Everyone's Talking About Stupak, But What About the Health Care Bill's More Insidious Features?

The current bill involves some quietly coercive (and racist) provisions that no one wants to mention.

The Stupak amendment isn’t the only troubling intrusion into reproductive rights in the House version of the health care reform bill -- low-income women are also facing attempts at fertility control from the federal government. The bill requires that Medicaid recipients who are having their first baby or who have a child under the age of two be visited at home by nurses in order to advance certain reproductive and family goals. Sounds like a good thing, right? New parents could use some help, and a nurse should be able to give them decent tips. These kinds of visits happen all the time in countries like France and England. I’m pretty sure a similar visit was recordered in Michael Moore’s Sicko. It’s about time that we gave new parents the support that they need.

Except this program isn’t about support. It’s about the same old social engineering wherein a particular class of people is deemed unfit to reproduce, and the folks in charge go to great lengths to either force or coerce the less powerful class out of making babies. The goals of this program include "increasing birth intervals between pregnancies," "reducing maternal and child involvement in the criminal justice system," "increasing economic self-sufficiency," and "reducing dependence on public assistance."

I will just let Dorothy Roberts and Gwendolyn Mink explain why this is a problem:

These goals of the home visitation program have nothing to do with providing health care. Instead, they are based on the false premise that poor mothers’ childbearing is to blame for social problems. The proposed visitation program is eugenicist, deceptive, discriminatory against low-income women, and utterly inappropriate to the medical work of nurses.

Under the program envisioned in the House bill, government-sponsored medical professionals are charged with exhorting fertility control among poor women, based on the mistaken premise that reproduction among the poor leads to crime, neglect, low educational attainment, and dependency. Yet according to the government’s own statistics, families receiving welfare have, on average, only 1.8 children; half the families receiving welfare have only one child, and only one in ten have more than three children.

Although the data show that poverty is not correlated with family size — and that childbearing does not cause poverty — the U.S. House of Representatives seeks to tell low-income women who receive medical assistance how many children to have and when to have them.

If you read the actual language of the bill, it’s not all bad — but there was obviously some tinkering to pull in the lines about the criminal justice system and public assistance. I would have no problem with this bill if it were about helping women and offering resources. Parenthood is hard, and there’s an unreasonable expectation that women naturally know what to do without any sort of community support. Offering that support -- including information about childhood nutrition, reproductive health, age-appropriate punishment, intimate partner violence and school preparation -- would be wonderful. I would love to see it offered in the health care bill.

Jill Filipovic is a New York-based freelance writer and a law student at NYU. More of her writing is available online at her blog, Feministe.
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