It looks like the Trump administration may be following through with its promise to overhaul the birth control mandate from the Affordable Care Act according to a leaked draft of the regulation obtained by Vox. If enacted, any employer would be able to request a moral or religious exemption for providing birth control, regardless of size or affiliation.
Under the ACA — also known as Obamacare — almost all employers are required to offer health insurance to their employees that includes coverage of various forms of contraception, including birth control pills and intrauterine devices. Employers do have the ability to request a moral or religious exemption under the ACA, but only religious houses of worship eligible — later broadened by the Hobby Lobby case to include “closely held” private businesses if covering birth control violated their religious beliefs.
If this leaked draft proposal is approved, this would be a huge blow to women’s reproductive rights in the United States, as many of the women who currently receive birth control with no co-pay through their employer’s health insurance plan would have to pay out of pocket.
On the other hand, if passed, this regulation would be a victory for Republicans and conservative religious organizations who have pushed back against this part of Obamacare since it first became law, claiming that they should not be required to provide coverage for birth control because it violates their religious and/or moral beliefs. Under this proposal, universities providing health care for students would be considered employers and could request the exemption.
“Expanding the exemption removes religious and moral obstacles that entities and certain individuals may face who otherwise wish to participate in the healthcare market,” the proposal explains.
The leaked draft of the regulation obtained by Vox is dated May 23, and it is unclear whether the Trump administration has made any changes to it or whether this is the final version. Currently, the Office of Management and Budget is reviewing the proposal, which is the last step before it becomes an official regulation. If passed, it would be effectively immediately.
Prior to Obamacare, 20 percent of American women of reproductive age paid out of pocket for oral contraceptives, which decreased to less than 4 percent a few years after the ACA became the law. If this regulation is approved, that number will likely go right back up again.
“It’s just a very, very, very broad exception for everybody,” Tim Jost, a health law professor at Washington and Lee University, told Vox. “If you don’t want to provide it, you don’t have to provide it.”