Exemptions to coverage of birth control expanding

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 Obamaera 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 forprofit — 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 man date 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,” American Civil Liberties Union deputy legal director Louise Melling said in a conference call Thursday with reporters. “There’s no backstop to ensure coverage for employees.”

The number of companies that would actually opt for such exemptions is unclear. An employee’s coverage would depend largely on the employer’s insurance plan, as well as the state’s laws. Currently, 30 states and the District of Columbia require insurance plans to cover contraceptives to some extent, with certain exemptions, according to the Kaiser Family Foundation. But state laws in those places do not have authority over all plans. Meanwhile, 20 states have no contraception requirements for insurance plans.

The birth control rules are part of a broader effort by conservatives inside and outside of the White House to prioritize religious liberty. It also comes in the midst of an ongoing court battle.