Trump's Plans to Roll Back Birth Control Coverage
Thanks to the Affordable Care Act (ACA), over 55 million women have insurance coverage for birth control and other preventive services with no out-of-pocket costs. Contraceptive coverage saved women $1.4 billion on birth control pills in the first year it went into effect, and by spring 2014, two-thirds of women using birth control pills and three-quarters using the contraceptive ring were no longer paying out-of-pocket. Better access to contraception has contributed to the lowest U.S. abortion rate since the procedure became legal in 1973. Now, a recently leaked draft regulation indicates the Trump Administration is planning to dismantle this essential health benefit under the guise of “religious freedom.”
Trump’s proposed Interim Final Rule would significantly broaden the existing religious exemption to include any employer who objects to providing contraceptive coverage for any religious or moral reason. The new rule is currently under review by the White House Office of Management and Budget (OMB), and would go into effect as soon as it is published. The change is in line with the executive order on religious freedom signed by Trump in early May.
The ACA’s contraceptive mandate has always included an exemption for “religious employers” (defined by the IRS as “churches and other houses of worship”). Religious employers who object to contraception are not required to include it in the health plans they provide to their employees.
Religiously affiliated nonprofits (Catholic hospitals and universities, for example), while not currently exempt from providing contraceptive coverage, are eligible for an “accommodation.” The accommodation was crafted by the Obama Administration to respect the religious beliefs of the organization while preventing women–as well as transgender and gender nonbinary people who use contraception–from losing their coverage just because of their employer’s religious beliefs. The accommodation works like this: the employer simply fills out a form certifying their objection to providing contraceptive coverage and the employer’s insurance plan steps in to provide the coverage directly. In Burwell v. Hobby Lobby, the Supreme Court allowed “closely held” private businesses with religious objections the same accommodation.
Unfortunately, in a series of lawsuits over the past several years, many of which are still ongoing, religious nonprofits have fought the accommodation under the Religious Freedom Restoration Act (RFRA). They claim that the very act of filling out the form violates their religious freedom because it “triggers” the insurance company to provide the contraception, thereby making them complicit in an action they object to.
Trump’s proposed rule goes even further than the accommodation. It would offer religious nonprofits – and indeed, any employers who claimed a religious or moral objection – an outright exemption, meaning that the employees of these businesses would lose their contraceptive coverage.
At Boulder Valley Women’s Health Center, we know contraception is basic health care – for virtually all sexually active women for over three decades of their lives. And while we support the religious freedom of employers, employers’ religious beliefs do not give them the right to take access to basic health care away from their employees. Women’s Health will continue to resist any action by the Trump Administration to make contraception less affordable, less accessible, and less available.