Updated June 5, 2019.
As policymakers, advocates and health care analysts contemplate the future of the U.S. health care system, the Guttmacher Institute is evaluating how sexual and reproductive health and rights fit into future health care reform efforts.
Framework for Our Analysis
More to Be Done: Individuals’ Needs for Sexual and Reproductive Health Coverage and Care
There are a wide array of sexual and reproductive health needs that the U.S. health care system should address: contraception, abortion, maternal and newborn care, infertility, reproductive cancers, sexual or intimate partner violence, HIV/AIDS and other STIs, and additional health needs that cut across categories.
Principles for Reform: New U.S. Health Care Proposals Cannot Overlook Sexual and Reproductive Health
Key principles for addressing sexual and reproductive health needs within the U.S. health care system include: comprehensive and universal coverage; unrestricted patient access to a broad network of qualified providers; and robust patient protections against barriers to care, violations of privacy and autonomy, and discrimination.
Analysis of Specific Proposals
In the resources below, we evaluate how well individual health care reform proposals address sexual and reproductive health and rights.
President Biden's Health Insurance Plan
Proposed by President Biden during the 2020 election campaign; as of 11/13/2020
Creates a new public option for individuals purchasing coverage on the Affordable Care Act’s (ACA) health insurance marketplaces and for lower-income people in states that have not adopted the ACA’s Medicaid expansion. Read how this proposal addresses sexual and reproductive health and rights
Medicare for America Act (H.R. 2452, 116th Congress)
Sponsored by Rep. Rosa DeLauro (D-CT); as of 5/1/2019
Creates a new national health insurance program available to U.S. residents to replace many existing public and private plans, but leaves employer-sponsored private coverage as an option. Read how this proposal addresses sexual and reproductive health and rights
Choose Medicare Act (S. 1261 and H.R. 2463, 116th Congress)
Sponsored by Sen. Jeff Merkley (D-OR) and Rep. Cedric L. Richmond (D-LA); as of 5/1/2019
Creates new public health plans (known as Medicare Part E plans) that would be available as options for people buying insurance through an employer or on their own through the Affordable Care Act’s (ACA) health insurance marketplaces, with all of the ACA’s subsidies to make coverage more affordable. Read how this proposal addresses sexual and reproductive health and rights
Medicare for All Act (S. 1129, 116th Congress)
Sponsored by Sen. Bernie Sanders (I-VT); as of 4/10/2019
Creates a federally run, nationwide health insurance program (often described as a "single-payer" program) to cover all U.S. residents, replacing existing private and public health insurance programs. Read how this proposal addresses sexual and reproductive health and rights
CHOICE Act (S. 1033 and H.R. 2085, 116th Congress)
Sponsored by Sen. Sheldon Whitehouse (D-RI) and Rep. Janice Schakowsky (D-IL); as of 4/4/2019
Creates a new public option for individual and small-group plans to be sold on the Affordable Care Act’s (ACA) health insurance marketplaces, with all of the ACA’s subsidies to make coverage more affordable. Read how this proposal addresses sexual and reproductive health and rights
Medicare-X Choice Act (S. 981, 116th Congress)
Sponsored by Sen. Michael F. Bennet (D-CO); as of 4/2/2019
Creates a new public option for individual and small-group plans to be sold on the Affordable Care Act’s (ACA) health insurance marketplaces, with all of the ACA’s subsidies to make coverage more affordable. Read how this proposal addresses sexual and reproductive health and rights
Medicare for All Act (H.R. 1384, 116th Congress)
Sponsored by Rep. Pramila Jayapal (D-WA); as of 2/27/2019
Creates a federally run, nationwide health insurance program (often described as a "single-payer" program) to cover all U.S. residents, replacing existing private and public health insurance programs. Read how this proposal addresses sexual and reproductive health and rights
State Public Option Act (S. 489 and H.R. 1277, 116th Congress)
Sponsored by Sen. Brian Schatz (D-HI) and Rep. Ben Ray Lujan (D-NM); as of 2/14/2019
Allows states to offer residents of all incomes the option of buying into Medicaid, as a public option that would compete with private plans in the Affordable Care Act’s (ACA) health insurance marketplaces. Read how this proposal addresses sexual and reproductive health and rights