Since 2012, more than 55 million people across the country accessed birth control for free. Now, a federal rule — announced Friday and effective immediately — would make it easier for employers to stop covering birth control.
The Trump administration rolled back the Obama-era federal requirement for employers to include birth control coverage in their health insurance plans. Under the new rule, employers (non-and-for profit companies), universities/colleges (that offer student health plans), and insurers can seek federal exemptions by citing religious or moral objections.
The changes fulfill a campaign promise made to social conservatives, who’ve held longstanding objections to the federal requirement and challenged it in court. For the vast majority of U.S. residents, who support the contraception mandate, it deals yet another major setback to reproductive health under the current administration.
This rule in particular was much anticipated. In fact, after President Trump won the election last November, Planned Parenthood saw a 900 percent increase in demand for long-acting reversible contraception (LARC). Many anticipated something like this would happen, and so they switched from daily birth control pills to intrauterine devices (IUD), which can last anywhere between three to ten years. For many women and gender minorities, birth control isn’t just to control when they get pregnant.
“Contraception is an essential component of health care. It not only allows women to plan and space their pregnancies in a way that is best for their health and their families, but also helps manage a variety of health conditions,” Dr. Anne Davis, consulting medical director for Physicians for Reproductive Health. “Insurance coverage must include birth control so that women can choose the method that meets their needs and have access to it consistently.”
It’s not clear if employers or insurance companies would seek an exception. Following a Supreme Court decision win for social conservatives, nonprofits could seek religious accommodation and a few did. Already, The National Women’s Law Center, a nonprofit advocacy group, has been preparing a lawsuit since last spring against the expected rule. In a call with reporters Friday, The American Civil Liberties Union’s Brigitte Amiri, California Attorney General Xavier Becerra, Americans United for Separation of Church and State’s Richard Katskee, and the Center for Reproductive Rights’s Julie Rikelman said they plan to file lawsuits as well.
Life before the birth control mandate
The National Academy of Medicine, then-called the Institute of Medicine, recommended that the Obama Administration include birth control as one of the eight preventative health benefits that Affordable Care Act (ACA) compliant health plans cover at no cost to patients.
The recommendation came because birth control, especially the more effective types, is expensive. In the absence of the contraceptive coverage guarantee, people would need to pay more than $1,000 to start using contraception like IUDs, implants and sterilization — nearly one month’s salary for a woman working full-time at the federal minimum wage of $7.25 an hour, according to Guttmacher Institute. Even oral birth control pills, which are more cost effective, add up because they require monthly or bi-monthly co-payments.
Out-of-pocket costs for prescription drugs dramatically reduced for women after the contraception mandate went into effect in 2012:
The contraception mandate has since made life easier for many women:
The Trump administration and reproductive health
This new rule reflects a trend in both the Trump administration and the current Congress to dismantle women’s access to health care, say health experts. This includes the administration appointees who oppose abortion rights, cutting grants aimed at teen pregnancy, legislation allowing states to restrict family planning funds, and a G.O.P. health care repeal bill that would have left millions of Americans uninsured or without coverage for essential services.
The Department of Health and Human Services told a group of reporters before the rule’s publication that they project that “99.9 percent of women” will be unaffected. “They like to talk about these policies in isolation,” the Guttmacher Institute’s Adam Sonfield told ThinkProgress. “They are not just trying to undermine contraceptive coverage. They’ve tried to cut Title X funding, Planned Parenthood funding… you have to see it as a coordinated campaign.”
The Trump administration’s approach to reproductive health is vastly different than Obama’s, where the former often blurs religion and science. The federal regulation even cites an “abstinence until marriage” study:
Federal funding for abstinence-only programs was cut under the Obama administration based on research that shows the approach tends to increase rather than reduce teen pregnancy.
Although the federal rule goes into effect immediately, this does not mean employers will automatically seek exceptions to cover birth control. And many states implemented their own laws, safeguarding patients. Sonfield said, “the oversight is us saying to our employer, we demand this.”
This post has been updated to reflect that the ACLU, CRR, AUSCS, and California intend to file a lawsuit against new rules.