As House Republicans move to pass a replacement health care bill, this Denver Democrat continues to fight for healthcare access and reproductive rights.

diana-degette — Diana DeGette chats with constituents. Courtesy of Diana Degette

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It’s a quiet Friday morning in December, and Chief Deputy Whip, 20-year member of Congress, and healthcare warrior Rep. Diana DeGette (D-Denver) leans back in her black leather conference room chair with a satisfied smile. Congress is on a holiday break and her Denver office, just south of Governor’s Park, pulses with a quiet hum. With the contentious 2016 election over and the post-inauguration upheaval yet to begin, the Denver Democrat enjoys a rare pause for reflection in the eye of a political storm.

The dean of Colorado’s nine-member delegation, DeGette is the state’s most senior national legislator and its only woman in Congress. She earned her liberal 1st District seat in 1996 when it was vacated by the Centennial State’s first U.S. Congresswoman, Rep. Patricia Schroeder, and has been re-elected with at least a two-thirds majority in every election since.

Carrying on Schroeder’s legacy, DeGette is a champion for women. She advocates for family planning and women’s reproductive rights as part of her broader commitment to advance healthcare and make it accessible to all people. She’s a senior member of the House Energy & Commerce Committee, which oversees health policy, and co-chairs the Pro-Choice Caucus. “Diana is continuing a strong tradition of making sure that women’s views are represented in Congress,” says Karen Middleton, executive director of NARAL Pro-Choice Colorado and a former state legislator. “She’s really been a part of why we continue to see more women rising in leadership in the state.”

As I enter the front lobby, a lone staffer is deeply engrossed in a phone conversation with a constituent. It’s a sharp contrast to what will happen when the new session of Congress starts in January, as Coloradans flood their representatives’ offices with three times the volume of calls and notes than DeGette’s office normally receives.

DeGette welcomes the activism. As someone on the front lines of the ongoing battle to defend both the Affordable Care Act (ACA) and women’s reproductive healthcare from Republican rollbacks, her strategy includes a mix of community advocacy, behind-the-scenes diplomacy, and proactive legislation. In January, DeGette held a Denver rally to support the ACA, walked alongside fellow Coloradans at the Women’s March on Washington, and reintroduced legislation to allow coverage of abortion care in public health insurance programs. In February, she hosted a Denver town hall of nearly 1,000 constituents—a crowd so large she had to switch venues for the event.

And in early March, DeGette worked through the night to defend reproductive rights in the Energy & Commerce Committee’s markup of the GOP’s American Health Care Act, which aims to replace the ACA. Her amendment to protect Planned Parenthood funding was defeated on a party line vote at 2:30 a.m.

At the time of our December interview, however, quietude prevails. DeGette’s composure and self-assured poise can be deceiving for those who underestimate her dedication to the causes she holds dear, such as healthcare advances, women’s equality, and protecting the environment. But there’s no hiding the excitement in her voice.

DeGette’s just returned from a whirlwind trip to Washington, D.C., to see her bipartisan 21st Century Cures Act signed into law. It was the last public bill signed by President Barack Obama before leaving office—and a pinnacle of DeGette’s two decade-long congressional career. Former Vice President Joe Biden also attended the signing of the $6.3 billion bill to modernize biomedical research, which includes $1.8 billion for his “Cancer Moonshot,” as well as funding for mental health reform, combatting opioid addictions, and research for brain diseases. “This is the biggest piece of legislation I’ve ever passed,” DeGette says. “It was really quite something to be there.”

For DeGette, the Cures Act was personal: Her mother died from lung cancer at the age of 54, and her daughter, Francesca, was diagnosed with type 1 diabetes when she was just four years old. “It doesn’t matter if you’re a Democrat or Republican—every family has faced some kind of disease,” she says. “That’s why I was so enthusiastic to do this bill, and that’s why I wouldn’t let it die.”

DeGette has the patience and experience to play a long game—a strategic skillset that will be key for Democrats hoping to transform the protests of citizen foot soldiers into voters in 2018 and beyond. Case in point: The 21st Century Cures Act was three years in the making and included countless roundtables, white papers, hearings, and meetings with a broad range of stakeholders.

“When Diana decides to pursue something, she is steadfast in working it and achieving her goal,” says Rep. Ed Perlmutter, who has known DeGette for more than 25 years, since their early days as Denver lawyers. “Her leadership on these issues is more important than ever as we move forward with this new administration.”

DeGette is calling for a similar bipartisan approach to fixing the ACA, which Democrats prefer over a repeal. As House Republicans fast-tracked a replacement bill through the Energy and Commerce Committee in early March, without analysis from the nonpartisan Congressional Budget Office (CBO), DeGette urged her GOP colleagues to slow down. “We should sit down together, just like we did on 21st Century Cures,” she says during the markup. “We should come up with a bill that fixes Obamacare that we could pass unanimously, and then we can uphold the proud tradition of this committee.”

DeGette may still get her chance: On March 13, the CBO estimated that the GOP health plan would cause 24 million people to lose their insurance by 2026, compared to the current law. The Republican plan would also create higher deductibles and out-of-pocket expenses for the insured, increasing annual costs for the average enrollee by $2,409 per year in 2020.

In order to win votes—and resolve infighting—House Republicans revised the bill Monday night. The new draft, scheduled for a Thursday vote, tries to woo both conservative and moderate Republicans.

But the GOP’s plan leaves in place provisions that could disproportionately harm women, including ending federal coverage of benefits such as pregnancy, maternity, and newborn care in 2020. It would also end the ACA’s Medicaid expansion in 2020 (women make up nearly 70 percent of adults on Medicaid), defund Planned Parenthood, and ban individuals from purchasing private insurance policies that cover abortion if they receive any federal subsidies.

Cutting funding from Planned Parenthood— the only family-planning organization impacted under the new health plan—would cause 15 percent of low-income women to lose access to any reproductive healthcare, according to the CBO report. The ACA’s mandate for coverage of contraceptives is also likely to be rolled back in a future phase of the plan, impacting 55 million women who now get birth control with no co-pay. (It’s no wonder that since the election, the demand for IUDs at Planned Parenthood has jumped 900 percent.)

Colorado may provide one of the clearest examples of why insurance coverage of contraceptives is an important public health goal. Long Acting Reversible Contraceptives (LARCs) such as IUDs and implants are the most effective forms of birth control, but are also the most expensive, costing up to $1,000. When Colorado’s five-year Family Planning Initiative provided LARCs to low-income teens, our state’s birth rates and abortion rates for teens dropped by nearly half from 2009 through 2014. The program also saved the state about $40 million on care for unintended births and has been copied by other states.

DeGette plans to introduce a new bill this spring to enable other states to create a version of Colorado’s successful program. “If you want to reduce unwanted pregnancies, then all the evidence shows you need to give people safe, long-acting birth-control methods,” she says. Evidence backs this up: A new study by the Guttmacher Institute, a research and policy organization focused on sexual and reproductive health, found that the U.S. abortion rate is at an all-time low, in large part because of better access to contraception.

“Diana gets in her bones why these issues are important, and why women should have the unfettered ability to make their own health care decisions,” says Vicki Cowart, CEO of Planned Parenthood of the Rocky Mountains.

In her early days in Congress, DeGette was a working mother of two young girls. But long before that, she had three younger sisters. “We all grew up as feminists in that era and were strongly pro-choice,” she says. “Having my two daughters just made me realize how important it is to preserve that for future generations.”

Colorado was the first state to liberalize abortion for certain circumstances in 1967. Twenty-five years later, DeGette authored the so-called “Bubble Bill” during her first of two terms in the state legislature. The bill created an eight-foot privacy bubble around any person within 100 feet of a Colorado health care facility clinic, and has survived a Supreme Court challenge. “I wanted to make a legislative statement that we were still a pro-choice state,” she says.

DeGette continues her fight in Congress, where she’s been proactive in protecting reproductive rights for all women—and that includes access to abortion care when needed. She believes that many people rely on incorrect assumptions when it comes to choice. “If you talk about so-called late-term abortions, first they are very rare, and second, almost all of them are done because there’s some severe fetal abnormality or something terribly catastrophic happened,” DeGette says. “It’s important for people to understand the health issues.”

DeGette is a sponsor of the EACH Woman Act to allow Medicaid funding for abortions, which was reintroduced in January. She also led the debate against an opposing GOP bill that passed in the House. Spending federal money on abortions is currently prohibited by the Hyde Amendment (except in cases of rape, incest, or when a woman’s life is in danger), which was first passed in 1976 and is reauthorized annually. But DeGette says the provision unfairly targets low-income women who rely on government-funded healthcare.

“When we introduced the [EACH Woman Act], everybody said that’s really edgy, because Hyde has been the law of the land for so long,” DeGette says. “And we said yes, but it’s a bad law.”

While other legislators may look for easier wins, DeGette is forging ahead on her goal to make sure that all women have equal access to a full range of healthcare. “She is really known as a legislator who gets things done,” Middleton says. “That’s really good for Colorado, good for healthcare, and good for women’s health.”

Two floors below us, the surrounding Speer neighborhood is starting to bustle with a lunch crowd stocking up at Trader Joe’s and lining up to sample Little India Restaurant’s fragrant curries.

The interlude will soon be over, and DeGette will be back to business. Although widespread policy changes are on the way, she is resolute in her fight.

“Obviously pro-choice values are core to me, but I think that the most important thing that you can have as a legislator is that people trust you,” she says. “People know that if I tell them I stand in a certain place, they can count on that.”

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Diana DeGette Is (Still) Championing Women's Health