Trump Restricts Birth Control Coverage

The Affordable Care Act, founded under the Obama administration, expanded access to contraception by making it a regular benefit of health insurance. It is now provided to more than 55 million women without cost. This health care benefit saved women $1.4 billion on birth control pills in 2013 alone, according to the National Women’s Law Center.

The Obama administration offered an exemption to employers from houses of worship who provide their employee’s health care due to religious opposition to providing coverage. The administration also gave a more limited accommodation, but not a full exemption, to certain other employers who were religiously objected to helping supply contraception. In 2014, the Supreme Court ruled that the contraceptive coverage mandate did not apply to closely held corporations, but did not decide on whether religious freedom to not provide contraception should also be granted to publicly traded, for-profit corporations.

The Obama administration boasted the mandates success quoting studies done showing that with the greater accessibility of contraception, the rate of unintended pregnancies went down.

The Trump administration has countered these findings stating, “these studies are insufficient to demonstrate a causal link.” The administration has countered with their own studies to show “as contraception became available and its use increased, teen sexual activity outside of marriage likewise increased.”

Responding to the lawsuits against the contraceptive coverage mandate filed by religious persons, charitable organizations, hospitals, advocacy groups, and colleges and universities, President Trump has sought to change the mandate by expanding the number of employers and insurers who can qualify for exemption. The Trump administration will also allow health insurance companies to be exempt from providing contraception based on religious or moral objection.  

The change seeks to “balance the interests” of women and their employers and insurers who have religious and/or conscientious objections to aiding the use of contraception. The draft rule would allow for-profit, nonprofit, closely held, and publicly traded companies to be exempt from providing coverage based off of either religious objection or moral objection.

The explanation of the intended policy stretches on for 34,000 words and states that “the government does not have a compelling interest in applying the mandate to employers that object.” The explanation is also blunt in stating this policy change “will result in some enrollees in plans of exempt entities not receiving coverage”. Once this new mandate goes into effect, hundreds of thousands of women will cease to receive coverage for contraception.

The House Democratic leader, Nancy Pelosi, has called the draft rule a “sickening plan to roll back women’s access to contraception.”

The Obama administration allowed exemptions to houses of worship because of the Religious Freedom Restoration Act of 1993 which protects religious liberty. However, this law does not protect employers and insurers right to refuse paying for birth control under nonreligious, moral conscientious objections. The Trump administration has cited the ability of certain conscientious objectors who have been exempt from military service as an example that should be brought over into the healthcare field. The administration also cited an early version of the First Amendment which protected freedom of religion and “the full and equal rights of conscience.”

New rules are usually issues as proposals with an opportunity for public comment, however the new rule is being labeled as an interim final rule. This puts the policy into effect immediately without public comment. The administration states the reasoning for this as, “it would be impracticable and contrary to the public interest to engage in full notice-and-comment rule-making.”

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