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2020 Election: Women's Health is On the Ballot
2020 is an election year, and women’s health is on the ballot. Engaging in the electoral process is one of the most critical ways to impact the health care your community receives, ensure your elected representatives work to support your practices and your patients, and hold politicians accountable to evidence-based policies.
Election Day is Tuesday, November 3, 2020, which is right around the corner! The stakes just keep getting higher for our specialty and our patients. That’s why ACOG is leading the charge to ensure that the voices of the ob-gyn community are heard at the polls this year and that all of our members are inspired, informed, and ready to Get Out the Vote!
In the coming weeks, we will continue to add voter information, social media content, physician stories, and more to help you make a voting plan, choose the candidates you support, and spread the word about the importance of voting. Check back regularly for new information and resources, and keep an eye on our social media channels for real-time updates.
What is at Stake: ACOG's Policy Priorities
These profiles will help you evaluate where the candidates on YOUR ballot stand on issues that are most important to you.
Each issue features an overview of ACOG’s position and questions to ask as you research a candidate’s track record and platform. One place to start is a candidate’s campaign site, but you’ll want to also look for op-eds they’ve published, media statements they’ve made, and social media posts weighing in on topical issues; if they’re elected officials, check out positions they’ve taken on key issues in the past. You can also directly ask candidates questions by checking if they will be holding virtual town halls or other interactive opportunities. Email, Twitter, and Facebook are other ways to start a dialogue with candidates!
This list is far from comprehensive! ACOG works daily on a wide breadth of issues of importance to ob-gyns and our patients. The topics profiled here are ones ACOG has identified as high-profile and consequential in the coming election, but we know there are many issues our members are passionate about that impact public health, women’s health, and obstetrician-gynecologists’ practices. If your issue is not on this list, check out our advocacy page for a broader menu of ACOG’s advocacy priorities, and let us know what issues you advocate for that affect your patients and your practices.
ACOG’s Policy Priorities
The U.S. is the only well-resourced country in the world with a rising maternal mortality rate, with Black and American Indian/Alaska Native women disproportionately dying from pregnancy-related complications. ACOG supports evidence-based policies to end preventable maternal deaths and eliminate racial inequities in maternal health. These policies include extending pregnancy-related Medicaid coverage to one year postpartum, investing in the Alliance for Innovation on Maternal Health and other quality improvement initiatives, implementing implicit bias and racism training for health care professionals, and improving access to maternity care in rural areas.
Does the candidate:
- Support policies to ensure women who rely on pregnancy-related Medicaid have access to comprehensive insurance coverage through one year postpartum?
- Support investment in infrastructure for thorough reviews and analyses of maternal deaths, as well as state-based evidence-based quality improvement programs?
- Support enhancing programs proven to address the social determinants of health and improve maternal health outcomes including safety net programs such as nutrition assistance and home-visiting programs?
- Support investment in obstetric training and education that includes elevating and addressing the needs of communities of color and underserved communities?
- Support investment in research specific to obstetrics and gynecology, including related to the unique treatment needs of pregnant and lactating women and the effects of the COVID-19 pandemic on pregnancy?
Racism in overt and covert forms persists in the delivery of health care and throughout our society. Black women and American Indian and Alaska Native women are two to three times more likely to die from pregnancy-related complications than white women. Black and Latinx populations experience higher rates of mortality from cervical cancer than white populations. ACOG is committed to eliminating inequities and to confronting implicit bias and racism. This means addressing the way in which health care systems perpetuate inequality as well as advocating for systemic change at every level of policymaking to address societal inequities that impact health outcomes.
Does the candidate:
- Recognize that structural racism permeates society and incorporate an equity lens in their policy platforms?
- Recognize racism as a public health crisis and support policies to address the social determinants of health, including access to health care, educational attainment, healthy foods, and transportation?
- Support policies that elevate the voices, perspectives, and needs of communities of color and communities already experiencing structural, societal, economic, and health inequities—including racism and gender oppression?
- Support policies to ensure that all Americans can vote?
To ensure patients have continued access to quality care, their physicians must be reimbursed fairly and equitably. COVID-19 has severely burdened our health care system, contributing to already concerning physician shortages, and causing significant financial strain for obstetrician-gynecologists. ACOG is committed to protecting access to women’s health services by ensuring obstetrician-gynecologists are reimbursed equitably and sustainably.
Does the candidate:
- Support direct financial support for physicians serving patients amid the COVID-19 pandemic, including through grants, interest-free loans, and other mechanisms?
- Support legislation that would hold health care professionals harmless and prevent payment cuts to gynecologic services associated with the finalized E/M code policies?
- Support legislation to address surprise medical billing that holds patients harmless, secures an equal playing field for physicians and insurers, and ensures the financial sustainability of physician practices?
- Policy Brief: Payment for Office Visits, Obstetric Care, and Surgical Services in 2021
- Payment Resources
- Equitable Payment Rates for Maternity and Surgical Care
An ineffective, costly, and – at times – unjust landscape in the U.S. tort system has had negative impacts on obstetrician-gynecologists, including increased stress and burden on physicians. The medical liability crises threaten access to prenatal and delivery services and create disincentives for physicians to deliver babies and medical students to go into ob-gyn. ACOG advocates for medical liability reform that ensures patient protections while supporting the financial health of obstetrician-gynecologists.
Does the candidate:
- Support meaningful reforms that help lower and stabilize professional liability costs, restore and protect access to needed care for women, families and communities, make medical care safer, and improve the process for dealing with medical errors?
- Support COVID-19 response legislation to provide limited and targeted liability protections to health professionals and facilities for care provided in good faith during the public health emergency?
The Affordable Care Act (ACA) established landmark protections for women, significantly improved access to essential health services for millions of people, and helped drive the rate of uninsured individuals to historic lows. It guaranteed women coverage of preventive services without cost-sharing, including well-woman visits, contraception, and coverage for maternity care. Policy changes to our nation’s health care system must never compromise or reduce these health insurance guarantees and protections.
Does the candidate:
- Oppose efforts to repeal the ACA?
- Support safeguarding and strengthening the ACA’s patient protections, including prohibiting health plans from denying coverage based on preexisting conditions, establishing annual and lifetime caps, and charging higher premiums based on gender?
- Support ensuring that all health plans are required to provide coverage for evidence-based, essential benefits including maternity care and preventive services at no out-of-pocket cost to insured individuals, including contraception and other women’s preventive services?
- Support efforts to expand Medicaid to childless adults as permitted under the ACA?
- Patient Coverage Protections
- Joint Recommendations on Priorities for Coverage, Benefits and Consumer Protections
- Four Leading Medical Organizations Urge Congress to Protect Patients’ Access to Health Care
Medicaid is a jointly-financed state-federal health insurance program for low-income individuals, including pregnant women, individuals with disabilities, and individuals in nursing homes. More than 73 million people in the U.S. are covered by the Medicaid program. Medicaid is the largest single payer of maternity care in the U.S., covering more than 43% of U.S. births. ACOG advocates for a strong and robust Medicaid program that provides meaningful coverage without barriers.
Does the candidate:
- Support strengthening the Medicaid program and ensuring meaningful coverage is accessible to low-income women?
- Oppose state and federal reforms aimed at reducing participation in the Medicaid program and erecting unnecessary barriers to care?
- Support appropriate and equitable reimbursement for physicians who serve patients enrolled in the Medicaid program?
- Support extending pregnancy-related Medicaid coverage to one year postpartum?
- Oppose efforts to limit access to qualified women’s health care providers in the Medicaid program?
Abortion is an integral component of health care. State and federal elected officials can serve a valuable role in making health policy when its purpose is to improve patient health and advance medical and scientific progress; however, abortion is increasingly out of reach because of mounting government-imposed restrictions targeting women, physicians, and other clinicians who provide care to women. ACOG advocates to ensure the availability of equitable and accessible abortion services free from harmful restrictions and interference in the patient-clinician relationship.
Does the Candidate oppose policies that:
- Criminalize or otherwise penalize physicians for providing evidence-based, compassionate reproductive health care?
- Ban abortion based on arbitrary gestational ages or based on a woman’s reason for seeking care?
- Hold abortion facilities, providers, and care to medically unjustified regulatory standards that do not improve safety, including unnecessary structural requirements for facilities, admitting privileges and transfer agreement mandates, and requirements that clinicians be physically present to administer medication abortion?
- Compromise the informed consent process, such as mandates to give patients inaccurate or biased information, and limits on comprehensive, non-directive referrals?
- Require unnecessary procedures and tests or ban evidence-based options and procedures?
- Erect unnecessary and burdensome obstacles to patients’ access to care?
Does the Candidate support policies that:
- Support the right to abortion without unjustified regulation or discriminatory barriers?
- Lift limitations on funding for abortion services and training, such as the federal Hyde amendment and other federal and state restrictions on public and private insurance coverage of abortion?
- Allow appropriately trained and credentialed advanced practice clinicians to provide abortion care?
- Ensure young women can access confidential care?
- Abortion Access
- Abortion Policy
- Increasing Access to Abortion
- Colorado voters: Abortion Access is on the Ballot. Vote No on Proposition 115
OverviewAccess to comprehensive family planning is an integral component of women’s health care. ACOG advocates for unhindered, equitable, and affordable access to all FDA-approved contraceptives.Does the candidate support policies that:
- Preserve the contraceptive coverage guarantee under the Affordable Care Act?
- Prohibit co-pays and cost-sharing for contraception, including over-the-counter contraception?
- Protect confidential, comprehensive care and referrals for low-income women and adolescents at Title X-funded and other safety net facilities?
- Ensure qualified providers, like Planned Parenthood, can participate in family planning programs such as Title X, Medicaid, and state-funded programs?
- Confer over-the-counter status for self-administered, hormonal contraceptives without barriers such as cost-sharing or age restrictions?
Leading medical organizations including ACOG endorse strong vaccination requirements and elimination of non-medical exemptions. Science supports our confidence in vaccines. Vaccines protect individuals directly and high vaccination rates protect entire communities from disease outbreaks. ACOG opposes non-medical exemptions from immunization requirements – personal, philosophical or religious – and urges ob-gyns to educate and encourage patients to get immunized.
Does the candidate:
- Support vaccines and immunization generally?
- Oppose legislation to expand exemptions?
- Support widespread distribution of vaccines and access by all individuals and communities?
- Support adequate funding for immunization and public health infrastructure including staffing of local public health departments and clinics
- Prioritize rapid COVID-19 vaccination uptake in all communities with minimal to no patient cost-sharing?
Make Your Voting Plan
Research shows that planning the logistics of voting can improve the likelihood of voting. In the middle of a pandemic, it’s especially important to start thinking through these factors early to give yourself, your election officials, and the postal service plenty of time. It sounds simple, but having a detailed plan written out can make the difference between having your vote counted or missing your chance to be heard!
To avoid large crowds during the COVID-19 pandemic, many states are making alternatives to Election-Day voting more available, and for clinicians with hectic schedules, taking advantage of these options can be especially useful.
Here are some considerations you’ll need to think through as you start making your plan to vote. Once you know the answers to these questions, write down the specific details of your plan.
First things first:
- Are you registered to vote? You can confirm your registration status at the following websites:
- Even if you think you’re registered, double check to confirm!
- When is your registration deadline? (Don’t wait! But you may want to be aware in case someone else asks.)
- Can you vote early in your state, either in person or by mail?
Mailing in your ballot or early in-person voting may be a good option for physicians with busy schedules — or for anyone looking to limit potential COVID exposure by avoiding busy polling locations on Election Day. Each state has different laws about early voting and mail-in voting. You can learn more about the options in your state by finding your state:
Voting by mail (sometimes called "absentee” voting)
- Do you need to provide a reason to vote by mail, or are all residents eligible? Your state may have broadened this option due to COVID-19.
- Do you need to request a ballot, or does your state automatically send ballots to all voters?
- Confirm the process—once your ballot comes in the mail, will you mail it back, or is there an option to drop your ballot in a secure Mail Ballot Drop Box?
- Start the process early! The US Postal Service recommends mailing your ballot at least 7 days before Election Day, and requesting your ballot at least 15 days in advance - that's a minimum! Don't cut it close!
- Follow instructions carefully! Don’t let an accidental typo invalidate your ballot!
If you do plan to vote by mail, request your ballot today! You’ll want to make sure to mail in your ballot by early- to mid-October to ensure that it arrives in time. It’s also a good idea to follow up with a call in a week or two, to make sure your ballot has been received and processed without any issues.
Voting early, in person:
- Can you vote early at a polling place?
- Where can you vote early? It may not be the same polling location you’re used to.
- Does your state have ID requirements? What are they?
- Can you vote early by dropping your ballot in a secure Mail Ballot Drop Box?
Voting in person, on Election Day:
- Does your state have ID requirements? What are they?
- Where is your polling place? Is it your usual polling place, or has your city or county opened up new options because of the COVID-19 pandemic
- When do polls open? When do they close?
- Think through logistics: What time of day will you vote? Where will you be coming from? What is your plan in case of a delay, such as a long line?
- Have you coordinated with your colleagues, your residency program, or your institution to ensure you and your colleagues have protected time?
What's on Your Ballot?
What’s on the ballot? While you’re looking up your voting options at https://www.usa.gov/election-office, you can also learn about what will be on your ballot this year. The Presidential election gets a lot of press, but even very local offices like school board can have a big impact on day to day life in your community! And while everyone will be voting on the next President, different states, counties, and cities have different governing structures and term lengths for many offices, so many of the federal, state, and local offices you’ll be voting on depend on where you live.
For example, all of the 435 seats in the U.S. House of Representatives are up for election every two years, so everyone will vote on one House seat this year. However, the 100 seats of the U.S. Senate rotate in three separate classes, so only about a third of the U.S. Senate seats are up for election every two years. Will you be voting for a U.S. Senator this year?
Your state and local elections will also depend on your jurisdiction. Are you in one of the 11 states or two territories that will be electing a Governor this year? Will you be voting on state legislators, judges, sheriffs, or commissioners? You’ll want to start thinking about all of this before you head to the polls!
We’ll keep updating this page with more information about how and why to Get Out The Vote this year. Keep an eye out for emails and social media posts as well, and please help us spread the word by forwarding, sharing, and retweeting. We can’t let this opportunity pass us by – there’s too much at stake. Women’s health is on the ballot!