Why Senator Jeanne Shaheen Is Fighting to Put Women and Families at the Forefront of the Health Care Debate

There's been no issue that's divided Americans this year the way health care has. Congress has spent the year trying to repeal the Affordable Care Act (ACA) and proposing bills that would gut Medicaid and the Children's Health Insurance Program (CHIP), allow states to opt out of providing essentials benefits, such as birth control, well-woman visits and prenatal care and newborn care, and take us back to the days where insurers could charge people with preexisting conditions more for life-saving care.

Among those who would be hit hardest? Women — especially women who want to start a family. That's why New Hampshire Senator Jeanne Shaheen is elevating women's voices when it comes to the health care debate. Below, she and What to Expect author Heidi Murkoff discuss why access to high-quality health care is so important for everyone (but especially women) and how Senator Shaheen fights every day to put moms and their families first.

Heidi Murkoff (HM): Your "Coffee with Jeanne" meetings with constituents give you the opportunity to hear directly from Granite Staters, and I imagine many of them are moms (and dads) with young families. What is their most-asked question, or most-raised concern, about health care? 

Senator Jeanne Shaheen (JS): People are scared. I hear stories from mothers of children with pre-existing conditions who are worried about their son or daughter losing coverage. I’ve spoken with women who are fearful that they’ll lose access to contraception. And I’ve sat down with families of those who rely on Medicaid to cover treatment for substance use disorders. As you may know, New Hampshire has been devastated by the opioid epidemic – we have the second highest overdose death rate in the country. Losing access to health care would be disastrous, particularly for those who have access to substance use treatment through the ACA. The ACA isn’t perfect, but it has undoubtedly made New Hampshire healthier. We’ve come a long way with the ACA, and we still have further to go, but we can’t risk undoing all the progress we’ve made.

HM: The ACA made maternity care an essential health benefit that states and insurers couldn’t opt out of offering. GOP plans to repeal and replace have sought to reinstate that opt-out, potentially leaving thousands of pregnant women without coverage for their care. What’s wrong with that picture?

JS: This has been a longstanding fight in Congress. During the health care reform debate back in 2009, there was an infamous exchange as senators were considering an amendment that would strip these essential benefits from the bill. The male senator, who introduced the amendment, said he didn’t need maternity care in his insurance plan. Senator Debbie Stabenow, from Michigan, responded, “I think your mom probably did.” I thought that was very telling. There needs to be a broader understanding, that when it comes to health care, we’re all in this together. While it may seem like common sense to most moms around the country that health care plans should cover maternity care as an essential benefit, unfortunately in Congress, this battle continues today. 

HM: One step the ACA didn’t take is to allow pregnant women to sign up outside of open enrollment, as a qualifying life event. Why do you think that it was excluded in the drafting of ACA? 

JS: The Affordable Care Act was a landmark legislative achievement for Americans, but the story isn’t supposed to end there. Just like other laws that touch many people’s lives, like Social Security and Medicare, Congress should be working across the aisle to continually improve and adjust the ACA so that the law works better. Unfortunately, since the ACA was signed into law, Republicans have focused entirely on repealing it. Since these repeal efforts failed for now, I remain hopeful that we can move past these partisan repeal efforts in Congress and begin making improvements that perhaps should have been included from the beginning. Unfortunately, as we’re seeing with the Republican tax bill, significant parts of the health care reform law are still under attack. I’m continuing to work across the aisle to improve the law, and I remain hopeful that, eventually, more Republicans will come to the table.

HM: Contraceptive coverage is a critical part of reproductive care — allowing healthy women to plan healthy pregnancies, when and if they choose, resulting in healthier moms, healthier babies, and lower health care costs for all. Why, in 2017, does it continue to be such a third rail in politics?

JS: It’s ideology and partisanship trumping the health care needs of women. Ensuring women can make their own health decisions and increasing access to contraception have always been priorities for me. I think this administration’s obsession with attacking women’s reproductive rights demonstrates a very shallow understanding of women’s health care. Abortions are at an all-time low – cutting off access to preventative services, including birth control, will lead to an increase in unwanted pregnancies, and threatens the progress we’ve made on women’s reproductive freedom. I know all the attacks on women’s health care can seem overwhelming but I can’t say it enough: we have to continue making our voices heard and never let up the fight  — we’re not going to go backward!

HM: One thing I don’t hear enough about in the health care debate is how routine preconception and pregnancy care are the ultimate in prevention — and offering this care to all moms would lower health care costs exponentially, preventing pregnancy complications like gestational diabetes and preeclampsia, and greatly improving a baby's chances of future good health.  Why do you think that hasn’t been a focus of attention?

JS: I think that primary and preventative care [have] been largely left out of the health reform debate. Not just for expectant mothers, but for everyone. As I’ve said before, the ACA was a good first step — it mainly focused on getting individuals covered — but we now need to work on increasing access and awareness of preventative services. Not only do folks who receive regular checkups feel better, but they are healthier in the long run because they know how to better manage their chronic conditions and prevent new ailments from arising.

Preventative and primary care [don’t] just increase patient well-being, [they] also cost our economy less in things like unnecessary emergency room visits, and increase our overall productivity because people are at work, instead of out sick or in the emergency room.

HM: Can you tell me the story of one mom who has inspired you to keep fighting for affordable, accessible, high-quality health care? 

JS: There are so many — it’s hard to pick just one. Here are a few moms who come to mind:

Nansie from Concord, New Hampshire, told me that the Affordable Care Act saved her son’s life by helping provide access to treatment and recovery programs following his substance misuse. 

Deodonne, who is also from Concord, told me that the Affordable Care Act helped her find quality coverage for her son Bodhi, who has Spinal Muscular Atrophy, a degenerative neuromuscular disease that causes his muscles to be very weak. 

And Jayne from Hanover, New Hampshire, told me that the Affordable Care Act’s ban on discrimination against those with preexisting conditions helped her find more affordable health coverage for her son, who has hemophilia. 

HM: Why is protecting Medicaid a priority for families?

JS: Medicaid is crucial to Granite State families and millions more across the United States, who, before the Affordable Care Act, didn’t have health care coverage. The Medicaid expansion under the ACA helped nearly 50,000 New Hampshire residents find affordable insurance plans. Like I mentioned earlier, this is particularly important to our state, which is grappling with the opioid epidemic. Thanks to the ACA, 11,000 individuals living with substance use disorders have been able to seek treatment for the first time. We cannot pull the rug out from families who rely on Medicaid for this necessary care.

CHIP has yet to be extended — and as you know, this program benefits not only 9 million children, but many pregnant women.  Why would Congress allow it to expire when children’s lives depend on it?

JS: There’s bipartisan support for reauthorizing CHIP, but it’s being held hostage by extreme voices within the Republican party. Now, sadly, CHIP programs around the country are already preparing to wind down their services for children due to the uncertainty this has created. It’s needless and shameful. I’m urging a resolution here so that we can avert a disaster. It’s unconscionable that children’s health care would be the victim of partisan politics in Congress.

HM: What’s the most important thing you want your constituents to know about open enrollment? 

JS: You can sign up right now! You can do that by going to www.healthcare.gov/get-coverage. The enrollment period runs through December 15, which is approaching quickly. The Trump administration doesn’t want you to know about open enrollment — they’ve cut advertising and cut the open enrollment period in half. That’s why it’s up to us to get the word out.

HM: Finish this sentence (please:): Health care should be…

JS: ...affordable and accessible for every American family.

HM: Why do you think moms and families are not prioritized when it comes to budget priorities, at least not lately?

JS: That’s a really good question, and I feel like I’ve been trying to get to the bottom of that for a long time.  I think that in years past, our society frowned upon women speaking up and asking to be part of the conversation.  We see this in the percentage of women versus men CEOs, the gender wage gap, the family medical leave debate, the number of women pursuing STEM careers and so forth. I do think that this is changing because women like you and me, like my other Senate and House female Members of Congress, and an awful lot of your readers are speaking up and speaking out against policies that are harmful to women.  I have always encouraged women to stand up for what they believe in, and I think that it is our job to advocate for priorities that help build success for women and our families.

HM: I have one grandson and [he’s] the best thing that ever happened to me. What’s your favorite part about being a grandmother? 

JS: I love watching my grandchildren grow up and seeing what inspires them. My grandchildren are all different ages and have different interests, and I enjoy witnessing their personal growth and getting to share experiences with them.  One of my grandchildren just left for a humanitarian trip, another just started college and is studying drama…I could go on and on; I am their grandmother, after all! But it is such a privilege to share their interests with them, and watch them as they learn new skills and contribute to their communities in New Hampshire and around the world.