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U.S. News & World Report, November 7, 2008

7 Things Obama's Win Could Mean for Women's Health

By Deborah Kotz

Women's health activists are fist-bumping each other over Obama's slam-dunk win, and they're hoping that he'll reverse some of the policies put in place by Bush. Yesterday, I had a chance to catch up with Planned Parenthood President Cecile Richards in between her strategy meetings and blogging for the Huffington Post. She predicted seven things that would change in the new administration.

1. No more federal funds for abstinence-only education. Two years ago Obama told a conservative Christianaudience that abstinence-only education was not enough to prevent teen pregnancy and that he "respectfully but unequivocally" disagrees with those who oppose condom distribution to prevent HIV transmission, according to the reproductive health blog Reality Check. He's also an original co-sponsor of the Prevention First Act, which mandates that all federal sex-education programs be medically accurate and include information about contraception. That legislation could be resurrected in the new Congress.

2. No more global gag rule. On Bush's first day in office in 2001, he reinstituted the "global gag rule" that restricted federally funded health clinics in foreign countries from performing abortions or even providing referrals or medical counseling on abortion. "We think there's going to be a change in that approach and that these clinics will be allowed once again to offer a full range of family planning services," Richards says.

3. Better coverage for contraception and pregnancy. While Richards says women's health activists had to "battle the current administration to get emergency contraception approved over the counter," they're now hoping that Obama's proposed health plan will make contraception more affordable to women. It could force drug plans to cover birth control pills as they would any other drug. (Many still do not.) And it could include more comprehensive prenatal coverage; some women shell out $5,000 or more to have a baby. I'm also curious to see whether Obama reverses a Medicaid rule that last year stopped allowing discounted birth control pills to be dispensed on college campuses.

4. Reversal of the "conscience" regulation that threatens women's access to birth control. Obama will probably reverse a new rule, opposed by most medical organizations including the American Medical Association and the American College of Obstetricians and Gynecologists, that's slated to be enacted in the next few weeks by the Department of Health and Human Services. It allows doctors and other healthcare workers to opt out of certain practices that some of them find morally objectionable—like prescribing birth control pills, inserting IUDs, or dispensing emergency contraception (a.k.a. the morning-after pill) to rape victims—without fear of losing their jobs. Read more about this here.

5. Increases in funding for reproductive health clinics serving uninsured. While Title X federal funds were recently increased for Planned Parenthood and other family planning clinics, Richards hopes an Obama administration will provide further increases. "We're currently meeting the needs of 3 million women," she says, "but an additional 14 million who need our services aren't getting them."

6. Fixing gender disparities in health insurance premiums. While Obama's proposed health plan is probably a pipedream in this economic climate, it could (if ever enacted) ensure that women who buy individual policies aren't discriminated against because of their gender. A recent analysis of 3,500 health plans from the National Women's Law Center found that insurers charged 40-year-old women anywhere from 4 percent to 48 percent more than they charged men of the same age. "The average woman uses healthcare more because she spends an average of 5 years getting pregnant and 30 years trying not to," explains Richards. "It's certainly not fair that she pays more, and this is the kind of issue that Obama wants to address."

7. Improved access to morning after pills and abortions for U.S. military women serving overseas. Women who become pregnant while serving overseas are immediately shipped home. They aren't allowed to get surgical abortions in military hospitals, nor do they have access to medical abortions early in the pregnancy using Mifeprex, a combination of two medications. Obama's health plan includes coverage for abortions, and he could join with the Democrat-led Congress to enact legislation that ensures that soldiers get the same health benefits as the rest of us.

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