Mr. Trump’s Attack on Birth Control

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Celia Jacobs

Under the guise of protecting religious freedom and moral sensibilities, the Trump administration is making it harder for women to get access to birth control. On Friday, it rolled back an Obama-era rule requiring most employers to provide their employees with birth control coverage without co-payments. The mandate, established under the Affordable Care Act, has helped millions of women avoid unwanted pregnancy by eliminating out-of-pockets costs for contraception.


Under new rules, the Departments of Health and Human Services, Treasury and Labor will make it easier for employers to deny contraception coverage if they have a “religious or moral objection” to doing so. Further, the departments have made it harder for women who are denied birth control coverage to get no-cost contraception directly from insurance companies, under a process established by the previous administration.

If that were not bad enough, officials made the changes effective immediately. The administration claimed, absurdly, that the rule had to be issued quickly because the normal process of seeking public comment before acting would be “impracticable, unnecessary, or contrary to the public interest.” It used other specious arguments to justify its decision — asserting, for instance, that coverage of contraception could lead to more “risky sexual behavior” among some teenagers and young women.

These regulatory rollbacks will almost surely reverse years of progress. The percentage of reproductive-age women who faced out-of-pocket costs for oral contraceptives, for example, fell to less than 4 percent by 2014 from more than 20 percent just two years earlier, according to the Kaiser Family Foundation. One study estimates that women are saving about $1.4 billion on the pill. The mandate to cover birth control is also very popular; 68 percent of people say they support it.

The Obama administration, knowing that right-wing groups would seize on any pretext to limit access to birth control and other reproductive health services, carefully exempted churches, mosques and other houses of worship from the mandate. Later, under pressure from religious nonprofit organizations, officials also created a process that allowed those groups to opt out of paying for birth control coverage. In 2014, the Supreme Court ruled 5 to 4 that closely held for-profit companies could also deny contraceptive coverage to employees on religious grounds, in a case brought by Hobby Lobby, the arts and crafts retailer.

The new Trump rules go much further than the Hobby Lobby ruling by effectively allowing any business, university or other organization to opt out, without having to notify the government that it is doing so. That puts hundreds of thousands of women at risk of losing benefits. Under the system created by the Obama administration, when an employer chose not to pay for birth control, employees were provided coverage directly by insurance companies at no cost to the beneficiary. That system will now become optional for employers.

The Trump administration says, with no evidence whatsoever, that its new rules will have no effect on “over 99.9 percent of the 165 million women in the United States.” It further argues that low-income women will still be able to get subsidized or free contraception through community health programs and government health programs. Left unsaid is that the administration has made no secret of its desire to substantially cut government spending on programs like these. Several public interest groups, like the Center for Reproductive Rights, the National Women’s Law Center and the American Civil Liberties Union, say they plan to challenge the Trump rules in court.

President Trump’s assault on the birth control mandate is like his broader attack on the Affordable Care Act, filled with spite, based on falsehoods and fueled by vindictiveness toward his predecessor. And both will hurt millions of people.


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