Based on a new rule sent to the White House Office of Management and Budget last week, the Trump administration is expected to try again to broaden faith-based exemptions for health-insurance coverage of contraception. If the regulation clears the review process, it could expand the number of employers able to opt out of paying for birth control through company health plans.
Last October, the Trump administration attempted to weaken the so-called “birth control mandate” of the Obama-era Affordable Care Act (ACA). Two new federal rules permitted universities and publicly traded for-profit companies to forgo the mandate because of religious or moral beliefs, even if the organization isn’t faith-based. Those new rules have been on hold, however, due to lawsuits from several states, including California and Pennsylvania. The new regulation could be an effort to work around pending litigation, say some health advocates.
Critics warn that increased exemptions are radical and jeopardize women’s well-being. After the October 2017 rules were announced, Louise Melling, deputy legal director at the American Civil Liberties Union, said, “Any rule that allows employers to deny contraceptive coverage to their employees is an attempt at allowing religion to be used as a license to discriminate.”
Some Say the Mandate Violates Their Conscience
In May 2017, President Trump signed an executive order seeking to “address conscience-based objections” to birth control coverage. Attending that ceremony were nuns from the Little Sisters of the Poor, an order that tried to weaken the contraceptive mandate beyond the landmark 2014 Burwell vs. Hobby Lobby ruling. In that case, the Supreme Court said private, for-profit companies weren’t required to pay for employees’ contraception if the business had religious objections. The Court, in a 5-4 decision, said the mandate “substantially burdens the exercise of religion.”
Hobby Lobby president Steve Green, an evangelical Christian, argued that some forms of birth control “violate our conscience” because they induce early abortions. “We believe that life begins at conception,” he said, “and it’s something that we have no desire to fully fund, which is what the mandate requires.”
The ACA’s birth control mandate includes coverage of drugs known to cause “chemical abortions” after fertilization. That’s one reason the U.S. Conference of Catholic Bishops had called the mandate an “unprecedented attack” on religious liberty.
Soon after the mandate was announced in 2012, a poll showed that 57 percent of people said contraceptive coverage should be optional for religious-affiliated organizations.
Expanding a Religious Exemption Could Have a Major Impact
Half of Americans, some 157 million people, have health insurance through an employer. After the ACA required company health-care plans to cover birth control at no additional cost, access to contraception was greatly expanded.
The mandate, according to one estimate, has saved U.S. women $1.4 billion on birth control. The Kaiser Family Foundation reports that only 4 percent of privately insured women now pay out-of-pocket for contraception, compared to 20 percent before the ACA passed.
Details about the new rule haven’t been made public yet. But some people say it’s part of the Trump administration’s big-picture effort to broaden religious objections to certain medical procedures, tighten abortion restrictions and limit family-planning services.