So Far, 2018 Looks Like More of the Same

The end of 2017 and the beginning of 2018 felt uncannily familiar. Just like a year earlier, there were unexpected election results, millions of outraged women marching through the streets, and, of course, a Congress that just couldn’t get it together.

No Moore

In a surprising turn of events, Democrat Doug Jones won the December 12 special election to fill the Alabama U.S. Senate seat vacated by Jeff Sessions, who resigned in order to become Trump’s attorney general.

Jones is the first Democrat to win a Senate seat in Alabama since 1992, and the first to win any statewide office since 2008. He is also, especially for Alabama, quite progressive. He was open throughout the campaign about his pro-choice views and his belief that healthcare is a human right.

His opponent was disgraced former judge and long-time (alleged) sexual predator Roy Moore, who is on the record saying that Muslims should not be allowed to hold elective office in the U.S., and that we don’t need any constitutional amendments after the first ten (which do not include the amendments banning slavery, granting women the right to vote, or guaranteeing equal protection under the law to anyone who isn’t a straight, white, Christian male).

Moore refused to concede the race, even filing multiple lawsuits alleging irregularities. Despite these efforts, Jones was sworn in on January 3. His win leaves Republicans with a thin 51-49 majority in the Senate.

Rollback Hits Roadblock

In our last issue, we reported that the Trump administration had announced a rollback of the Affordable Care Act’s birth control benefit, which had required that insurers offer prescription birth control methods without copays. We also reported that the attorneys general of several states planned to sue to stop the rollback.

Several such suits were filed, and in mid-December, two federal judges — one in Pennsylvania and another in California — issued temporary injunctions preventing the rollback from going forward until litigation is finished. The Trump administration plans to appeal the rulings, so it may be quite some time before we know the final outcome.

A Tax Bill with a Healthcare Twist

Desperate to record a legislative win by the end of the year, in late December Republican leaders dragged a poorly understood and shoddily drafted tax bill through Congress and sent it to Trump’s desk. He signed it on December 22.

The law included cuts to both the corporate and individual tax rates. But while the corporate cuts are permanent, a number of the cuts for the middle class are set to phase out over the next ten years. The bill also included, as a “cost-cutting” measure, a provision eliminating the Affordable Care Act’s individual mandate.

It’s true that the individual mandate cost the government money. The mandate required people to carry health insurance, and other parts of the ACA offered subsidies to help offset the cost for people who couldn’t afford it. If eliminating the mandate leads to people dropping their coverage altogether, then the government won’t have to spend the subsidy money.

But at what ultimate price? Experts disagree about the effect of the mandate’s removal. Some argue that the number of people who drop their insurance as a result of the change will be low, meaning there won’t be much of an impact. Others believe that the move could be catastrophic, sending the individual insurance market into a “death spiral.” Because the rules requiring insurers to cover people with pre-existing conditions are still in place, anyone can now elect not to carry health insurance and still get covered later if they become ill. Of course, only healthy people are likely to make that decision. Sick people will want to keep their coverage. That means a sicker insurance pool, which means higher premiums, which would mean more healthy people decide to drop their coverage (because of course they know they can jump back in if they get sick), which leads to… you get the picture.

Changes at HHS

On January 12, Teresa Manning, the anti-choice activist Trump appointed to head the Office of Population Affairs (OPA) at the Department of Health and Human Services (HHS), abruptly resigned her position. Manning, who has written that “contraception doesn’t work” and that it is “anti-family,” had been in charge of overseeing the Title X program, which provides family planning funding for 4 million low-income Americans. There has been no public explanation for her departure.

Her resignation might seem like cause for celebration, but the reality, as is so often the case under this administration, is disappointing. Valerie Huber, former head of Ascend (previously known as the National Abstinence Education Association), and Manning’s Chief of Staff, has stepped into the role on an interim basis. Whether Huber or someone else, when it comes to reproductive health, it’s a safe bet that the new OPA head isn’t going to be an improvement over the old one.

In other HHS news, in mid-January the Trump administration announced the establishment of a new “Conscience and Religious Freedom Division” within the agency. The administration says its aim is to protect healthcare “providers who refuse to perform, accommodate, or assist with certain healthcare services on religious or moral grounds.” The broad, nonspecific language and lack of details in the announcement is worrying.

How far does the administration mean for the rule to go? Which workers are included? Can a nurse with a moral objection to single parenthood refuse to care for someone who is unmarried and pregnant? What about a lab technician? We don’t have the parameters yet, but we know from past experience that women seeking reproductive healthcare and members of the LGBTQ+ community will be the ones most impacted.

Budget Showdown = Shutdown

The fiscal year 2018 budget process, which in theory should have been completed back in September 2017, instead dragged on well into the new year. As the end of the fiscal year came and went, Congress passed two continuing resolutions, the second of which expired at midnight on Friday, January 19, causing the government to briefly shut down. On Monday, January 22, Congress passed — and Trump signed — a third continuing resolution, re-opening the government and moving the new target date for a longer term budget deal to February 8. The print deadline for this issue is before that, so I can’t tell you how the story ends. Hopefully, by the time you read this in March, there will be some sort of resolution.

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