The Trump administration has released new rules exempting many employers from the Affordable Care Act’s requirement that health insurance plans cover contraception without copays. The rules came with two 100-plus page documents explaining the new religious and moral exemptions from the law.
While there were many harmful, insulting and inaccurate claims in these documents, I think these 10 are the most egregious.
- The new rules expand the exemption beyond religious institutions, non-profits and for-profit corporations privately owned by religious people (think Hobby Lobby) to exempt all employers. That means Walmart could decide that they have religious objections to providing contraception coverage to its employees and opt out of the ACA mandate.
- The new rules expand the exemption beyond religious beliefs to include non-religious “moral convictions.” That means your employer could decide that it’s immoral for you to use contraception and then legally refuse to allow your health insurance to provide you with coverage.
- The new rules expand the exemption beyond employers to include an exemption for insurance companies with religious or moral objections as well. That means you will be subject to the moral beliefs not only of your employer but of your insurance company as well. They also exempt schools, colleges and universities—meaning that students will be barred from accessing contraception.
- In addition to refusing to cover the cost of contraception, exempt employers may bar insurance coverage for the cost of medical counseling about contraception. Meaning that employers, schools and insurance companies can bar your access to information from your doctor about contraception.
- Despite the fact that employers can refuse to offer contraception coverage, the new rules require that employers offer individual employees with moral or religious objections the option of buying insurance that does not include contraceptive coverage.
- The new regulations allow employers and schools to prevent insurance companies from providing contraception, leaving women without any coverage for contraception. The Obama administration had developed an accommodation process whereby employers and schools only had to notify the government about their objections to covering contraception in order to be exempt, whereupon coverage would be arranged for the employees through their health insurance company. But the Trump administration believes that even this violates employers’ religious beliefs because it makes them complicit in women gaining access to contraception.
- While the justifications for the rules expansively address the importance of religious beliefs and moral convictions of individuals and corporations, the Trump administration dismisses the importance of contraception to women’s health and prevention of pregnancy. Instead, the administration emphasizes the supposed “negative health effects” of contraception and its likelihood of encouraging “risky sexual behaviors,” especially among young adults. The Guttmacher Institute has documented the proven positive health effects of contraceptive use, including decreased unintended pregnancy and abortion.
- The Trump administration’s’ justification for the new rules uncritically repeats the inaccurate claim that contraception causes abortion. To the contrary, the American Congress of Obstetricians and Gynecologists have strongly stated that contraception cannot end a pregnancy.
- The administration admits that the rules will result in some people not receiving coverage and that they “do not have sufficient data to determine the actual effect of these rules” on women, but they conclude that the effects are negligible. Yet they estimate that just the religious exemption would amount to a loss of coverage for of up to 120,000 women at a cost of up to $70.1 million dollars. Critics estimate that many more people will lose coverage. After the contraception mandate went into effect in 2012, the number of women paying for contraceptives fell from nearly 21 to fewer than 4 percent by 2014. That percentage is sure to go back up under the new rules.
- Perhaps most insulting of all, the rules never mention women’s rights to bodily autonomy, privacy or equality.
The new rules were immediately challenged by four Attorneys General, as well as the ACLU. These challenges argue that the new rules violate the First Amendment prohibition of government action “respecting an establishment of religion.” The Center for Reproductive Rights, on behalf of Medical Students for Choice, is also challenging the law in court.
Despite the gaping hole that these rules have torn into the contraception mandate, it’s important to remember that the contraception mandate still exists. However, the Trump administration has suggested scrapping the mandate altogether. And of course, we know they are trying as hard as they can end the Affordable Care Act itself. But in the meantime, HHS has called for public comments on whether the exemption for moral convictions should be expanded to apply to publicly-traded for-profit corporations. (You can submit your comments here.)
On the same day as the Trump administration’s one-two punch to the ACA’s contraception mandate, Jeff Sessions issued a 25-page memo directing government attorneys to broadly interpret religious liberty protections in federal law, opening the door to religious justifications for discrimination against women and LGBT people. Would this allow an employer to fire a woman for having an abortion or using contraception? Or for that matter, having sex outside of marriage or working when she has young children?
The new contraception rules and Sessions’ religious liberty memo are clear attempts by the Christian right to evade civil rights and labor laws in the name of religion, as documented in a recent report by Massachusetts-based social justice think tank Political Research Associates.
How appropriate that these scary new rules went into effect on Friday the 13th!