National Partnership for Women & Families

In the News

Commentary: '[L]ongstanding' TRICARE repro health restrictions 'become more pronounced in the face of Zika'

"[O]ne group vulnerable to the [Zika] virus has been left out of congressional aid efforts: women in the military," Jenny Kutner writes for Policy.Mic.

According to Kutner, the Department of Defense (DOD) estimates that as of Sept. 28, 128 beneficiaries of the military health care system -- including servicewomen and dependents of servicemembers -- have been infected with Zika this year. She writes that if pregnant women enrolled in TRICARE, the military's health care program, contract the virus, they "will find themselves in a difficult situation should they try to have an abortion." Women who need abortion care outside of those narrow exceptions cannot access abortion care at military facilities due to a statutory ban on abortion provision.

The TRICARE abortion restrictions are similar to those imposed under the Hyde Amendment, which withholds coverage of abortion care for women enrolled in Medicaid except in limited circumstances (Kutner, Policy.Mic, 10/5). However, it wasn't until 2013 that TRICARE covered abortion care in cases of rape and incest -- that was achieved via the Shaheen Amendment, which expanded coverage for servicewomen and military family members (Women's Health Policy Report, 12/19/12).

Kutner writes that, according to Perry O'Brien, a veteran army medic and political organizer, "women enrolled in TRICARE have to find an alternative health care provider and cover the cost of the procedure themselves." In turn, the restrictions deny women "continuity of care," O'Brien notes. He says, "When it comes to reproductive rights (and) seeking an abortion, women are forced outside of [the] system completely, and are thus being denied one of the greatest strengths of the military healthcare system."

Kutner writes, "These longstanding issues of accessing comprehensive reproductive health care have only become more pronounced in the face of Zika." She states that "[m]any service members already face concerns about how cost and career flexibility impact their reproductive decisions even without the threat of the virus," citing a study that found women stationed abroad face numerous barriers to accessing abortion care including legal and logistical barriers to accessing care in-country and confidentiality concerns. Further, military women face a higher rate of unintended pregnancy than the general population, Kutner writes. She cites a study that found the rate of unintended pregnancy among military women to be 78 cases per 1,000 women of reproductive age compared with 52 in the general population.

While the Pentagon has offered service members in areas affected by the Zika virus "the opportunity to relocate," critics note that "the proposal skirts the larger issue: lack of access to reproductive and sexual health services for military women," Kutner writes. She adds that while relocation in the face of Zika "might make sense" for some military families, "[f]or others, it's not enough."

Kutner concludes by quoting O'Brien, who says, "We're now saying that women can put their bodies on the line alongside men, and accept equal risks of physical harm. And yet, they don't have the same equal rights over their bodies that their civilian counterparts do" (Policy.Mic, 10/5).