As the United States’ largest public health insurance program, Medicaid has since 1965 played a crucial role in the struggle for equitable health care access. It has the potential to be a powerful instrument of reproductive justice, yet discriminatory policies that deny coverage for vital sexual, reproductive, or other health services, or exclude entire populations of people with low incomes from coverage altogether, constrain peoples’ health and reproductive futures. Resulting discrimination in Medicaid law and policy thwart the program’s ability to promote intergenerational health equity and reproductive justice for underserved communities.This Article provides an account of why reproductive justice is a necessary framework for examining, reimagining, and reforming Medicaid coverage law and policy. Part I gives a brief history and overview of reproductive justice, which serves as “an open source code that people have used to pursue fresh critical thinking regarding power and powerlessness.” Part II argues that we should utilize that open source code in Medicaid coverage reform. Using some of the reproductive justice movement’s critiques as a starting point, it explores how reproductive oppression has shaped Medicaid coverage law, policy, and mainstream reproductive and health care reform movements’ proposals, and to what effect. It argues that examining Medicaid law, policy, and proposed reforms through this lens and in collaboration with the reproductive justice movement can enable health advocates and policymakers to more fully understand, disrupt, and dismantle reproductive injustices that drive health inequities. Ultimately, it can empower reformers to build a more equitable public health insurance safety net that brings us closer to reproductive justice for all.

中文翻译：

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为生殖正义改革医疗补助计划

作为美国最大的公共健康保险计划，自 1965 年以来，医疗补助计划在争取公平获得医疗保健的斗争中发挥了至关重要的作用。它有可能成为生殖正义的有力工具，但拒绝覆盖重要的性健康、生殖健康或其他健康服务，或将所有低收入人群完全排除在覆盖范围之外的歧视性政策，限制了人们的健康和生育未来. 由此导致的医疗补助法律和政策中的歧视阻碍了该计划促进服务欠缺社区的代际健康公平和生殖正义的能力。本文解释了为什么生殖正义是审查、重新构想和改革医疗补助覆盖法律和政策的必要框架。第一部分简要介绍了生殖正义的历史和概述，它是“人们用来追求关于权力和无权的新批判性思维的开源代码”。第二部分认为我们应该在医疗补助覆盖范围改革中利用该开源代码。它以生殖正义运动的一些批评为起点，探讨了生殖压迫如何影响医疗补助覆盖法律、政策以及主流生殖和医疗改革运动的提案，以及产生了什么影响。它认为，从这个角度审视医疗补助法律、政策和拟议的改革，并与生殖正义运动合作，可以使健康倡导者和政策制定者更充分地理解、破坏和消除导致健康不公平的生殖不公正现象。最终，