Trump to expand religious exemptions to birth control coverage
WASHINGTON — The Trump administration is expected to soon issue regulations that would expand religious and moral exemptions for covering birth control in employer health insurance plans, a move that critics say would limit women’s access to contraception.
The rules would likely roll back a controversial Obama-era mandate in the Affordable Care Act that required employers to cover birth control. The regulations were filed last week for review with the Office of Management and Budget, indicating that the administration is in the final stages of issuing the expanded exemptions.
The exact details of the exemptions, and when they would take effect, remain unclear. But women’s health advocates are bracing for a legal fight. They expect the rules to mimic earlier regulations enacted by the Trump administration last year before being blocked by federal judges.
The rules allowed nearly any employer — nonprofit or for-profit — with a religious or moral objection to opt out of the Affordable Care Act provision requiring the coverage of contraception at no cost for the employee. The rules vastly expanded which companies could be exempt from the mandate and why, including a broad exemption for a “sincerely held moral conviction” not based in any particular religious belief. Perhaps most significantly, it required employers to provide no other accommodations for employees seeking birth control coverage.
The Trump administration rules were “nothing short of radical,” Louise Melling, American Civil Liberties Union deputy legal director, said in a phone call Thursday with reporters. “There’s no backstop to ensure coverage for employees.”
After a Supreme Court decision in the Hobby Lobby case, the Obama administration allowed religiously affiliated nonprofits and certain private, for-profit corporations to opt out of the coverage, as long as their employees were provided with an accommodation. The accommodations allowed for affected women to still get the coverage they needed for birth control, but the company’s insurer would pay, not the company itself.
Then, in October 2017, the Trump administration issued its directive significantly expanding those exemptions. “It drives a Mack truck” through the Obamaera rules, said Mara Gandal-Powers, director of birth control access and senior counsel for the National Women’s Law Center. “We’re really concerned about how far it goes.”
Several states and advocacy groups quickly sued, arguing in part that the Department of Health and Human Services enacted its rules without the notice and comment period required by federal law.
In December 2017, federal judges in California and Pennsylvania issued preliminary injunctions blocking the rules from taking effect. The Trump administration appealed both injunctions.