The Biggest Lesson From the Trumpcare Debacle

It showed us how government by misogynists actually translates into policy.

The cruel and stupid legislative clusterfuck known as the American Health Care Act has now failed. In trying to ram it through, however, Republicans succeeded in demonstrating, with coruscating clarity, what misogynist government looks like. In the negotiations over the ACHA, male Republicans treated women’s health as a token to be traded away, repeatedly upping the ante with inventive new ways to make women vulnerable. Before it went down in flames, the Republican attempt to repeal Obamacare showed us how total disregard for women’s lives translates into policy.

I’m not just talking about the Republican attempt to destroy Planned Parenthood. It was clear from the beginning that Republicans would use their version of health care reform to undermine the country’s largest provider of reproductive health care. (At least, it was clear to everyone except the Trump-voting working-class white women who depend on Planned Parenthood.) The AHCA would have prohibited poor women from using their Medicaid at Planned Parenthood, even in counties where they have no other reproductive health care options. Because 40 percent of Planned Parenthood’s budget comes from federal funding, the AHCA would have likely led to Planned Parenthood clinics closing all over the country, affecting women who aren’t even on Medicaid.

This would have been devastating for women, but it wouldn’t have been surprising coming from this GOP. Conservative Republicans in the House, however, still felt the AHCA was too generous. So Republican leaders sweetened the pot with provisions targeting Medicaid further. Among them was one that would have allowed states to institute work requirements for Medicaid recipients. (States that did so would get a 5 percent bump in federal assistance.) Though pregnant women would be exempted, for at least some mothers the work requirements would kick in two months after giving birth. Women caring for newborns would thus have to scramble to find both a job and child care immediately or risk losing their health insurance.

But conservatives who wanted total Obamacare repeal still balked, so the White House came back with a further offer: It would agree to scrap the part of the current law requiring health insurance policies to cover essential health benefits. Among other things, that meant jettisoning mandatory maternity care. Prior to the passage of the Affordable Care Act, most individual health insurance plans didn’t cover maternity care. Women could buy pregnancy riders—according to the Kaiser Family Foundation, they could cost up to $1,600 a month. But as Alina Salganicoff, vice president and director of women’s health policy at Kaiser, points out, nearly half of pregnancies are unintended. And for women who got pregnant without first purchasing riders, pregnancy would be considered a pre-existing condition. “This left women who were pregnant and who didn’t have coverage without a pathway for coverage,” Salganicoff says. In the failed AHCA negotiations, one thing that both Trump and recalcitrant Republicans were able to agree on is that we should return to this state of affairs.

A widely circulated photograph from Thursday showed Vice President Mike Pence sitting with a conference table full of men, apparently discussing plans to get rid of essential benefits. “A rare look inside the GOP’s women’s health caucus,” tweeted Sen. Patty Murray. It was a funny line, but in a smashing-your-head-on-the-desk sort of way; these men didn’t even feel like they needed a couple of women around for show as they bargained away our health care.

Friday morning, Trump sent out a tweet castigating conservative opponents of his plan for allowing “P.P. to continue.” Inasmuch as anything that Trump says can be taken literally, the tweet was interesting as an admission that cutting federal funding was meant to destroy Planned Parenthood altogether. The great dealmaker’s final gambit was to put the country’s foremost family planning provider on the chopping block and dare House Republicans not to swing the ax.

In the end, of course, they called his bluff, and the AHCA failed, though not because large number of Republican officials objected to the effects it would have on women. This awful bill’s demise is great news. Still, the past week has shown anew how little women are worth to the men who are running the country. There’s only so much comfort to be found in their incompetence.