Where the 2020 Democratic candidates stand on women’s health issues

(WASHINGTON) — Women voters will play a crucial role in the 2020 presidential election.

Women make up about 60 percent of Democratic primary voters and typically turn out at higher rates than men, according to FiveThirtyEight.com. And for the first time in modern history, there are two female candidates on the Democratic primary ballot for president.

To date, top women’s health issues, from abortion to maternal mortality, have not received much attention in the Democratic presidential debates. That is due, in part, to large similarities and policy proposals among the candidates.

“Despite the exclusion of reproductive health from the debates, we have seen unprecedented interest among candidates to prioritize these issues,” Alexis McGill Johnson, acting president and CEO of the Planned Parenthood Action Fund, told ABC News’ Good Morning America, adding that when it comes to women’s health issues, “everything is on the line this year.”

The 2020 Democratic candidates are all campaigning on protecting safe and legal access to abortion services, expanding reproductive health care and education and reinforcing the Affordable Care Act, which made birth control free for most women and prohibited insurance companies from gender discrimination and denying coverage based on pre-existing conditions.

Still, there are some differences in the views and past votes of the five highest-profile candidates — Sen. Bernie Sanders, former New York City Mayor Mike Bloomberg, former Vice President Joe Biden, Sen. Amy Klobuchar and Sen. Elizabeth Warren.

Here is where they stand on four women’s health issues:

1. Maternal mortality

The U.S. has the worst maternal mortality rate among developed countries and the only one where the rate has been rising, according to a 2017 investigation by ProPublica and NPR.

Sen. Elizabeth Warren: Warren often discusses the racial disparity in maternal mortality rates on the campaign trail, highlighting data that shows black women are more likely than white women to die from pregnancy or childbirth-related causes.

Warren’s plan would have health care systems set one price for the care a pregnant woman needs and then be held “accountable for the outcome,” according to her campaign website.

Sen. Amy Klobuchar: Klobuchar also talks about the racial disparity on the campaign trail and proposes a new law that would address the shortage of nurses, midwives and obstetricians in “underserved areas.” Klobuchar also plans to “develop best models of care to address racial disparities,” according to her campaign website. The mom of a now-adult daughter says she fought to pass a law guaranteeing moms and babies a 48-hour hospital stay after she was forced to leave the hospital 24 hours after giving birth.

Sen. Bernie Sanders: Sanders points to increasing access to health care through his Medicare for All plan as a way to decrease the rate of maternal mortality. On the campaign trail, Sanders will often mention health disparities, including maternal mortality.

“We do not have enough black, doctors, we do not have enough black psychiatrists, psychologists, nurses,” he said at the Iowa Brown & Black Presidential Forum in January. “Under Medicare for All, what we will do is make sure that people can go to medical school and practice the kind of medicine that needs to be practiced without going deeply into debt.”

Joe Biden: Biden plans to take nationwide a strategy that was successful in California to decrease rates of maternal mortality, according to his campaign website.

California created the California Maternal Quality Care Collaborative (CMQCC) in 2006. The collaborative is a “multi-stakeholder organization” that “uses research, quality improvement toolkits, state-wide outreach collaboratives” and a “Maternal Data Center to improve health outcomes,” according to the CMQCC website.

Mike Bloomberg: The former mayor plans to require doctors to undergo bias training, centralize data collection at the Centers for Disease Control and Prevention and bring more doctors to rural areas, according to his website.

2. Access to contraceptive services

Sixty percent of all women of reproductive age are currently using a contraceptive method, according to data shared by the Guttmacher Institute, a reproductive rights research group.

Sen. Elizabeth Warren: Warren, who supports a Medicare for All program, says as president she will “guarantee reproductive health coverage as part of all health coverage.” She notes the U.S. should “ensure that all future health coverage — including Medicare for All — includes contraception and abortion coverage,” according to her website. She is also a co-sponsor in the Senate of the Affordability is Access Act (AAA) that would expand access to birth control, including requiring insurance plans to cover FDA-approved over-the-counter contraceptives, even without a prescription.

Sen. Amy Klobuchar: Klobuchar does not address coverage for contraceptive services specifically on her campaign website. She has called for Planned Parenthood to be fully funded and, like Warren, is a Senate co-sponsor of the Affordability is Access Act. Klobuchar supports a universal health care option that would allow people to buy health insurance coverage through Medicare or Medicaid.

Sen. Bernie Sanders:
Sanders’ proposed Medicare for All program would include coverage of reproductive care, according to his website. He also says he will “fully fund Planned Parenthood, Title X, and other initiatives that protect women’s health, access to contraception, and the availability of a safe and legal abortion.” Sanders is also a co-sponsor of the Affordability is Access Act.

Joe Biden: Biden says his proposed public health insurance option will cover contraception. He plans to protect and build on the Affordable Care Act, which passed while he was vice president and ensures free birth control access for most women.

Mike Bloomberg: Bloomberg says he will “encourage states” to allow the prescription of birth control through telemedicine. He also plans to limit “religious and moral exemptions in the Affordable Care Act for companies that do not wish to provide insurance coverage for contraceptives in employee health plans,” according to his website. Bloomberg’s proposed health plan would be run by the federal government but paid for by customer premiums.

3. Abortion

More than 250 abortion restrictions were introduced in states across the U.S. during the 2018-2019 legislative session.

Sen. Elizabeth Warren: Warren plans to pass legislation that would protect women’s reproductive rights and repeal the Hyde Amendment, which bans federal funding for abortion except in cases of rape, incest or to save a woman’s life. The law primarily affects women who are on Medicaid, meaning low-income patients have to pay for an abortion out-of-pocket.

Warren is also a cosponsor of the Equal Access to Abortion Coverage in Health Insurance (EACH) Woman Act, which would ban abortion restrictions in private insurance. She stated at a debate last November that “protecting the right of a woman to be able to make decisions about her own body is fundamentally what we do and what we stand for as a Democratic Party.”

Sen. Amy Klobuchar: Klobuchar also plans to “fight for legislation that codifies Roe V. Wade,” according to her website. She will also in her first 100 days reverse the Trump Administration’s 2019 decision to ban grantees of the Title X family planning program, including Planned Parenthood, from referring or providing patients for abortion except in cases of medical emergency, rape or incest.

Klobuchar, also a co-sponsor of the EACH Woman Act, had to defend her pro-choice record earlier this year when Fox News published audio from 2006 of her saying “we need to talk about reducing the number of abortions and making them safe, but making them rare.” The senator told ABC’s The View last month that she “is strongly pro-choice” but believes other views can exist in the Democratic Party saying, in part, “I believe we’re a big tent party and there are pro-life Democrats and they are part of our party and I think we need to build a big tent.”

Sen. Bernie Sanders: Sanders would as president appoint federal judges who would uphold women’s right to choose and “repeal the Hyde Amendment and fully fund Planned Parenthood, Title X, and other initiatives that protect women’s health, access to contraception, and the availability of a safe and legal abortion,” according to his website.

Joe Biden: Biden’s plan includes codifying Roe v. Wade and stopping state laws that violate a woman’s right to choose. He also says he will restore federal funding for Planned Parenthood and restore U.S. federal funding to global health efforts by organizations that offer information on abortion services, according to his website.

Biden now supports repealing the Hyde Amendment, a reversal in position that came last June after he received some backlash for initially reiterating his support for the measure.

Mike Bloomberg: In addition to working on federal and state laws to protect women’s right to an abortion, Bloomberg’s plan includes increasing access to reproductive services by working with states to “expand the types of medical professionals permitted to perform them,” according to his website. Bloomberg also says he will “empower the FDA to make decisions based on science, including by reviewing its current guidelines for mifepristone,” a drug used to terminate a pregnancy.

4. Mental health

Women are almost twice as likely as men to have symptoms of depression, according to data shared by the U.S. Office on Women’s Health.

Sen. Elizabeth Warren: Warren’s plan focuses on prioritizing “affordable, high-quality mental health services,” according to her website. Last year she introduced the Behavioral Health Coverage Transparency Act that Warren describes as holding “insurers accountable for providing adequate mental health benefits.”

Sen. Amy Klobuchar: Mental health is included in Klobuchar’s plan for her first 100 days as president. Klobuchar says she wants to prioritize mental health by “launching new prevention and early intervention initiatives, expanding access to treatment, enforcing mental health parity laws” and “addressing workforce shortages for nurses, psychiatrists and other mental health professionals in many areas of the country.” She also plans to “launch a nationwide suicide prevention and mental health awareness campaign.”

Sen. Bernie Sanders: Sanders’ Medicare for All plan notes that Medicare coverage will be expanded to include mental health treatment.

Joe Biden: Biden plans to “redouble” efforts to expand funding for mental health services and work to make sure mental health parity laws that ensure equal coverage for mental health conditions are enforced, according to his website.

Mike Bloomberg: Bloomberg plans to require insurance coverage for mental health care by enforcing federal laws “mandating insurance coverage for mental health and substance abuse disorders,” according to his website.

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