I AM A LOOKING TO GO

AMSA Reproductive Health Project eNews #46 – May 24, 2025

 

Is This Reproductive Justice?

House Passed Bill that Takes Health Care & SNAP Away
from Millions to Fund Tax Cuts

_____________________________

Greetings from the AMSA Repro Project!

At AMSA we uphold the Reproductive Justice Framework that includes:

the right to nurture the children we have in a safe and healthy environment.

After waking to the news Thursday morning and learning what was done in the U.S. House of Representatives in the dark of the night I was appalled and sickened. 

How can leaders in a country as wealthy as ours vote to take health care and food assistance away from people in need
in order to fund tax cuts designed to overwhelmingly benefit the richest people in our nation?

Yet, that’s just what happened. At 7amE, the “big, beautiful bill” you may have been hearing about was passed by House GOP majority vote: 215 to 214. For a start, if this bill becomes law, it will:

    And, because the bill adds $2.3 trillion to the deficit, it will trigger Medicare cuts that unless Congress takes action will curtail Medicare spending by $45 billion in 2026 and $490 billion from 2027 to 2034.

    Over 78 million people get their health care coverage through Medicaid and CHIP– Medicaid.gov

    Half of all children in the U.S. are covered by Medicaid – Childern’s Hospital Association

    42% of all births U.S. are covered by Medicaid.
    That includes 64% of all deliveries among Black women and 58% among Hispanic women. – Center for Reproductive Rights

    “The House has passed a reconciliation bill that would take health coverage away from millions of people and dramatically raise health care costs for millions more.

    Roughly 15 million people by 2034 would lose health coverage and become uninsured because of the Medicaid cuts, the bill’s failure to extend enhanced premium tax credits for Affordable Care Act (ACA) marketplace coverage, and other harmful ACA marketplace changes, according to estimates from the Congressional Budget Office (CBO). This figure could well rise to account for last-minute changes in the House that made the bill harsher.”

    -CBO estimates project that 7.6 million people would become uninsured due to Medicaid policies passed by the Energy and Commerce Committee (E&C).

    -1.8 million people would become uninsured due to codification of the Trump Administration marketplace rule provisions, which the E&C Committee also passed.

    -2.1 million people would become uninsured because of marketplace policies passed by the Ways and Means Committee.

    -An additional 4.2 million people would lose marketplace coverage because the legislation fails to extend the premium tax credit enhancements.

    Link to Learn More – Center on Budget and Policy Priorities

    Number of Rural Hospitals in Each State at “Immediate Risk of Closure”

    “The Center for Healthcare Quality and Payment Reform has identified over 300 rural hospitals at “immediate risk” of closure”
    Click to Learn More & Explore this Map  – Newsweek, May 14, 2025

     

    Work Requirements = Paperwork Barriers to Care for People in Need

    “Medicaid work requirements, under consideration as part of the House Republicans‘ budget to cut federal spending, are “impossible” to navigate for those using the program, experts said.”

    Newsweek, May 22, 2025

    Harsh Work Requirements in House Republican Bill Would Take Away Medicaid Coverage From Millions:
    State and Congressional District Estimates – Center on Budget & Policy Priorities –
    Link

    Learn More:

    • He Became the Face of Georgia’s Medicaid Work Requirement. Now He’s Fed Up With It. A 54-year-old mechanic called Pathways to Coverage a “great program” at the governor’s press conference. But after getting kicked off the health insurance program for low-income Georgians twice, bureaucratic red tape has him at his wit’s end. ProPublica – Link
    • Implementing Work Requirements on a National Scale: What We Know from State Waiver Experience, KFF – Link
    • FACT SHEET: Medicaid Work Reporting Requirements Bureaucratic Burdens as a ‘Solution in Search of a Problem’, Families USA – Link

    Medicaid Has Many State Names

    Scroll Down to Find Out What Medicaid is Called in YOUR State

    Our thanks to Wendell Potter & Joey Rettino at Health Care un-covered for compiling & sharing this list – Learn more here

     

    Alabama: Alabama Medicaid (no rebrand)

    Alaska: DenaliCare (formerly Alaska Medicaid)

    Arizona: Arizona Health Care Cost Containment System (AHCCCS)

    Arkansas: Arkansas Medicaid (no rebrand; “Arkansas Works” was used for expansion but is no longer active)

    California: Medi-Cal (distinct state branding)

    Colorado: Health First Colorado (distinct state branding)

    Connecticut: HUSKY Health (HUSKY A, B, C, and D are Medicaid/CHIP programs)

    Delaware: Delaware Medicaid (no rebrand)

    Florida: Florida Medicaid (no major rebrand, but the program, administered by private insurers, is called the “Florida Medicaid Managed Medical Assistance Program”)

    Georgia: Georgia Medicaid (managed care program branded as “Georgia Families”)

    Hawaii: Med-QUEST (distinct state branding)

    Idaho: Idaho Medicaid (no rebrand)

    Illinois: Illinois Medicaid (managed care program called “HealthChoice Illinois”)

    Indiana: Hoosier Healthwise (for children and pregnant women) and Healthy Indiana Plan (HIP) (for adults)

    Iowa: IA Health Link (managed care program branding)

    Kansas: KanCare (distinct state branding)

    Kentucky: Kentucky Medicaid (managed care; an attempt was made to rebrand it as “Kentucky HEALTH” but it was blocked)

    Louisiana: Healthy Louisiana (distinct managed care branding)

    Maine: MaineCare (distinct state branding)

    Maryland: Maryland Medicaid (managed care program called “HealthChoice”)

    Massachusetts: MassHealth (distinct state branding)

    Michigan: Michigan Medicaid (expansion population covered under “Healthy Michigan Plan”)

    Minnesota: Medical Assistance (MA) (official term; no separate brand)

    Mississippi: Mississippi Medicaid (no rebrand)

    Missouri: MO HealthNet (distinct state branding)

    Montana: Montana Medicaid (no rebrand; Medicaid expansion called “HELP Plan”)

    Nebraska: Nebraska Medicaid (managed care program called “Heritage Health”)

    Nevada: Nevada Medicaid (no major rebrand; CHIP is called “Nevada Check Up”)

    New Hampshire: New Hampshire Medicaid (expansion population previously under “NH Health Protection Program”)

    New Jersey: NJ FamilyCare (distinct state branding)

    New Mexico: Centennial Care (distinct state branding)

    New York: New York State Medicaid (managed care under “Mainstream Medicaid Managed Care”)

    North Carolina: NC Medicaid (managed care launched as “NC Medicaid Managed Care” in 2021)

    North Dakota: North Dakota Medicaid (no rebrand)

    Ohio: Ohio Medicaid (no rebrand)

    Oklahoma: SoonerCare (distinct state branding)

    Oregon: Oregon Health Plan (OHP) (distinct state branding)

    Pennsylvania: Pennsylvania Medicaid (managed care program called “HealthChoices”)

    Rhode Island: Rhode Island Medicaid (expansion populations also branded under “Rhody Health Partners”)

    South Carolina: Healthy Connections (distinct state branding)

    South Dakota: South Dakota Medicaid (no rebrand)

    Tennessee: TennCare (distinct state branding)

    Texas: Texas Medicaid (no rebrand, but widespread managed care through various private plans)

    Utah: Utah Medicaid (expansion branded temporarily as “Medicaid Expansion” or limited benefits under “Primary Care Network (PCN)”)

    Vermont: Green Mountain Care (umbrella branding for Medicaid and other health programs)

    Virginia: Virginia Medicaid (managed care for certain populations branded under “Commonwealth Coordinated Care Plus”)

    Washington: Apple Health (distinct state branding)

    West Virginia: West Virginia Medicaid (no rebrand)

    Wisconsin: Wisconsin Medicaid (expansion program called “BadgerCare Plus”)

    Wyoming: Wyoming Medicaid (no rebrand)

    Medicaid & CHIP Coverage by Congressional District – Center for American Progress 

    Click the map to learn how many people in YOUR Congressional district get their health care coverage through Medicaid or CHIP 

    States Rely on Medicaid for Nursing Home Care

    “Nursing homes across the country rely heavily on Medicaid, with the safety net program covering more than 6 in 10 residents in 18 states,
    according to an analysis of federal data by Assisted Living Magazine shared exclusively with Axios.”

    Learn More – AXIOS – 042925

    The final vote count on the One Big Beautiful Act was 215 to 214

    To find out if YOUR U.S. House Rep. voted YEA or NAY on the One Big Beautiful Act – click HERE
    *Votes are recorded by Representative last names 

    Don’t yet know your Reps last name? – To learn who represents YOUR congressional district – click HERE

    SPOTLIGHT ON AMSA REPRO at FP4Change2025!

    Written by Jeff Koetje, MD, AMSA Reproductive Health Programming Strategist & Aliye Runyan, MD, AMSA Reproductive Health Strategist


    One month ago, several hundred future physicians gathered in Washington, DC. for the 75th AMSA annual convention, Future Physicians for Change 2025. For this Spotlight article, we (Drs. Runyan and Koetje) will offer some reflections on the convention, focusing on the repro-related programming, sponsored and organized by the AMSA Reproductive Health Project. If you were in attendance at the convention and participated in some or all of the repro programming, we hope that this will be a pleasant stroll down memory lane; if you were not able to join us this year, we hope you’ll join us at the next AMSA national convention and experience it for yourself! 

    First, a quick overview of the repro-related programming at FP4C2025: two break-out sessions, two clinical skills workshops (MVA and IUD Insertion), and a keynote address given by none other than Renee Bracey Sherman, founder of We Testify. Our first panel discussion took up the topic of what it’s like to be an abortion provider in this present moment, and featured Drs. Aliye Runyan, Kristyn Brandi, and Avanthi Jayaweera. The second breakout session featured these same three abortion providers in a discussion about what it means, and what it can look like, for practicing physicians and future physicians to “get into good trouble” for the cause of justice.

    The discussions across these two breakout sessions are exactly the sort of discussions we need more of in medicine,
    precisely because evidence-based medical practices

    – starting with abortion care, family planning, and trans-affirming healthcare –
    are in the crosshairs of our increasingly authoritarian and fascist state and federal governments. 

    Unlike most other physicians, abortion providers have been forced to contend with threatened and actual violence for decades, and have borne the brunt of government intrusion into the clinical delivery of evidence-based care, a violation of professional autonomy the likes of which would hardly be tolerated in any other learned profession. 

    We are a profession of rules-followers (we’ve been trained to be), and our profession is dangerously close – and inching closer – to passive and active compliance with authoritarian laws that actually cause us to violate our professional ethics of care and principled commitments to academic integrity and freedom. Medical schools are largely ignoring or refusing to address the sociopolitical crisis that is past the threshold and has forced its way into the House of Medicine. And those with significant power and/or influence within the profession are largely silent, with few exceptions. Drs. Alice T. Chen and Vivek Murthy (former US Surgeon General), recently penned this compelling call for physician moral leadership, The Power of Physicians in Dangerous Times and there is this growing list of academic institutions, associations, and organizations which have signed onto a public statement regarding academic and intellectual freedom put out by the American Association of Colleges and Universities (AAC&U). While there are over 650 academic institutions, associations, and organizations which have signed onto this public statement, a close look reveals that just four medical schools have signed onto the statement. And you will not find the national associations representing this country’s allopathic and osteopathic medical schools – AAMC and AACOM, respectively – on this list, even though you will see that the American Dental Education Association (ADEA) has added their name to this list. This leaves current medical students with little to no evidence  of a profession capable of organizing itself in order to resist and refuse compliance and complicity with the inhuman violence of fascist State power. Institutional and academic medicine is thus far failing to meet this moment with the moral clarity that is essential. In the absence of clear, direct, and responsive moral leadership from the current power-holders in academic and institutional medicine, the AMSA Repro Project seeks to platform physicians, advocates, and activists who actually model a principled stand for bodily autonomy, reproductive freedom, and collective liberation.

    Which brings us to Renee Bracey Sherman and her keynote address, titled, “Liberating Abortion: Building the Reproductive Future We Deserve,” based on her recently published, co-authored book, Liberating Abortion: Claiming Our History, Sharing Our Stories, and Building the Reproductive Future We Deserve. I highly recommend you get yourself a copy and read it! As we mentioned above, Renee is the founder and co-executive director of We Testify, which employs the power of people who have had abortions and their abortion stories to transform the way we talk and think about abortion. 

    On the one hand, her work and the work of We Testify addresses the origins of abortion stigma, anti-abortion policy, and the social context of white supremacy, anti-Black racism, patriarchy, and misogyny within which abortions, those who have them, and those who provide them are demonized. On the other hand, Renee Bracey Sherman unapologetically calls for – demands – nothing less than the liberation of abortion: a full release of abortion from the social, cultural, and political constraints imposed by this society. 

    Powerfully and compellingly, Renee connected abortion liberation with a key concept that we within medicine need to be engaging with much more than we currently are: abolitionism. At one point in her keynote, which was in the form of a “fireside chat” (moderated brilliantly by Joy Udoh, DO, AMSA Repro Project Fellow), Renee said, “Oh, and yes: fuck the police,” to which the students responded with snaps, claps, and the energized rustling of an audience that wasn’t expecting to hear something like that. There’s no mistaking the face-value of that statement, but there’s something much deeper in the point she was making: abortion criminalization is a tactic of a carceral state. (A carceral state is a system of formal institutions and informal processes that place vulnerable and marginalized populations under surveillance, criminalization, control, and confinement. It relies on incarceration of a large number of citizens, often accompanied by other methods of criminal justice control. The United States is a carceral state.) 

    Renee argues that abortion liberation demands the abolition of every formal and informal system and process of a carceral state that denies and violates people’s universal and inalienable human rights to bodily autonomy / body sovereignty, not least of which are the right to have children and the right to not have children. Her moral call to us, an audience of future physicians, is to deeply interrogate how the profession of medicine frequently gets deputized by a carceral state to serve as an administrative arm of that carceral state power, and how frequently we within medicine are willing and even eager to serve in that capacity. When doctors play the role of cops, we violate the trust and safety of people seeking medical care: we cause harm in violation of our first stated ethical principle. And in so many instances, physicians play the role of cops over pregnant people and people who seek abortion care.

    Abolitionism often gets misrepresented as just a desire to “burn everything down.” It is not that. It is, actually, a call to moral imagination: given the horrors of a carceral state, let’s imagine – and get to work on creating – a new, better, safer society in which everyone has what they need in order to flourish and thrive. A differently constructed world within which all people are liberated from oppressive forces of social control and coercion. Renee’s point: when abortion is liberated, we will find that we have created the material conditions for our own collective liberation. 

    Stay Tuned – Our next Spotlight will feature abortion care and reproductive health related posters presented at FP4Chang2025!

    Action Tools & Resources


    AMSA Gender Justice & Healing in Medicine Retreat

    In-person Aug 7-10
    Register HERE

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    Explore Past Issues

     

    Research, Recordings, Opportunities


    • Countering Misinformation About Abortion: The Role of Health Sciences Librarians
      American Journal of Public Health  – Link
    • Reducing the Prevalence and Impacts of Abortion Care Deserts, Pregnancy Care Deserts, Broadband Internet Deserts, and Food Deserts in the United States, National Women’s Law Center – Link
      Deeper Dives:
      Read the full report HERE and policy brief HERE
    • Federally Qualified Health Centers Could Not Readily Replace Planned Parenthood
      Guttmacher Institute – Link
      Deeper Dives: Fact Sheet – Publicly Supported Family Planning Services in the United States – Link
      Report – Publicly Supported Family Planning Services in the United States: Likely Need, Availability and Use, 2020 – Link
    • “A Big, Ugly, Destructive, Deadly Bill”: Bishop William Barber Slams Bill Cutting Medicaid, Medicare – Democracy Now – Link
    • The Power of Physicians in Dangerous Times: Interview with Alice Chen on responding to the U.S. administration’s threats to health and physicians’ values and maintaining hope in difficult times. NEJM – Link
    • RePROs Fight Back: 50-State Report Card Highlights WebinarLink
      • Deeper Dive: Explore YOUR State Report Card – Link
    • June 2 Online @ 2-3pmE – Abusive Preemption & Reproductive Justice: What You Need to Know, National Institute for Reproductive Health – Link
      • Deeper Dive: Still Moving Towards Reproductive Freedom: A Policy Blueprint for States – Link
    • June 9 Online & In-person 1-5pmE – How Research on Abortion Bans Can Inform Public Health Policy Symposium, co-sponsored by Hopkins Population Center, Population Reference Bureau (PRB), William H. Gates Sr. Institute for Population and Reproductive Health (WHGI), and the State Innovation Exchange’s Reproductive Freedom Leadership Council – Link
    • Aug 6-8 Fully Virtual – Building a Brighter Future: Advancing Reproductive Health for All, National Reproductive Health Conference – Link