After Four Decades with Roe, U.S. Women Still Need Abortion Access, and So Much More

Yesterday’s 42^nd anniversary of the Supreme Court’s Roe v. Wade decision prompted a week of stark contradictions. Thousands of anti-choice protesters descended on Washington yesterday while the House of Representatives passed HR7, a bill limiting insurance coverage for abortions (after a broader abortion ban was – for the time – abandoned). Yesterday, Congressional Democrats re-introduced the Women’s Health Protection Act, a bill meant to protect abortion access from the medically unnecessary restrictions that have already made the landmark decision meaningless in many parts of the country. And in his State of the Union address on Tuesday night, President Obama professed his support for abortion rights, along with equal pay, paid sick and family leave, a minimum wage hike, and expanded health coverage. It’s all been a reminder of what has been won and just how much there is left to fight for – from abortion rights to economic security.

Over the past four years we’ve seen an unprecedented number of attacks on reproductive health – more than 200 between 2011 and 2013 – leaving many states with a scant number of abortion providers. Scores of women are now required to travel long distances, at great cost, to access not just abortion, but a wide range of comprehensive health services.

While reproductive health has certainly been the obsession of choice of conservative lawmakers in recent years, it hasn’t been the only issue in their crosshairs. In many ways, the increasing hostility to abortion and family planning is reflective of a broader war against the poor that is sure to persist under the new Congress. It turns out the same lawmakers who have championed abortion restrictions in the name of protecting women’s health have done very little to actually help women and families. Indeed, a recent report from the Center for Reproductive Rights and Ibis Reproductive Health shows that states with the most abortion restrictions also have some of the worst indicators for women’s health and wellbeing. So lawmakers are restricting access to health services at the same time they are dismantling the social safety net on which so many women and families rely. The overall impact has been devastating.

In states across the country, women are struggling under the burden of intersecting health and economic injustices. Let’s look, for example, at Kansas, where conservative Governor Brownback slashed business regulations, cut taxes for the wealthy, nearly eliminated income taxes, and privatized Medicaid delivery, all with the goal of making the state a conservative utopia. In the meantime, Kansas women continue to struggle with high rates of poverty, a lack of health insurance, un- and underemployment, and a persistent wage gap. Kansas is one of the sixteen states that refuse to participate in Medicaid expansion under the Affordable Care Act, leaving nearly 80,000 adults (half of whom are women) uninsured. It is the only state in the country that actually experienced an increase in its uninsured rate last year.

To make matters worse for women in Kansas, lawmakers eliminated abortion access from 98 percent of the state’s counties – in which 74 percent of the state’s women live – and passed House Bill 2253, a 47-page law comprised of countless and senseless abortion restrictions. It included a 24-hour waiting period; medically inaccurate pre-abortion counseling; prohibiting abortion providers from working or volunteering in public schools; banning University of Kansas Medical School faculty members from teaching students and residents how to perform abortions; and eliminating public health insurance coverage of all abortion services. And the list goes on. Sadly these laws are not unique to Kansas and they have significantly diluted the initial promise Roe held four decades ago.

The economic injustices described above, and those being felt by low-income families throughout the country, are starting to get the attention they deserve, and the policy solutions to address them are gaining traction (see the recent support for raising the minimum wage and instituting paid sick and family leave). But while economists and policymakers are increasingly focused on the pernicious impacts of inequality and economic insecurity, they rarely acknowledge how these issues intersect with reproductive health and rights.

Let us use the anniversary of Roe to remember there can be no economic justice without reproductive justice. We can’t win on one front while losing on the other. Reproductive health – a cornerstone of which is family planning and abortion – is not a frill. It is a core component of comprehensive health care, which is a basic pillar of every individual’s personal, social, and economic wellbeing.

What good is better and more equal pay if we can’t plan the timing and size of our families? What good is paid sick and family leave if there are no quality, affordable, and accessible providers to give us the care we need when we need it? We need all of it. Now. That’s just demanding a basic – very basic – floor of wellbeing. And that shouldn’t be too much to ask. Roe has served as part of that foundation for the last 42 years. But conservatives have successfully chipped away at it and will continue to do so until there’s nothing left to stand on. Perhaps we can seize upon the new energy around closing the inequality gap to remind our leaders that without bodily autonomy, we will never be secure.