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Trump administration narrows Affordable Care Act’s contraception mandate

By: Juliet Eilperin, Amy Goldstein and William Wan, The Washington Post
October 6, 2017 Updated: October 6, 2017 at 1:37 pm
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photo - Trump administration narrows Affordable Care Act’s contraception mandate (stock photo)
Trump administration narrows Affordable Care Act’s contraception mandate (stock photo) 

The Trump administration issued a rule Friday that sharply limits the Affordable Care Act’s contraception coverage mandate, a move that could mean many American women would no longer have access to birth control free of charge.

The new regulation, issued by the Health and Human Services Department, allows a much broader group of employers and insurers to exempt themselves from covering contraceptives such as birth control pills on religious or moral grounds. The decision, anticipated from the Trump administration for months, is the latest twist in a seesawing legal and ideological fight that has surrounded this aspect of the 2010 health-care law nearly from the start.

Several religious groups, which battled the Obama administration for years over the controversial requirement, welcomed the action.

Women’s rights organizations and some medical professionals portrayed it as a blow to women’s health, warning that it could lead to a higher number of unintended pregnancies.

The rule change is among the recent moves by President Trump to dismantle initiatives enacted under the Obama administration. It fulfills a crucial promise Trump made as a candidate to appeal to social conservatives and that he repeated in May when he signed an executive order in the Rose Garden to expand religious liberty.

Senior Health and Human Services officials, briefing reporters early on condition of anonymity, contended the change will still leave “99.9 percent of women” with access to free birth control through their insurance. They said the estimate was based on the finite number of groups that have filed about 50 lawsuits over the provision.

This latest rewriting of the federal policy, in an interim final rule that takes effect immediately, broadens the entities that may claim religious objections to providing contraceptive coverage to nonprofit organizations and for-profit companies, even ones that are publicly traded. Also included are higher educational institutions that arrange for insurance for their students, as well as individuals whose employers are willing to provide health plans consistent with their beliefs.

A separate section covers moral objections, allowing exemptions under similar circumstances except for publicly traded companies.

As part of the rule, made publicly available in the Federal Register late Friday morning, administration officials estimate that 120,000 women at most will lose access to free contraceptives — many fewer than critics predict.

They write that they do not know how many employers or insurers that omitted contraceptive coverage before the ACA did so based on religious beliefs that would now allow them to be exempt. For that reason, the law says, HHS cannot predict how many entities will want exemptions, other than the groups that have filed recent lawsuits or made other public statements against the Obama-era policy.

The analysis concludes that perhaps one-third of women who get insurance through such groups — the estimated 120,000 — would end up paying for birth control on their own.

The new policy “will result in some persons covered in plans of newly exempt entities not receiving coverage or payments for contraceptive services,” the rule acknowledges. But it says there is not “sufficient data to determine the actual effect . . . on plan participants and beneficiaries, including for costs they may incur for contraceptive coverage, nor of unintended pregnancies that may occur.”

Read the story at The Washington Post.

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