One of the major benefits to women under the Affordable Care Act (also known as Obamacare) is the birth control mandate, which made birth control available under insurance with no co-pay. It’s counted as a preventive service and, honestly, what could be more preventive than birth control? Since 2011, women of reproductive age have been able to control whether or not they want to have a baby at no extra cost. Dope, right? Well, the Trump administration may be taking that away again.
Under the ACA, religious employers are allowed to choose not to pay for birth control — but that’s pretty much limited only to houses of worship who didn’t employ anyone of a different faith or “closely held” private institutions, like Hobby Lobby. It’s not easy to qualify for the exemption and, as a result, most companies are required to cover birth control. And even if a company does qualify, health insurers are still required to cover the cost of employee’s birth control.
But according to leaked documents obtained by Vox, the Trump administration is proposing expanding the current religious exemption law for birth control, making it much, much easier for anyone to refuse to cover birth control based on religious grounds. Basically, any company — from the local mom and pop to universities to major corporations — could say “I have a moral objection!” and they wouldn’t have to cover birth control anymore. Under the draft rule, they wouldn’t even have to tell the government they weren’t covering it, although they would be required to tell employees.
The draft proposal hasn’t been published — the document was obtained by Vox, so it’s not a law yet. However, if the draft is finalized and published as is, it will go into effect immediately and will potentially strip far too many women of access to free birth control. Sound terrible? It is. Here’s what four women’s health experts think of the leaked birth control mandate changes.
1. What Planned Parenthood Thinks
This rule would mean women across the country could be denied insurance coverage for birth control on a whim from their employer or university. It makes a farce of the Trump administration’s so-called ‘women’s empowerment’ agenda and endangers a woman’s ability to make the most basic and personal of decisions – when and if to have a child. It would expand the Supreme Court’s Hobby Lobby ruling to allow any employer – including huge, publicly traded companies – to deny birth control coverage to their employees. Think about it: Under this rule, bosses will be able to impose their personal beliefs on their female employees’ private medical decisions.
This is the latest in a long line of attacks on women’s health we’ve seen from this administration. Birth control is essential for women’s health and lives, and should never be a decision made by a woman’s employer. In the last decade, we’ve made important progress advancing the cause of women’s health: Unintended pregnancy is at an all-time low today thanks in part to expanded access to birth control, an Affordable Care Act provision that saved women an estimated $1.4 billion in its first year alone. This measure threatens that progress. The Trump administration should not release it.
-Dana Singiser, Vice President for Public Policy and Government Relations, Planned Parenthood Federation of America
2. What Advocacy Experts Think
The Trump Administration’s reported plans to partially roll back the contraceptive coverage mandate of the Affordable Care Act, which has ensured access to affordable birth control for millions of women nationwide, is just the latest example of the dangerously hostile position it has taken against contraception access. Together with President Trump’s religious freedom executive order and the many harmful provisions in the ACA repeal bill recently approved by the House, a shocking number of policymakers seem determined to restrict access to critical, preventive reproductive health care, including contraception, which is used by almost all women at some point in their lives. Access to contraception is critical for women’s rights and improves the health of women, children, and families. Contraceptive access supports people to complete the education and career paths they aspire to. Contraception is a critical component of comprehensive reproductive health care, including safe abortion care, which should be accessible to all people, regardless of zip code or income. Our goal must be to move forward and expand access to affordable contraception, not restrict it. Time and again, the Trump administration has demonstrated its failure to grasp this concept and do what’s right for our nation’s health.
-Kelly Blanchard, president of Ibis Reproductive Health.
It's clear that this administration's attack on access to contraception is a core tenet of its harmful agenda. All young people deserve to lead safe and healthy lives, and access to the full array of reproductive health care services, including contraception, is essential as youth age. Even under the barrage of attacks to their communities coming from the highest office in the nation, young people across the United States are demanding that their country move forward, not backwards. This youth-led movement won't stand for the deterioration of civil rights or for a government-sanctioned right to discriminate. Advocates for Youth stands in opposition to the Trump Administration's medieval and harmful agenda and will resist any further actions that jeopardize the health and safety of young people.
-Debra Hauser, President of Advocates for Youth
3. What Doctors Think
We are deeply concerned about the reports of a draft rule that could take away contraceptive coverage from patients because of their employers’ beliefs. Contraception is a key part of preventive care for women. Insurance coverage for contraception, now covered under the Affordable Care Act without extra fees, preserves health and well-being in countless ways. Women and their physicians know from firsthand experience that with contraception, pregnancy can happen at the right time. That should be our goal, whatever an employer’s personal beliefs.
The ACA requirements have made birth control more affordable, meaning that a patient can choose the contraception that is best for her rather than selecting based on cost. Taking away coverage that my patients rely on will be disastrous. Countless families now live healthier lives because insurance must cover all methods of contraception. Let’s not go back to the days when birth control was off the table for too many because it was too expensive.
We note that some employers have objected to covering contraception because of the mistaken belief that certain methods of contraception are abortifacients. Contraception works by preventing pregnancy, not by disrupting an established pregnancy. A woman’s health insurance should meet all of her health care needs, including contraception. Employers should not interfere in what is a private decision by withholding insurance coverage.
-Dr. Anne Davis, Consulting Medical Director of Physicians for Reproductive Health