A fresh start

Yesterday was my first day back in the classroom since spring break 2020, March 5. To say I had reservations is an understatement.  I had more anxiety about returning to the classroom during the pandemic than I remember having my first day as a newly minted Ph.D. entering the classroom at Barnard College and Columbia University 23 years ago.

And like many returning to in-person teaching, I had to embrace some changes.  Instead of sharing an office with two other adjunct faculty, I now share a lounge with other adjunct faculty.  I had to set up my laptop to connect to campus wifi and find my classroom.  Gone are the days of walking to the dining room (my home office)!

I had not expected to like teaching via Zoom, but I LOVED IT!  I liked being able to use the chat feature to have side conversations with students.  I liked having them use the using emoji 👍🏽 to signal if they understood.  I liked how they could ask me a question without their peers knowing – it really changed the classroom dynamics for shy students.  But most of all, I like how I could see all their faces at the start of class, which is harder to do in a classroom because they are spread out.

For all I will miss about Zoom, I forgot what it is like to SEE them, not just faces. As I headed to class, I met a student from last semester, Mckenna, on the steps.  We were like, Hey! How cool to see you in person!

But with the mask mandate, I worry I will have to guess when they are smiling at my corny jokes though I’ll still be able to see the eye rolls (parents know what I mean).

Each semester is a new start with a set of young people who inspire, challenge, require me to be fair and give my best.  Mary Kate Knoell was one of the students last semester.  You can read her blog on the Hyde Amendment below.

Be well,
Rhonda

In discussions over women’s reproductive health, there can be confusion between reproductive rights and reproductive justice. Reproductive rights are enforced by the legal regulations that guarantee women access to reproductive health services. Reproductive rights activists fail to address the wider range of reproductive issues women face, such as choices for healthy parenting and pregnancy termination, which reproductive justice addresses. Loretta Ross, a reproductive justice advocate, emphasizes that focusing only on abortion ignores the larger reproductive issues women face. Abortion should not be the only reproductive health option women are given, but it is one important component of reproductive justice.

Biden’s 2022 budget request calls for an end to the Hyde Amendment, which restricts federal funding for abortions, except in cases of rape, incest, or endangerment of the mother’s life. Since Medicaid does not cover the cost of an abortion, the Hyde amendment affects low-income women of reproductive age. If unable to pay for an abortion out-of-pocket, these women are denied the right to choose whether or not to have children because of their financial ability.

In the context of Indigenous American women’s health, the Hyde Amendment serves as a major barrier to their reproductive justice. Before the Hyde Amendment, Indigenous American women experienced a long history of reproductive health abuses and barriers, including sterilization in the 1970s. The Indian Health Services reported 3,406 sterilizations from 1973 to 1976, many of which had consent forms signed by women on the day they had a C-section or the day after the sterilization. The Department of Health, Education, and Welfare prohibited physicians from sterilizing women under 21 years old or those “judged mentally incompetent.” Still, many ignored this policy and performed these operations without documenting them or using consent forms that did not properly inform women of the risks. Restrictions on family planning and reproductive rights are nothing new for Indigenous American women. In the 1970s, Indigenous American women were denied the right to become mothers, and now their choice to terminate a pregnancy is heavily restricted by the Hyde Amendment.

Nationally, Indigenous American and Alaska Native people make up about 1% of Medicaid beneficiaries, but they make up a much larger percentage in states with high Indigenous populations. Indigenous Americans make up 13.7% of Medicaid beneficiaries in Montana, 12.7% in New Mexico, 19.3% in North Dakota, 8.9% in Oklahoma, and 32.6% in South Dakota (See Figure 1). In these heavily Indigenous populated states, the Indian Health Service delivers medical care to those with Medicaid. Without federal funding for abortion, Indigenous American women in these areas will not have the cost of abortion covered under their Medicaid plan.

Figure 1. Indigenous American Medicaid Enrollment by State


Source: Distribution of the Nonelderly with Medicaid by Race/Ethnicity, Kaiser Family Foundation.

To be clear, the Hyde Amendment does not explicitly prevent women under Medicaid from receiving abortions – women may pay out-of-pocket for the procedure. However, in 2019, 9.5% of Indigenous American families with married parents lived below the poverty line, and 33.2% of Indigenous families with single mothers lived below the poverty line. Abortions in the United States can cost up to $1,500 (See Figure 2). If Medicaid does not cover abortion, then it is likely these women will be unable to afford such a procedure themselves, so they do not have a real choice with their pregnancy. The Hyde Amendment deems abortion an elective procedure uncovered by Medicaid, even though access to such a procedure is essential to reproductive justice.

Figure 2. Indigenous American Families (Married & Single) below the Poverty Line
Source: Table created by WISER using 2019 American Community Survey, U.S. Census

Biden’s proposal to repeal the Hyde Amendment would allow Medicaid beneficiaries, like many Indigenous American women, to have the cost of an abortion covered. Pro-choice people believe women should have the ability to choose to have an abortion but do not necessarily think Medicaid should cover the cost of such a procedure. Low-income women can likely not afford the cost of abortion out of their own pockets, so they really do not have the choice to terminate their pregnancy or not.

The U.S. seems to morally accept the idea of abortion since Roe v. Wade gives women the right to have safe abortions. So if abortion is deemed morally acceptable, then why restrict funding for a reproductive right that all women should be guaranteed? The Hyde Amendment clarifies that the restriction on federal funding is more about classism than morality. High-income women who can afford abortions are free to do so, but low-income women who cannot pay do not have this reproductive choice. Repealing the Hyde Amendment and giving federal funding for abortion would give low-income women greater reproductive autonomy, making progress toward reproductive justice for women in all income brackets.

The Indian Health Service is federally funded, so currently, IHS centers have very slim resources and equipment to provide abortions to any patients who need them, even those who might pay out-of-pocket. If the Hyde Amendment was to be repealed and IHS received funding for abortion services, Indigenous American women could gain more reproductive autonomy and have expanded access to essential health services that women in non-Indigenous communities have within much closer reach.

Repealing the Hyde Amendment is important for Indigenous American communities and low-income women, and future female generations. Young women need to know that their reproductive autonomy is respected and protected, not contingent upon their income and policymakers.

Mary Kate Knoell
Summer Research Assistant

In July, WISER held its first webinar on child care in America.  I was joined by Dr. Dionne Dobbins, who serves as Research Director for Child Care Aware of America, and Lakesha Petty, the owner of Pamper Me Nursery.

We agreed that sustained financial support for families with childcare needs, more information about funding opportunities and resources available for childcare centers, and higher wages for childcare workers are needed to reduce the number of child care deserts in America.  Dr. Dobbins pointed out the importance of assessing the childcare needs of communities and families.  For example, she said it is important to know if parents want child care near their homes or jobs.

However, what I have noticed is missing from childcare conversations is how to address the shortage of childcare professionals.  As an expert in logistics, I understand the bottlenecks that can occur if there is an increase in the supply of childcare centers without an increase in qualified early childhood education teachers to staff these centers.

A complete needs assessment of child care includes identifying local and regional staffing needs and crafting initiatives to train a qualified workforce to eliminate the current childcare worker shortage and the looming one in the future.

Jerry
Research Director

There has been a lot of buzz around this so-called digital transformation, which some say we are undergoing due to the pandemic.  It feels unfair to say it is happening to all of us when it is happening around vulnerable populations.

A digital transformation should be both inclusive and sustainable.

Some will sustain pandemic norms like telehealth services.  Without addressing (and assisting) populations that have historically been left out of the world wide web, inequalities will be exacerbated, and the digital divide becomes deeper.

A report by Deloitte Insights calls this “digital transformation” one big beta test, which is fair. To note- the shift is happening, and we are still trying to understand who is connected and whose system crashed or was hacked.  The Deloitte study provides a snapshot of how most Americans are faring (feeling?). But how informative is a survey that does not disclose any results by gender, income level, race/ethnicity, or age?

What vulnerable or marginalized populations are hidden in the aggregate survey results?

My undergraduate minor was medical humanities, which exposed me to health equity.  The pandemic has energized my willingness to question how we ensure digital healthcare systems meet the (unique) needs of the communities they serve.  My experience with telehealth says equitable care requires reliable broadband access and digital literacy.

Himaja
Associate Director

News

We are excited to announce the National Science Foundation has awarded the Economics Department at Howard University $2.75 mil (over 5 years) to support the AEA Summer Training Program and WISER’s IPOD mentoring program.