What We Ask of Women When Affordable Health Insurance Is Tied to Full-Time Work

The first time I feel the lump, I’m driving my eldest to his first year of college on the day my marriage ends. I would have preferred to spread out these plot points, were I in charge, but you get what you get, and you don’t get upset. Which is a kind of shitty thing we say to our kids, now that I think about it. Better would be: “You get what you get, and if you do get upset—which is totally normal, because sometimes what you get blows—you’ll have to learn to sit with those feelings and breathe through them. Preferably in sweatpants.”

Less catchy, but much healthier in terms of acknowledging the corrosive effects of cortisol, the stress hormone that gets triggered whenever we experience adversity and have to swallow our feelings. Or as Lorenzo Cohen, director of the Integrative Medicine Program at MD Anderson Cancer Center, put it more bluntly, “Stress makes your body more hospitable to cancer.” Chronic stress, in fact—such as the kind that might be experienced day after day in an emotionally challenging long-term marriage—inhibits a natural process called anoikis, which destroys diseased cells and prevents them from spreading. Indeed, a number of different studies have shown a causal effect between chronic stress and the production of certain growth factors that can actually speed the development of cancer.

The lump, when I palpate it, is hard. Noticeable. Located on the outside curve of my left breast. Before I reach over and feel it with my right hand, I first feel it as a nagging presence: not painful, like the mastitis I contracted breastfeeding each child, but extant, demanding attention, like a toddler’s hand on a shirttail. Of course, I think, confirming its existence. Just when my health insurance has run out.

I’d previously been covered under my TV producer jobs at ABC and NBC News, where I wrote and produced long-form news stories between 1992 and 1998, first at Day One, then at Dateline NBC. Prior to that, when I was based in Paris for four years, I didn’t need health insurance: I just went to a doctor whenever I needed one and never paid a centime, and the monthly cost of my birth control pills was negligible. When I sold Shutterbabe in 1998, for twice my Dateline salary, I switched to my husband’s plan, after he’d landed a job with health insurance. This was after the NBC News brass had overturned my Dateline NBC boss’s approval to work a four-day-a-week schedule. Fourteen years after leaving that job, when I’d appear on the Today show as a guest for The Red Book—the same day, I should note, Ms. Death Panel Myth herself, Sarah Palin, co-hosted—the producer pre-interviewing me over the phone had said, “Wait, did you used to work here? Your name sounds familiar.”

“Yes,” I said. “From 1994 to 1998.”

“Oh my god! Did you have a somewhat . . . spicy exit interview?”

“Yes,” I said, suddenly alarmed. “How do you know that?”

Neal Shapiro, my enlightened boss at the time, had approved my four-day-a-week proposal at four-fifths pay without hesitation. He knew I could do the same job in less time, he’d pay me fewer dollars, I’d see my toddlers more, my childcare costs would go down, I’d get to keep my family’s health insurance, and he’d retain a dedicated employee: win-win-win-win-win-win. But the NBC vice president whose job it was to formally approve this arrangement—a woman with children of her own—said a mother had to choose: You either worked ten to twelve hours a day, five days a week and on weekends, or you could go home and be a mommy. Which had been the unstated but understood policy at both NBC and so many other white-collar American corporations: To work a corporate job, particularly if you were on one of the lower rungs of the ladder, meant to be owned by your company every hour of every day, fifty weeks a year and sometimes during your two weeks of vacation as well, depending on the news cycle. (Back then, before cellphones, we all wore beepers.) This serflike system favored—still favors—parents with spouses at home to pick up the slack. It also discouraged removing your mouth from the health insurance–equipped NBC teat. Go freelance and actually get paid for every hour you work, then if you get in a car accident or come down with a serious illness, you are screwed.

For a country founded on the ideals of freedom, liberty, and justice for all, having affordable health insurance tied to full-time employment is an ironic and often fatal prison of our own making. Not to mention an obvious hindrance to that other pillar of American pride, entrepreneurship. How many new ideas and cures and inventions have we missed out on because some cog in the wheel of a giant corporation couldn’t risk taking that leap of faith without a parachute of health insurance for them and their family?

My request for a temporary four-fifths schedule, while my kids were toddlers, also came in the middle of an ongoing era of misleading journalism: cover story after cover story on mothers “opting out” of work, framed as personal choice rather than a result of corporate and government policies—or rather, the lack thereof—that forced them out. Eight years later, in 2006, Joan C. Williams, founding director of the Center for WorkLife Law at the University of California, Hastings College of Law, would publish a groundbreaking study on the false framing of the opt-out narrative that had been foisted upon American women since the mid-20th century. “Our review of these articles finds that the Opt Out story predominates in American newspapers, which focus overwhelmingly on psychological or biological ‘pulls’ that lure women back into traditional roles, rather than workplace ‘pushes’ that drive them out,” she’d write.

When it dawned on me that the NBC vice president had decided to veto my boss-approved request, and that nothing I could say or do would sway her, I looked her straight in the eye and said, loud enough for the other C-suite executives to hear, “There are currently a dozen pregnant or soon-to-be pregnant women on my floor alone. All of whom have been paying close attention to this request and its approval process. It is not an exaggeration to say you will lose nearly every single one of them if you keep pretending that their children do not exist. Do you really want a newsroom filled only with men with wives at home to pick up the slack and childless women? How is that in any way representative of the world we actually live in and its concerns, including the monumental barriers still in place for families with two working parents?”

Some new mothers at NBC, where six weeks of paid maternity leave had been the norm and was considered generous, were coming back to work before their episiotomies had healed, or when they still had grape-sized hemorrhoids, or complications from cesareans. Or they were, like me, going into credit card debt taking extra months of unpaid leave to bond with their infants during those scientifically proven crucial first three months of infant brain development.

My maternity leave with my second baby, who was not close to being weaned, was suddenly cut short when Princess Diana died, and I’d been asked to hop on a plane so quickly, I hadn’t had time to procure a travel-sized breast pump. My daughter wound up screaming and refusing the bottle for the majority of the ten days I was gone. I wound up manually expressing my milk, whenever engorgement became too painful to endure, into whichever Parisian toilet I could find. Upon my return, I greeted a baby who had learned, in my absence, both to crawl and to open my bottom dresser drawer, from which she would steal my nursing bras and wear them decoratively around her neck. I also ended up paying my babysitter more money in overtime than I’d actually earned during that week and a half abroad.

Many of my colleagues, shocked by how quickly overtime childcare costs ate up their own income; by how exhausting it was staying up all night with a screaming infant before working ten hours a day; by how unsanitary and chaotic it was to have to sneak in breast pumping sessions in toilet stalls, would simply quit soon after their too-early postpartum returns to work. The babysitters weren’t happy with this state of affairs either. Yes, they earned more money when we worked more hours and traveled for our jobs, but they didn’t want to work more than ten hours a day either, which they were often forced to do when the non-traveling parent—more often than not the father—wouldn’t or couldn’t pick up the slack.

“New parents not only want to work, we need to work and keep our health insurance now that we have the added expense and illnesses of kids!” I practically shouted at the vice president, pointing my finger straight at her. “But the way this job is currently set up doesn’t work for two-parent working households or their kids. Part-time is an excellent solution! Job-sharing is an excellent solution. You’ll get more work for less pay! You won’t have to retrain new employees! Babies grow up! You’ll get their parents back full-time soon enough. Even from a corporate profits point of view, why would you not support this?” On my way out, I’d slammed the door of her office, feeling like a deranged Nora Helmer in a rayon power suit.

“Oh my god!” the Today show producer squealed, a decade and a half later. “Half of us at the Today show work part-time because of that exit interview! Thank you!”

I choked up upon hearing that. Not only because I felt moved by the fact that the sound waves from my slammed door had reverberated into the future, but also because, having been denied those same rights as a young mother, I’d had to rely on my husband’s job for health insurance when I switched to writing, which had bound me even tighter to my increasingly troubled marriage. How many untenable marriages in America, I wondered, stayed together for the sake of health insurance? It was a story I might have pitched and produced at Dateline NBC, had I not felt pushed out of my health insurance–equipped job when my kids were small.

At the same time, it must be said: Handing over the reins to my husband for procuring a full-time job with health benefits—I’d previously supported him over the first six years of our relationship through his various unpaid and underpaid incarnations—was what had finally allowed me to take the leap, at 32, into full-time writing, which ended up bringing in more money while simultaneously slashing our babysitting costs in half. They’re only small once, I reasoned. I wanted to be around for some of it.

Now my first child, no longer a child but—abracadabra—a young man I’m driving to his first year of college, stirs in his sleep, switching from reclining in the passenger seat to folding over his knees, which is how I would often find him in the mornings before school.

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From the book Ladyparts by Deborah Copaken. Copyright © 2021 by Deborah Copaken. Published by Random House, an imprint and division of Penguin Random House LLC. All rights reserved.