After four attempts at repealing the Affordable Care Act failed, the Trump administration has begun to issue new rules that take away key parts of the 2010 healthcare bill. First on the chopping block: the mandate requiring health insurers and employers to provide birth control at low or no cost in their healthcare plans.
Currently, health insurers have been required to offer many types of contraception as part of their services, including:
Abortions and vasectomies were not necessarily included in the mandate. While some employers and groups were still allowed to not offer contraceptives—such as houses of worship or certain nonprofits—a 2015 executive order by then-President Obama allowed people covered under those plans to seek out contraception through a third party provider.
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But new rules will allow many additional companies and organizations to claim a moral reason to deny coverage for birth control, and will no longer guarantee that people who get health insurance that doesn't offer contraception coverage can get those services from a third party. Companies and organizations can claim exemptions for "sincerely held religious beliefs" against providing contraceptives or even just "on the basis of moral conviction which is not based in any particular religious belief."
And that's caused many health organizations, including the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, and the Society for Adolescent Health and Medicine, to release statements against the new rule. "We are concerned that today’s actions not only limit access to a vital service unnecessarily, but also open the door for other businesses to decide not to offer certain kinds of physician-recommended health services due to moral objection, such as immunizations or other evidence-based preventive services," AAP President Fernando Stein, MD, FAAP, said in a news release. “This rule sets a dangerous precedent and carries serious health consequences.”
Right now, the Department of Health & Human Services estimates that 120,000 women will lose contraceptive coverage due to this new ruling, basing their number on the number of companies who have filed lawsuits about the requirement to offer contraception. But critics are concerned that many more companies will take advantage of this ruling to reduce their healthcare costs.
The contraception coverage has been a very popular part of the Affordable Care Act, with more than 55 million women getting birth control coverage through it, according to the National Women's Law Center. And researchers say that the increase in contraceptive coverage has helped not only decrease the rate of unintended pregnancies by more than 18 percent, it also resulted in a huge decline in the abortion rate, which has now reached the lowest number since 1975. "Reducing access to contraceptive coverage threatens to reverse the tremendous progress our nation has made in recent years in lowering the unintended pregnancy rate," Dr. Haywood L. Brown, president of the American Congress of Obstetricians and Gynecologists, said in a statement.
Several organizations, including the ACLU and the National Women's Law Center, will be trying to fight against this rollback in court. They argue that it discriminates unfairly against women, who will face additional financial burdens as a result of the change, and that it amounts to religious discrimination, as it allows employers to push their own religious beliefs on their employees.
But now might be a good time to talk to your company's human resources department about what this means for your healthcare coverage—and to your gynecologist about your affordable contraception options.