Federal officials, under orders by President Donald Trump, have drafted a rule to roll back the Obama-era mandate that birth control be included under all employer insurance plans.
The final shape of roll back is still uncertain: The White House Office of Management and Budget (OMB) website says that it is reviewing the “interim final rule” to relax the requirements on preventative services. The rule change is specifically aimed at accommodations for religious organizations, some of whom have strongly objected to requirements that they include birth control coverage under their insurance for employees.
“We are sure that some women will lose birth control coverage.”
Typically, when an agency considers changing a rule — which can have immediate and sweeping policy impacts — they publish a preliminary version, solicit comments from the public, and incorporate the feedback into revisions before handing down the final change. If the OMB is reviewing the interim final rule, however, that means the rule has already been drafted by the relevant agencies and is in the last step before being published, according to the National Women’s Law Center.
“We think whatever the rule is, it will allow an employer’s religious beliefs to keep birth control away from women. We are sure that some women will lose birth control coverage,” Gretchen Borchelt, the vice president of the National Women’s Law Center, told the New York Times.
Under the current rules, implemented under President Obama, birth control coverage is considered part of preventative medical care and must be covered by all insurers with no co-pay. The mandate has guaranteed an estimated 55 million women access to birth control and other preventative services at no additional cost to them, regardless of their employer.
In 2013, the mandate saved women $1.4 billion on birth control pills, and since the law went into effect, there has been a nearly 5 percent uptick in birth control subscriptions, according to the NWLC. The increased access to contraceptives has also correlated with a sharp drop in unintended pregnancy and abortion rates.
These public health outcomes make it easy to see why the requirement has been widely lauded by women’s health advocates and providers.
“Without question, contraception is an integral part of preventive care; women benefit from seamless, affordable access to contraception, and our health system benefits as well,” the American College of Obstetricians and Gynecologists (ACOG) said in a statement about the mandate. “ACOG strongly believes that contraception is an essential part of women’s preventive care, and that any accommodation to employers’ beliefs must not impose barriers to women’s ability to access contraception.”
The law has been hotly contested, however, by religious organizations who object to having to include birth control in their insurance plans. Trump seized on their complaints while campaigning for the presidency, and in early May, fulfilled his pledges to evangelical Christian supporters by handing down an executive order on “religious freedom” that aimed to do two things: To make it easier for faith leaders to preach politics, and to allow employers to claim a religious exemption against providing contraceptive coverage for their employees.
Trump made the proclamation alongside representatives of Little Sisters of the Poor, an order of nuns who have been some of the most vocal opponents of Obamacare’s mandate that insurance include birth control coverage — taking the fight up all the way up to the Supreme Court.
“Your long ordeal will soon be over,” Trump told them when he announced the order.
Secretary of Health and Human Services Tom Price immediately issued a statement saying that he’d be happy to take have the opportunity to reshape the requirements on birth control coverage.
“We welcome today’s executive order directing the Department of Health and Human Services to reexamine the previous administration’s interpretation of the Affordable Care Act’s preventive services mandate, and commend President Trump for taking a strong stand for religious liberty,” he said in a press relief.
Price has long been a vocal critic of the birth control mandate on grounds of religious freedom, and has also been dismissive of its benefit to women.
“Bring me one woman who has been left behind. Bring me one. There’s not one,” Price said about women having trouble paying for birth control in an interview with ThinkProgress in 2012. “The fact of the matter is this is a trampling on religious freedom and religious liberty in this country.”
According to a recent survey by polling form PerryUndem, 33 percent of American women said they couldn’t afford to pay any more than a $10 copay for their birth control. Fourteen percent said that if they had to pay for birth control at all, they couldn’t afford it.