For instance, Congress directs how much the National Institutes of Health (NIH) spends each year to research breast cancer, autoimmune disorders, reproductive health, and more, says Susan F. Wood, Ph.D., director of the Jacobs Institute of Women’s Health at the George Washington University School of Public Health. Sometimes elected officials make women’s health a priority, as they did in the 1990s, when hundreds of millions of dollars flowed into the Women’s Health Initiative (WHI), a 15-year study that examined how hormone replacement therapy, diet, and certain supplements impacted postmenopausal health. When legislators don’t focus on women’s needs, important research (such as on endometriosis, which affects one in 10 women but about which little is known) goes unfunded. And it’s the President who appoints the executives who run those agencies, as did George H.W. Bush when the WHI was started, and who nominates Supreme Court justices, who decide the fate of many health laws.
Choices like these that are made behind closed doors may feel distant, says Sarah Christopherson, policy advocacy director for the NWHN, “but the consequences can be life-or-death.” A recent study in Women’s Health Issues found that states that expanded Medicaid under the ACA had fewer maternal deaths than those that didn’t, with non-Hispanic Black mothers benefiting most. Maternal mortality is one of many areas in which Black women fare worse than white ones—something elected representatives could address by funding research