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Religious objection order gives broad leeway to employers to drop birth control coverage

Supporters of religious non-profit organizations rallied outside the Supreme Court during oral arguments in March 2016. Photo: Richard Wolf, USA TODAY

(USA Today) — The Trump administration is expanding the religious exemption for employers that don’t want to provide insurance coverage for certain birth control methods because they have moral objections.

The Affordable Care Act required all employers to cover birth control for their workers without any co-payment, but the provision has been embroiled in lawsuits ever since.

The new rules, announced Friday (Oct. 6), allow any employer or insurer to stop covering contraceptive services if it has religious beliefs or moral convictions against covering birth control. It would be up to states to determine how companies should make these decisions.

Senior Health and Human Services officials said only a small fraction of women who get birth control without cost from their employers will be affected, as some large companies, including Pepsi and Exxon, had pre-ACA plans that will continue. Some church groups were already exempt from the law and not providing this coverage. The officials requested anonymity during a Friday call with reporters.

The National Women’s Law Center immediately vowed to sue the Trump administration to block the rules, which CEO Fatima Goss Graves said showed “callous disregard for women’s rights, health and autonomy.”

The Supreme Court decided in 2014 that the Affordable Care Act couldn’t require employers to offer insurance coverage for certain birth control methods they equate with abortion. The decision applied only to private corporations such as the family-owned companies — including retailer Hobby Lobby — that challenged the law. Women working for those companies would be able to get morning-after pills and IUDs from other sources, such as the government or private insurers.

Critics of the rule, including American Public Health Association executive director and physician Georges Benjamin, said it is a way for the Department of Health and Human Services to achieve what it hadn’t been able to do in Congress despite repeated attempts to repeal and replace the ACA.

It’s a “roundabout” way for the Trump administration to eliminate the ACA’s birth control coverage mandate, said American College of Obstetrics and Gynecology President Haywood Brown, an OB/GYN.

The group also said contraception reduces maternal mortality and improves the health and economic stability of families and communities.

ACA opponents sought to get rid of the so-called “essential health benefits” that the law requires all insurance plans to cover, which includes birth control.

Brown joined opponents of the Trump administration in a call about the expected rule that was set up by Planned Parenthood late Thursday.

“Any move to decrease access (to contraception) will have damaging effects on public health,” says ACOG CEO and OB/GYN Hal Lawrence, citing premature births, which are more common when babies aren’t planned.

The agency is showing a “deep disregard for women’s health,” he said.

It may be a costly change too. For every dollar spent on birth control, ACOG estimates $7 is spent on other health care costs associated with unintended pregnancies.

While contraception prices may not rival some of the sky-high prescription drug prices that have dominated the news, a 2010 Hart Research poll found 1 in 3 women voters struggled to afford prescription birth control and 57 percent of women aged 18 to 34 had trouble paying.

The percent of people who had to cover some of their birth control costs dropped from more than 20 percent before the ACA to 4 percent after it went into effect, according the Kaiser Family Foundation.

Conservative groups that fought the Obama administration in court over the birth control mandate applauded the expected rule when a draft began circulating this spring. These supporters said women seeking birth control from employers could still buy separate policies directly from insurance companies. They estimated fewer than 200,000 women would be affected.

Still, the Center for American Progress thinks “the floodgates” could open to “nearly any private employer refusing to cover birth control.”

Of the companies that filed requests for exemptions from offering birth control without a co-payment, 53 percent were for-profit companies, the group said in August. The group obtained the information through a Freedom of Information Act request.

“The data are only small slice of those seeking the right to deny coverage, but they demonstrate that this debate isn’t about houses of worship or faith-based organizations wanting accommodations,” the group’s Devon Kearns said Thursday. “A change in the rule would enable even more for-profit corporations the ability to make getting birth control more difficult.”

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  • Unbelievable. Make decisions on what needs to be included in medical insurance coverage based on religious beliefs, not from medical science or the experience of medical practitioners. And, make sure that the person who controls the jobs also controls the ability of those who work for them to make their own conscience based decisions about birth control.

    Religious freedom, folks? This is the opposite of religious freedom; it is government promoted religious coercion.

  • Struggling to comprehend the GOP/Religious Fundamentalist drive to consign women to Comstockian policy. Are they determined to next reverse Griswold v. Connecticut? Small government my ass!
    Folks should pay attention to how Catholic bishops are quietly monopolizing health care in many regions of the country. They arrange to take over/buy out struggling systems and force them to submit to religion based health care. This means complicated pregnancies run the greater risk of BOTH mother and fetus/infant dying from lack of timely, medically sound treatment.

  • The ongoing struggle between Pro-Choice forces and Pro-Life forces continues, or if you prefer, Pro-Choice/Anti-Choice, or Pro-Abortion/Anti-Abortion. Take your pick according to your own social, legal, or spiritual perspective.

  • Pope Francis visited with the Little Sisters of the Poor while in the US to encourage them in their lawsuit against the mandate which made it all the way to the Supreme Court. When Trump signed his “religious liberty” statement on May 4, it was the Little Sisters of the Poor he invited to the dais and shook their hands.

  • Dear ATF45,
    Are there any circumstances whereby it might be wrong to abort a child? How many abortions are enough? Do we need to increase abortions in America?

  • If you want to reduce the number of abortions, you need to reduce the number of unplanned pregnancies. The most effective way to reduce the number of unplanned pregnancies is through provision of effective birth control and access to good health care. You can be effective or sit on your high horse. Abstinence hasn’t been effective since the first eukaryotes bumped together about a billion years ago.

    This is not about coverage of abortion in health insurance. It is about coverage of birth control. Birth control does not equal abortion.

  • More than you do. I have yet to see someone who opposed access to abortion who gave a damn about actual born people. I have yet to see a post from you which wasn’t dripping with contempt and malice towards others.

  • Are there any circumstances where your input is requested or required when a woman makes a decision concerning her pregnancy?

    We need to keep abortion legal and accessible. Nothing good has ever happened to societies which ban it or attack access to it.

  • So they don’t want to cover birth control, prevent women from having abortions and cut the safety net?

  • The next exclusion will be blood -transfusions coverage . We ought to make a list of which kinds of medical instructions or treatment are frowned on by the world’s many religions . I remember that the heretical Albigensians of the Middle Ages taught that it was sinful to engage in sex on any occasion . Wouldn’t that exclude medical care during any stage of pregnancy ; or post pregnancy care for those little “bastards ” ?

  • richard, the coverage of blood transfusions was one of the things I quickly thought about. It is a good example.

    At some point, there has to be some consideration of the employees. We seem to continue to set up an extreme capitalist system, one in which the power to control jobs means the power to control employees. And that is what coverage under health insurance is – it is an ability to control the actions of others.

    I think the Hobby Lobby decision was a BIG mistake. I also think Citizens United was a big mistake. In too many ways, those who are not rich are being controlled by the power of those with money. They are controlling the media and hence the “news” and the political messages we hear. Even some Evangelicals believe that being rich in this world is a sign of God’s favor. There are too many Catholic hospitals that limit choices for women (I am Catholic and will not make use of any Catholic associated health care out of fear that an alternative provider will not make enough money, fold, and all that would be left is Catholic health care).

    This concentration of power that matches the concentration of wealth – is a loss of democracy, of freedom, of the right of individuals to make their own choices, to follow their own conscience on issues like contraceptives, sterilizations, and even blood transfusions. And, yes, on abortions, too, but I think there will have to be limits imposed, particularly on late term abortions, as long as a woman’s life is not put at risk.

    But, this is the era of Trump. I can’t even imagine what is next.

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