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Many people will have to reconsider the way they access healthcare in the future if the Affordable Care Act – better known as Obamacare – is scrapped. That change could potentially impact a wide range of services, but one of those that is talked about less often is sexual health.

Ending Obamacare

Sexual healthcare was more difficult to access before Obamacare, and as a result, more people ended up with serious health problems that might have been completely cured if caught earlier. Because fewer STDs were treated, there were more STDs in the population, which increased the risk of the infections spreading. There was also a greater risk of unplanned pregnancies because of the lack of free contraception. Are these problems now likely to return?

No more federal funding for Planned Parenthood

The most significant impact on sexual healthcare likely to stem from the scrapping of Obamacare concerns the withdrawal of federal funding for Planned Parenthood.

The most significant impact on sexual healthcare likely to stem from the scrapping of Obamacare concerns the withdrawal of federal funding for Planned Parenthood. That is officially because Planned Parenthood provides abortions, but it will impact its full range of services, including those aimed at helping women to avoid getting pregnant in the first place. It’s likely to have a particularly serious effect on LGBTQ people because few other healthcare providers have a nationwide policy of providing services to everybody and not tolerating homophobia or transphobia. It will also make life difficult for poor people who can’t afford to travel far, and who live in states where there are few other providers of contraceptive or obstetric services.

Access to contraception

An end to Obamacare would mean that employers would no longer be obliged to cover the cost of contraception for employees, something that could leave many women without affordable access to it. The situation is likely to be worsened if Planned Parenthood is forced to close down some of its services because it’s one of few places where women could guarantee getting their contraceptive prescriptions filled, something that’s increasingly difficult to do through ordinary pharmacies in some states. Contraceptive implants are likely to become the most practical option, but they can cause health problems in some individuals.

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STD testing

Where Planned Parenthood is no longer around to provide accessible STD testing services, which insurers may refuse to cover, there is a risk that rates of infection will rise. Some employers, understanding how STDs can impact employee productivity, are still likely to fund testing for their workers, but there will be no guarantee of this. The most practical option for many people will be visiting health centers that offer packages including STD testing, which is much more affordable than paying for tests individually.

Long-term care for HIV and AIDS patients

For people living with the long-term consequences of STDs like HIV, life is likely to become even more difficult, because provision of chronic disease management services will no longer be guaranteed. What’s more, long-term limits are likely to be reinstated on most healthcare plans, so if you rely on an employer-provided healthcare plan for support, then you could face bankruptcy when you reach your lifetime limit. Because of this, many HIV and AIDS patients are likely to end up being dependent on charities whose resources are already stretched.

Access to abortion

The loss of resources for Planned Parenthood is likely to make it very difficult for many women facing unwanted pregnancies to access safe abortion. An increase in the number of unplanned-for children could plunge many women and their families into poverty. It could also seriously endanger the health of women liable to complications during pregnancy, and endanger the mental health of some women, especially victims of rape and incest. It creates a likelihood that some desperate women will resort to backstreet abortions that could make them vulnerable to exploitation and place their lives at risk.

Cancer prevention and care

You might not think of cancer as a sexual health issue, but it’s a high risk factor when some STDs are not effectively treated. Many people rely on Planned Parenthood for cancer screenings relating to their breasts, genitals or reproductive organs. Cuts to Medicaid and lifetime cover limits are likely to make it harder to access cancer treatment, especially where chronic illness is involved, making it all the more important to catch these diseases early if possible.

All these changes mean that the repeal of Obamacare is likely to have serious consequences for the sexual health of poor and low-income people. Because state policies vary and charitable support is different in different states, it may be a practical time for some of those most severely at risk to think about moving. It’s vital to identify alternative ways that you can get the support you need.

Ben Chapman