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By Raegan McDonald-Mosley · Updated December 6, 2020

I met Tameka last year, a Baltimore resident, at Planned Parenthood Maryland for her annual well-woman exam.

Young, Black, and underinsured — like many of my patients — she’d already experienced an unintended pregnancy and opted to have an abortion because she wasn’t ready to be a parent.

Thanks to the Affordable Care Act, after a conversation about what will suit her life, I was able to provide Tameka with an IUD, one of the longest lasting and most effective forms of contraception at not cost to her.

“This will get me all the way through college!” she exclaimed, thrilled to have the care and peace of mind she couldn’t have otherwise afforded.

This month, in one fell swoop, the right-wing Republicans in the House of Representatives voted to repeal the ACA and replace it with the American Health Care Act (ACHA) — a move the nonpartisan Congressional Budget Office initially estimated would result in 24 million more uninsured people, increase premiums and deductibles and block Medicaid enrollees from seeking care at Planned Parenthood health centers. Make no mistake, this new bill — which is now being considered by the Senate — is bad for women.

But the stakes are even higher for women of color, who will fare far worse if this bill becomes law.

The ACA isn’t perfect, but consider how far we’ve come; The number of uninsured African-Americans has been reduced by nearly 3 million and more than 4 million Latinos have gained health coverage since 2013.

What Republican lawmakers propose would dismantle no-copay birth control benefits and mandatory coverage of essential health benefits like maternity care. It would also grant states the right to pick and choose covered services and let insurers charge people more based on pre-existing conditions, including being a woman. I’ve seen what happens when women’s access to preventive screenings and other kinds of health care is limited — later diagnosis and higher mortality rates for breast cancer, cervical cancer and other diseases including HIV.

With high costs and fewer options, people will typically delay or forego care altogether. And, women of color who are disproportionately impacted by breast and cervical cancer, as well as HIV, will be most impacted. Under AHCA, the average person would see a nearly $2500 in additional costs for insurance coverage. If forced to choose between our own wellness and feeding our families or paying the utility bill, I don’t have to tell you where most sisters would spend their money.

It’s a choice no person in living in America should have to make.

The implementation of the ACA was a game-changer, both for reproductive health care providers like myself and the patients we serve. For the first time, I could provide many more women with the care that best fit their bodies and lifestyles, not the option that best fits their financial circumstances.

The ACA helped us make huge strides in decreasing Baltimore’s teen pregnancy rate, disproportionately concentrated among Black and Latina girls. Planned Parenthood partnered with the Baltimore City Health Department to implement the “UCHOOSE, Know What U Want” campaign, which empowers young people to consider how family planning options like birth control can help them reach their goals. Over four years, we saw the teen pregnancy rate drop an astounding 32 percent. This is part of a broader trend nationwide.

Thanks to increased access to health care under the ACA, we’re at a historic low in teen pregnancy, and a 30-year low in unintended pregnancy. As many health care experts have attested, any move to decrease access to essential health care services would roll back this progress and produce devastating consequences for our nation’s public health. Rather than limiting health care access with the AHCA, we should come together to make it easier for people to access the vital care they need.

What I see on a daily basis is mirrored at Planned Parenthood health centers across the country. Nearly a quarter of our patients are Latino/a, 15 percent are Black, and 75 percent live with incomes at or below 150 percent of the federal poverty line. Many are able to access care only through Medicaid or Title X; others don’t have insurance at all. Everyone has their own unique reason for coming to see me, but what they all deserve is  high-quality, non-judgemental care.

My patients are mothers, students, daughters, aunties, partners. They are my neighbors and also my friends. As a Black woman and a Baltimore resident, I am connected to this vibrant community and deeply passionate about improving their health, and their lives. I feel blessed each day to give my community compassionate care. At Planned Parenthood, we provide all people with care, no matter what, and the ACA has only made it easier to do this.

The AHCA would take us backwards. Fewer people will have insurance; most who have it will pay more for less coverage, and women who get their health coverage through Medicaid won’t be able to see their provider of choice at Planned Parenthood. We could see  more illnesses go untreated, more cancers go undetected and more unintended pregnancies. Our communities may get sicker and our families less secure.

What was done by the House can be undone by the Senate, and if you want to see action, it’s important you contact your senators to tell them to vote no on the American Health Care Act.

Raegan McDonald-Mosley is the Chief Medical Officer at Planned Parenthood Action Fund 

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