On Friday, the Trump administration announced new regulations governing contraceptive coverage under the Affordable Care Act. The rules will make sweeping changes to the law’s requirement that most employers provide coverage of birth control with no out-of-pocket costs to women.
The changes were hailed by religious groups, including the U.S. Conference of Catholic Bishops, which said it was “a return to common sense, long-standing federal practice and peaceful coexistence between church and state.” But others, including the National Women’s Law Center, said they plan to file suit against the rules. The National Health Law Program said that the rules appeared “legally suspect.”
Here are some frequently asked questions and answers about the new rules.
Q: What is the new policy?
Trump administration officials said they are significantly rolling back rules requiring many insurers to provide contraceptive coverage to women. Employers with a moral or religious objection to contraceptive services will be allowed to stop offering that coverage.
Under provisions of the Affordable Care Act, the Obama administration had issued rulesrequiring most plans to cover all contraception methods that have been approved by the Food and Drug Administration with no out-of-pocket cost to women. The provision does not cover plans that have a grandfathered status under the law.
That guarantee was whittled back through regulation and court actions to exempt some religious-based organizations, such as churches, and some privately held companies in which the owners have strong objections to contraception. Other nonprofit religious employers were offered an accommodation so that they didn’t contract or pay for the insurance coverage for their workers.
The rules unveiled Friday expand those exemptions to any nonprofit organizations and for-profit companies with firm religious opposition, as well as health plans provided to students at colleges with a religious affiliation. A second rule extends an exemption to organizations and privately held companies that have moral objections.
If an employer doesn’t have any moral or religious objections to contraception coverage, current ACA guidelines still apply. Federal policy for programs that offer free or subsidized coverage to low-income women also will not change.
The rules become effective as soon as they are published in the Federal Register, which is expected soon. View them online here and here.
Q: Who is covered by the ruling?
Exactly who will be affected is in dispute.
In a news release, the Department of Health and Human Services said that the rules “will not affect over 99.9 percent” of the 165 million women in the United States. The exemptions announced Friday, HHS said, “may impact only about 200 entities, the number that filed lawsuits based on religious or moral objections.”
Groups that favor the ACA’s contraception coverage say the impact will be far larger.
“The Trump administration just took direct aim at birth control coverage for 62 million women,” Cecile Richards, president of the Planned Parenthood Federation of America, said in a statement. “With this rule in place, any employer could decide that their employees no longer have health insurance coverage for birth control.”
Mara Gandal-Powers, a senior counsel at the National Women’s Law Center, said that even though many employers will not change their coverage, women in some places could find it difficult to get the health care they need.
HHS estimated in 2015 that 55 million women were covered by policies that provide no-cost contraceptives. The number of women paying for contraceptives fell from nearly 21 percent in 2012 to fewer than 4 percent by 2014, according to the Kaiser Family Foundation. (Kaiser Health News is an editorially independent program of the foundation.)
While some employers will be exempt from the ACA rules covering contraception, they may not be exempt from applicable state laws. Eight states currently have laws requiring contraceptive coverage at no cost to employees, while another 20 states have laws requiring coverage of prescription contraceptives with the option of asking employees to pay some of the cost. Those state laws still apply, said Laurie Sobel, associate director of women’s health policy at the Kaiser Family Foundation.
Q: How have the courts ruled previously on the ACA and contraception coverage?
In 2014, the Supreme Court voted 5-4 to allow a key exemption to the health law’s contraception coverage requirements when it ruled that closely held, for-profit businesses could assert a religious objection to the Obama administration’s regulations.
The court’s majority said that the companies that filed suit — Hobby Lobby Stores, a nationwide chain of 500 arts-and-crafts stores, and Conestoga Wood Specialties, a custom cabinet manufacturer — did not have to offer female employees all of the Food and Drug Administration-approved contraceptives as part of a package of preventive services that must be covered without copays or deductibles under the law. The companies had argued that several types of contraceptives violate their owners’ religious beliefs.
The companies are family-owned, and they said that the health law’s contraception requirement violated their religious views. While both employers’ health plans covered some forms of birth control, they found some forms of emergency contraceptives objectionable, such as Plan B and Ella that can prevent a pregnancy if taken within a short window after unprotected sex. They said these contraceptive methods prevent a fertilized egg from implanting in the woman’s uterus and therefore are a type of abortion.
In another lawsuit, religious groups, including the Little Sisters of the Poor, an order of Roman Catholic nuns, said that complying with an Obama administration accommodation for religious-affiliated groups violated their religious views. In May 2016, the Supreme Court sent that lawsuit back to the lower courts to see if a compromise was possible.
Q: How does the Obama administration’s accommodation work?
The Obama administration’s policy also did not apply to churches or houses of worship. And in response to protests from other nonprofit religious organizations — such as church-affiliated hospitals or schools — officials set up an accommodation that allowed those employers to not contract for contraceptive coverage as part of the insurance that they offered workers. Instead, the insurance plan that served their employees would provide coverage, at no cost, to the workers. Some of those groups, such as the Little Sisters of the Poor, objected to this setup and challenged the policy in court.
–Mary Agnes Carey and Lexie Verdon, Kaiser Health News
Anonymous says
I’ll start this off. I don’t want to pay for some woman’s birth control as an employer for moral, religious and financial reasons. If a woman wants to make the choice to use birth control, don’t send me the bill.
Yellowstone says
Great . . . ! Now all those unsuspecting, romantic young high school girls (perhaps daughters of your readers) can figure out how they are going to pay the physicians for pre/post natal care and the epensive hospital ER bills. They certainly will not be using medicare/medicade to do so.
Seems like the GOP cares a great deal about ‘life in the womb’, but cares a great deal less once that life form is a living, breathing human being.
When is this nonsense going to end?
Florida Voter says
It’s about damn time the Gov. gets back to legislating Catholic values! It’s obviously that the Fed. Gov should focus more on making “sins” illegal, regardless of what freedoms they trample on or what securities it destroys. (Sarcasm.)
In all seriousness, though, is the preamble of the Constitution meaningless? Does “insure domestic tranquility, provide for the common defense, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity” mean that religiously based values outweigh freedom? Isn’t it in the interest of the “general welfare” for the government to reign in capitalism and maintain policies that promote health and wellness, especially for those who are already disadvantaged?
I guess my vocabulary doesn’t match that of the “constitutionalists” who maintain that a corporation can should have the same religious freedoms that individuals have, so allowing their employees access to contraceptives is somehow a “sin.” I thought “sin” was anything that separates a person’s relationship from the will of God. I’ll tell you one thing: I’ve never seen “Hobby Lobby” attend a church or even pray to God, so I’m not sure how a building could have a personal relationship with God.
I’m not perfect (okay Trolls, that was your invitation), but I do understand that there is a difference between “sin” and what the government should legislate.
Flatsflyer says
If birth control had been available 70 years ago Trump would not be here today.
Chris A Pickett says
Yellowstone, They’re called CONDOMS, and they protect both parties from pregnancy AND DISEASE. Not sure if your aware, but STD’d are exploding from all that “free love”. Also it seems not many of these young ladies are taking them now, judging from all the single young female with baby daddys……..Perhaps not having sex until you can support a child is a better idea. I mean that is the primary reason for sex, you do understand that right?
Mr Chris says
“When is this nonsense going to end” Interesting choice of words. I have seen this same line used by people upset by the event in Las Vegas last week but for the opposite reason.
Sherry says
@anonymous. . . Sooooooo, it is OK that “I” (insurance) pay for YOUR Viagra. . . right? If an old/impotent man still wants to get it up. . . “don’t send ME the bill”!
Sherry says
Right On Yellowstone! ” Seems like the GOP cares a great deal about ‘life in the womb’, but cares a great deal less once that life form is a living, breathing human being.
When is this nonsense going to end?”
Concerned Citizen says
Shouldn’t providing contraceptives be a personal obligation and not a government one? If you want to roll around in the hay you should have to pay.
It shouldn’t be your employers or governments job to make sure you are having safe sex. If you are going to be active then take the time to do it right. That includes both men and women.
There’s an ongoing trend in society now that it’s always someone else’s responsibility. Guys buy your condoms and keep it wrapped. Women do what you need to do to stay safe. Perhaps if you can’t afford safe sex then abstain?
The more we force coverage on people the higher premiums go. Making it more and more out of reach for the average American.
Health insurance has gotten so ridiculous that I haven’t had it for years now. It’s cheaper to pay the penalty at the end of the year or go to the ER and set up a payment plan.
Concerned Observer says
Regarding one commenters response, “When is this nonsense going to end? It just did. The government can please all of the people some of the time. It can please some of the people all of the time. As President Trump is learning, it cannot please all of the people all of the time.
Please read the article. It affects insurance coverage for birth control only. The number of companies exempted from paying for birth control coverage under established religious or ethical beliefs of the companies’ owners is infinitesimal when compared to those that must still cover it. The question is simple. When do the rights of one group override that of another’s? If insurance coverage for that narrowly defined set of circumstances is of such great importance to an employee, work somewhere else. One company mentioned in the article (Hobby Lobby), chooses to close their business Sundays. Should the government force them to keep their stores open to accommodate those employees who would choose to come to work on those days?
This ruling does not eliminate birth control insurance coverage for everyone (as some groups would like), it just limits the burden of paying for it by a limited group of employers. It does not affect insurance coverage for pre-natal, delivery or childcare.
another vet says
maybe those “romantic unsuspecting,(really) high schoolers should not have sex until they can afford to support there own kids
Anonymous says
I find it ridiculous how old men suddenly become moralists when the subject of birth control comes up, and funny, it’s the same old men who guzzle down the little blue pill that’s paid for by insurance, mind you. Please. Sex happens, it’s biologic, so I’m glad women have the means to avoid pregnancy if they so choose. Insurance is a kitty we all kick into for the general wellbeing of all. I wouldn’t deny a man past his abilities to achieve an erection on his own due to age, or injury, by keeping him from getting the little blue pill. Would a man accept that his inability to attain an erection is God’s will? Of course not. He’d be pounding down his doctor’s office door, so to speak, to get that taken care of, so why demand women be hands off on their own reproductive health?
RickG says
It sounds like in order to make America Great Again we have to go back to the early 20th century. All those who don’t want to pay for a woman’s birth control can rest assured that in one way or another you’ll be paying for all those newborns.
Stranger in a strange land says
Well said Yellowstone! Most conservatives are not pro-life, they are pro-fetus. Once a child is born into poverty, most so called “pro-lifers” say NO to supporting healthcare for the poor, NO to School budgets, NO to welfare programs, NO to school lunch programs, etc.etc. etc.. If you are truly pro-life, be willing to pay for, and be supportive of, taking care of that child (possibly from cradle to grave for those born with dissabilities especially those caused by adiction, bad nutrition,or bad healthcare. Births that would have been prevented by free or affordable bith control ). If you say you are “pro-life” then support programs that will take care of the births that occur because a woman can’t afford birth control. If not, you are a hipocrite!
Anonymous says
So the government is here to solve all our problems and fix our bad decisions. That’s promoting the “general welfare”? I think not. I must be deplorable.
Mark says
So the government is here to solve all our problems and fix all our bad decisions. That is “promote the general welfare”? I think not. I guess I’m just deplorable.
JasonB says
Republicans really, really hate women.
Sherry says
About “costs”. . . . insurance companies (and therefore we policyholders) pay MUCH LESS for birth control pills than for the costs associated with pregnancy and delivering a child. Therefore, if you are only looking to lower premiums then birth control is absolutely the way to do precisely that.
This is about women’s health care. . . . which should be up to a woman and her doctor, and NOT up to any employer or religious organization! This is nothing short of complete chauvinism by an admitted sexual predator!
Bill Weber says
Many women use birth control for medical reasons. Birth control pills are prescribed to prevent cysts, regulate menstrual cycles and clear acne.
Birth control pills are more essential for health than viagra. Why the government can spend millions on viagra?
Steadfastandloyal says
Yawn!! How ignorant these arguments. Seriously step back and really think hard about the root problem this resolves…you can do it its not difficult
Edith Campins says
1. Birth control pills are used in a number if health related issues, not just birth control.
2. This isn’t about the GOVERNMENT paying for birth control, as some of you seem to think. This is abut birth control being part of an employer’s health coverage.
3. For many, employer health plans cover only part of the premium and the employee has to pay for part of it.
4.Considering the cost of raising a child on welfare, it makes sense to have birth control widely available.
5. Why is it ok of pay for Viagra and not birth control?
6. What will come next? What if an employer decides they don’t want to pay for blood transfusions because it conflicts with their religious beliefs?
7. Republicans, taking us back to the dark ages one law at the time. No birth control, no clean water, no clean air and more guns for everybody.