On Friday, the Trump administration announced that effective immediately, the birth control mandate of the Affordable Care Act (ACA) will no longer be in effect.
Under the ACA, known colloquially as Obamacare, 62 million American women were able to access birth control without a copay under their insurance plan. The new rule from the Trump administration, however, undoes this part of the preventive care requirement of the ACA, which requires that all insurance plans guarantee birth control with no copay.
If a religiously affiliated employer had a religious objection to birth control, the Affordable Care Act ensured that employees’ birth control was covered through other means. The new Trump administration rule not only eliminates that coverage protection for employees, but allows any employer — not just those that are religiously affiliated — to deny employees coverage for birth control if they say they have a religious or moral objection.
Employers will not have to file with the government to cease offering birth-control coverage; instead, they simply have to notify their employees of the decision, The Hill reports.
This long-rumored religious and moral exemption is expected to energize Trump’s base and infuriate his opponents, but have a limited impact on most large American workplaces. Advocates such as the National Women’s Law Center announced immediate plans to attempt to block the new rule in court.
“We want to stop this rule as soon as we can,” Mara Gandal-Powers, senior counsel for reproductive rights and health at the National Women’s Law Center, tells Yahoo Lifestyle. “It’s really worrisome. Literally any employer can say, ‘I have a religious or moral objection to birth control and I don’t want it in my health plan for employees.’”
“This is not completely separate from clerks who say they don’t want to issue same-sex marriage licenses,” she says.
Heritage Foundation research associate Melanie Israel told Yahoo Lifestyle that the Obamacare mandate was “onerous,” and a ”burden on employers, individuals, and religious organizations who, because of their beliefs concerning the protection of unborn human life, are faced with the decision to violate sincerely held religious or moral beliefs, pay steep fines, or forgo offering or obtaining health insurance entirely.”
“Today, the Trump administration has changed course and provided relief for employers and educational institutions with religious objections to the mandate, as well as relief for certain organizations with similar objections based on moral convictions,” she said.
According to the Associated Press, the Trump administration has estimated that 200 employers who have already voiced objections to the Obama-era policy would qualify for the expanded opt-out, and that 120,000 women would be affected. However, it’s unclear how major religiously affiliated employers, such as Catholic hospitals and universities, will respond.
Some government officials took to Twitter to voice their opinions about the rule:
— Rep. Ted Lieu (@RepTedLieu) October 6, 2017
Denying women access to birth control is wrong and that’s exactly what the Trump Administration did today. https://t.co/38aeoeAfMM
— Senator Bob Casey (@SenBobCasey) October 6, 2017
Research has indicated that cost is a major barrier for women who want to access birth control — a factor significantly alleviated by the ACA’s contraceptive mandate and now undone by today’s rule.
A 2009 report by the Guttmacher Institute found that one in four women with household incomes of less than $75,000 have put off a doctor’s visit for birth control to save money in the past year. Twenty-nine percent of women report that they have tried to save money by using their birth control method inconsistently, while more than half of young adult women have said that they do not use their birth control method as directed because it was cost-prohibitive to do so.
The NWLC suit is rooted, Gandal-Powers explains, in the new rule being discriminatory toward women.
“Women on health insurance through their employers are getting health insurance that doesn’t meet their needs, and men would be getting health insurance that does. That’s really troublesome to us,” she says.
Public health experts also agree that rolling back the contraceptive mandate poses a major threat to women’s health and well-being.
“Contraception is an integral part of preventive care and a medical necessity for women during approximately 30 years of their lives. Since the Affordable Care Act increased access to contraceptives, our nation has achieved a 30 year low in its unintended pregnancy rate,” said Dr. Hal Lawrence, Executive Vice President and Chief Executive Officer, American Congress of Obstetricians in a press call on Thursday. “Any move to decrease access to these vital services would have damaging effects on public health and would essentially, turn back the clock on women’s health.”
Nearly nine out of ten women of reproductive age will use contraception at some point in their lives, whether for family planning or for other medical reasons, such as treating endometriosis. According to the Kaiser Family Foundation, before the ACA’s birth control provision took effect, more than 20 percent of American women had to pay out of pocket for birth control. After the contraceptive mandate took effect, that figure dropped to less than four percent.
Polling conducted by Hart Research Associates in 2014 commissioned by the Planned Parenthood Action Fund found that 71 percent of American voters say that insurers should be required to fully cover birth control pills and other forms of prescription contraception, as they were required to do under the ACA.