On Sunday, Speaker of the House Rep. Paul Ryan (R-WI) refused to tell CNN’s Jake Tapper whether or not the replacement of the Affordable Care Act which Republicans are hoping to pass under President Trump will maintain the current law’s free birth control to insured women.
“Obamacare provides birth control for women at no cost,” Tapper asked during an interview on CNN’s State of the Union. “Is that going to end or remain?”
“Look, I’m not going to get into the nitty-gritty details,” Ryan said, dodging the question.
“With all due respect, I don’t know that the average woman of childbearing years out there who relies upon contraception provided by health insurance mandated by the Affordable Care Act — I don’t know that she would think that that’s just a nitty-gritty detail,” Tapper responded.
But Ryan still refused to answer, telling Tapper that he was “not going to get into hypotheticals about legislation that hasn’t even been drafted yet.”
On the campaign trail, Trump made repealing and replacing the Affordable Care Act a key part of his stump speech, promising voters that he would completely repeal President Obama’s signature healthcare bill if he were elected president. Trump has since flip-flopped on that promise, telling the Wall Street Journal in an interview on Friday that he no longer was completely committed to repealing the act, but amending it, while keeping in place key provisions like prohibiting insurers from denying coverage based on a pre-existing condition, and allowing children to stay on their parent’s insurance until 26.
Trump has been quiet, however, about what he will do with the provision that requires free birth control — including long-term birth control like IUDs — for insured women. Trump himself has not called for an end to free birth control for insured women, or called for a ban on types of long-term birth control like IUDs, but he has called to end federal funding to Planned Parenthood and has been erratic, at best, with regards to his stance on crucial women’s health issues like abortion.
His vice president, Gov. Mike Pence (R-IN), has a much clearer track record of attacking women’s access to health care. Pence introduced the first amendment to cut off federal funding to Planned Parenthood in 2007, and signed a bill in Indiana this year that requires funerals for fetuses (it was later found unconstitutional by a federal judge).
Speaker Ryan has been critical of the Affordable Care Act’s requirement to make birth control free to insured women, saying in a speech in 2012 that the birth control mandate is actually a “threat” to poor Americans who rely on government programs and religious charities.
According to the New York Times, Trump could choose to undo the requirement for free birth control for insured women unilaterally, without needing to go through Congress, though it would take about a year to change that regulation.
Long-term birth control like IUDs, which can last between three and seven years, have been rising in popularity in recent years. IUDs and implants have failure rates of about one percent, making them incredibly effective at preventing unplanned pregnancies and reducing abortion rates. The birth control mandate of the Affordable Care Act has helped reduce financial barriers to long-term birth control like IUDs, helping boost their popularity.