Health Care: Why Women — and Nancy Pelosi — Won Big

By Mara Gay                                  photo:  TalkRadioNews under cc license.

It wasn't pretty. But not even cries of "baby killer" could obscure the truth: we have elections in the United States, and Sunday evening, the Democratic majority ushered in by the 2008 election passed the most important piece of social legislation since the 1960s.

And - despite President Obama's executive order cementing certain restrictions on abortion - the health care bill is a major victory for American women.

Three reasons for women to love health care reform.

1. Obama's executive order on abortion is meaningless

For months, there were legitimate fears that Democrats would be forced to cave in to conservative Democrats to win enough votes to pass health care. But that's not what happened. Instead, Rep. Bart Stupak's (D-MI) anti-abortion amendment - which would have indeed placed further restrictions on a woman's right to choose - failed.

And Stupak and his band of pro-life Democrats voted for the health care bill anyway, compromising on an executive order from President Obama that reaffirms the status quo of the Hyde Amendment: that there will be no federal funds spent on abortion. 

Pro-choice groups who say President Obama sold women out when he signed an executive order on abortion are wrong.

In an email to supporters Sunday evening, Nancy Keenan, President of NARAL America, was conflicted.

"I am extremely disappointed to tell you that the final package includes the insulting, unworkable Nelson restriction on abortion coverage in the new system," she wrote.

But the executive order is essentially toothless.

At The New Republic, Jonathan Cohn, who has written about health care reform for years, said, "it's not clear that the executive order actually changes anything."

2. Until Now, Being a Woman Was a Pre-Existing Condition

On the House floor Sunday evening, Speaker Nancy Pelosi celebrated the Democratic victory by declaring that, "Being a woman will no longer be a pre-existing condition." That wasn't just political theater.

In the United States, women only earn 77 cents for every dollar that men earn. Yet, according to the National Women's Law Center, women spend 68 percent more on health care then men, in part because of greater out-of-pocket costs from reproductive care like monthly birth control.

They are also less likely to have health insurance, because they are less likely to have a full-time job.

And women also pay higher premiums for health insurance, thanks to a process called "gender rating," where insurance companies charge women higher rates because of conditions associated only with being a woman, like pregnancy and childbirth.

And currently, some companies refuse to insure women because they are the victims of rape, domestic violence, or have simply had a C-Section.

Under the new health care legislation, denying women health care coverage or charging women higher rates because of such "pre-existing conditions" will be illegal by 2014.

3. Nancy Pelosi's Achievement

Already, Republicans are calling for her head. But 5, 10, 50 years from now, it won't matter that House Speaker Nancy Pelosi (D-CA) was one of the most reviled figures in American politics. She will simply be the woman who won the votes on health care, and happened to be the first female Speaker of the House to boot.

At the San Francisco Chronicle (a paper published in Pelosi's fiercely liberal home district) blogger Michael Yaki called Pelosi "the iron lady of American politics:"

When the conventional wisdom stated that the Dems were trying "deem and pass" to escape a recorded vote, one person kept on whipping the votes and working toward the magic 218. That person was Speaker Nancy Pelosi.

Steve Kornacki of Salon Magazine called health care Pelosi's "triumph:"

The passage of healthcare reform is not just a triumph of Pelosi's liberal idealism, though it is partly that. It's just as much a triumph of her underappreciated legislative savvy - mastery, really. In the '01 leadership race, Hoyer was supposed to be the skilled tactician. Pelosi was supposed to be the clueless ideologue. But as speaker, she's adeptly mixed her idealism with the deft touch of a seasoned congressional insider.

It took a woman to get health care passed in the House.

Mara Gay contributes to AOL news and previously worked for The Atlantic.  Her stories have appeared in The Washington Post and The Root.  She lives in New York.