Too often women are forced to choose between getting a mammogram and paying rent, birth control or groceries, taking their child to the doctor or making a car payment. Reproductive justice demands that all people have the economic means, social capital, and political power to make and exercise decisions about their own health, family, and future. Reproductive justice means no woman is forced to make such impossible decisions. Unfortunately, that is not the reality for the millions of Latinas that lack health insurance coverage. Many of these women make too little to qualify for assistance purchasing health insurance in the state marketplace but do not qualify for Medicaid, so they are left without coverage. The solution is simple: states need to expand Medicaid. 

Health Insurance and Reproductive Justice

Meaningful access to affordable health care is fundamental to reproductive justice. Without health insurance, many low-income women are unable to make decisions about their own health and the health of their families.

It is clear that lack of health coverage forces women to go without health care and leads to worse health outcomes. Approximately 59 percent of low-income women without health insurance report that cost prevented them from seeing a doctor at least once in the last 12 months, which is nearly 170 percent more than the 22 percent of low income women with health coverage who report cost as a barrier to care. When women go without care they may postpone diagnosis of a serious health problem, go without needed treatment, or incur financial losses related to missed work due to illness. Low-income uninsured women are less likely to report having had a regular check-up in the last two years than low-income women with health coverage. 

Women with higher medical needs bear a greater burden if they are unable to afford care. Latinas are more likely to be obese, have high blood pressure, diabetes, and be diagnosed with cervical or breast cancer than the general population. In addition, Latinas have a higher pregnancy rate than non-Hispanic white women and are more likely to suffer from postpartum depression. For many of these women, health insurance coverage is the only way they could afford necessary medical care.

Closing the Gap

Under the Affordable Care Act, states may use federal money to expand health care coverage through their Medicaid programs. When states refuse to expand Medicaid it results in a coverage gap. Women above the poverty level are eligible for subsidies for private health insurance available through the state marketplace, but a gap exists for women whose income falls below this level but above the level for traditional Medicaid eligibility.

Twenty states have refused to expand Medicaid, leaving many low-income women in this gap. Of the 6.3 million American adults that fall into the coverage gap, 1 in 5 are Latino. Nearly 1/3 of Hispanic adults are uninsured. Hispanic adults are uninsured at particularly high rates because they face a number of barriers to accessing coverage, including restrictions based on immigration status. However, Medicaid expansion would be a significant step in bringing these numbers down. 

Medicaid Expansion Now!

Ensuring that Latinas and their families can access quality health care is an essential step in promoting not only positive health outcomes but improving their economic security and achieving reproductive justice. This week the National Latina Institute for Reproductive Health is celebrating the 6th Annual Latina Week of Action for Reproductive Justice. Let’s use this week to demand states close the gap and expand Medicaid because the health of Latina women cannot wait.