Talk about a hard pill to swallow—The New York Times reported today that "the Trump administration on Friday moved to roll back the federal requirement for employers to include birth control coverage in their health insurance plans, vastly expanding exemptions for those that cite moral or religious objections."
Attorney General Jeff Sessions made a statement reminding the public that the change would be fulfilling a Trump campaign commitment. "President Trump promised that this administration would ‘lead by example on religious liberty,’ " said Sessions, "and he is delivering on that promise.” Meanwhile, Speaker of the House Paul Ryan said the new rules ensure that people "can freely live out their religious convictions and moral beliefs," and regarded this date as a "landmark day for religious liberty.”
Though, it's important to note this is no longer strictly a religious matter. The administration acknowledged that the Religious Freedom Restoration Act of 1993, “does not provide protection for nonreligious, moral conscientious objections," but "Congress has a consistent history of supporting conscience protections for moral convictions alongside protections for religious beliefs.”
Thus, one of the new updates says that exemptions should be available to colleges and universities that provide health insurance to students and employees, for-profit companies whether owned by single families or thousands of shareholders, and nonreligious, nonprofit organizations. Employers claiming an exemption from the contraceptive coverage mandate “do not need to file notices or certifications” with the government. They need only to inform employees of changes in coverage.
So what does this mean for you and your family on the daily?
From the numbers side of things, the Times reports that hundreds of thousands of women could lose birth control benefits they now receive at no cost under the Affordable Care Act. (Currently, more than 55 million women have access to birth control without copayments thanks to the contraceptive coverage mandate, according to a study commissioned by the Obama administration.) The current administration claimed the ACA imposed a “substantial burden” on the free exercise of religion by the employers who object to it, and this tweaking that would not explicitly require coverage of contraceptives "is necessary and appropriate to provide the expanded exemptions."
From the activism side of things, if you're upset, it's time to start talking. While the Trump team plans to have these adjustments take effect immediately, because "it would be impracticable and contrary to the public interest to engage in full notice and comment rule-making," they will still accept comments from the public.
Some adversaries, from Democrats to doctors, have already spoken up. “The administration is now stooping to a new low by attempting to deny women the preventive health care coverage they need,” said Senator Ron Wyden of Oregon, the senior Democrat on the finance committee. The present government says contraceptives come with many health risks and could promote "risky sexual behavior" among young people, but the president of the American College of Obstetricians and Gynecologists, Dr. Haywood L. Brown, says, "Affordable contraception for women saves lives. It improves maternal mortality. It prevents adolescent pregnancies.”
And some opponents are already walking their talk. Gretchen Borchelt, a vice president of the nonprofit advocacy group, National Women's Law Center, told the Times that her organization is preparing counteraction. Borchelt explained that if the rule is not adequately explained or justified, it could be deemed “arbitrary and capricious,” and thus in violation of federal law. She also made mention of a quieted provision of the ACA that maintains the health secretary shall not issue any rule that “impedes timely access to health care services” or “creates any unreasonable barriers to the ability of individuals to obtain appropriate medical care.”
Borchelt's lawsuit is, of course, not the first and won't likely be the last from both sides of the issue. The Trump management said the new rules were actually motivated by a “desire to bring to a close the more than five years of litigation."
We'd heard reports since early May that the current administration had plans to rescind the Obama-instituted mandate that employers include birth control in health insurance plans, courtesy of the NYT and The Wall Street Journal.
Trump issued an executive order on May 4 demanding that three cabinet departments “address conscience-based objections to the preventive-care mandate" and cited a section of the Affordable Care Act that refers specifically to preventive services for women. On the same day he also hosted the Little Sisters of the Poor in the White House's Rose Garden. Trump told the group, "With this executive order, we are ending the attacks on your religious liberty.”
The Little Sisters, one of many employers with religious-based rejections to the ACA, refused to comply and instead went after a Supreme Court ruling.
The suit was a sort of nonissue given a loophole that allowed employees to bypass their employers. "If an employer notifies the government of its unwillingness to cover contraceptives, that prompts the insurer administering the employer’s health benefits to assume the cost and administration of providing contraceptives, effectively cutting out the employer," explains The Cut.
This new drafted policy change eliminates this workaround, according to Democrats in Congress who spoke to the Times.
"Women saved more than $1.4 billion in out-of-pocket costs for birth control in 2013 alone,” Democratic Senator Patty Murray of Washington and 13 other Democratic senators wrote in a letter to Mick Mulvaney, the White House budget director. “Access to affordable preventive services, including contraception, is a critical part of women’s health care.”
The article also reported that, as Dr. Brown asserted today, researchers found that since the Affordable Care Act increased women's access to contraceptives, "it may have contributed to a decline in unintended pregnancies."
"The new rules, drafted mainly by political appointees at the White House and the Department of Health and Human Services, seek to better balance the interests of women with those of employers and insurers that have conscientious objections to contraceptive coverage," the Trump administration says, and maintains that, "The government already engages in dozens of programs that subsidize contraception for the low-income women who are most at risk for unintended pregnancy."
However, there doesn't seem to be any indication of an increased focus on those programs as a result of this mandate rollback. So while we're hoping for the best, for now, we'll leave this here: 6 essential facts you need to know about going off the Pill. Just in case.