The Trump administration may weaken or eliminate the provision for full coverage of contraception in the Affordable Care Act, experts say, and it may not require any action from Republican allies in Congress.
The provision that allows women to receive full coverage for birth control — including insertion and removal of an IUD — could be eliminated or at least weakened through regulations, guidance, or law. Reproductive rights advocates are also waiting to see whether the Trump administration will continue to defend the mandate in the courts on Tuesday.
Newly minted Secretary of Health and Human Services Tom Price has a record of dismissing women’s need for full coverage of birth control. In an interview with Think Progress in 2012, Price said, “Bring me one woman who has been left behind. Bring me one. There’s not one … The fact of the matter is this is a trampling on religious freedom and religious liberty in this country.”
During his confirmation hearing, Sen. Patty Murray (D-WA) asked Price about his 2012 statement on birth control because her constituents say birth control without a co-pay is essential to their health care. Price refused to commit to full coverage of birth control.
“There are avenues in the heath care system that doctors and hospitals take to make sure people can get the health care they need,” Price answered.
Price seems to think contraception is like having a doctor fill up a bag with pharmaceutical samples of something or other, to help out patients who can’t afford prescriptions. That sort of thing is usually done for a one time treatment. Contraception doesn’t work like that. As a former physician, I’m sure Mr. Price is aware of that, but that’s not as important as preventing people from having healthcare, especially those awful women. The way Price and his fellow travelers feel about it, contraception is a lifestyle choice, not a health issue.
Planned Parenthood clinics told NPR that, since the election of President Donald Trump, they have received more calls than usual from women interested in booking appointments for IUDs. An IUD is one of the most effective methods of birth control, since it is more than 99 percent effective. Without coverage provided by the mandate, a woman who works full time at minimum wage may have to pay a month’s salary for the cost of getting an IUD, according to the Guttmacher Institute.
Women who use contraceptives consistently and correctly only account for 5 percent of all unintended pregnancies. But with financial barriers to access — especially access to effective but costly methods such as IUDs — women’s ability to prevent unintended pregnancies is significantly hampered.
41 years ago, I got an IUD through planned parenthood. At that time, I was a paid member, so it didn’t cost me a thing. I don’t remember the membership cost, but it was around 25 or 35 dollars. Way back then, people in general were favorable towards accessible, inexpensive birth control. There was still a very heavy stigma attached to single parenthood, and it was still considered to be shameful to be pregnant out of wedlock. The stigma was starting to fade in 1975, but it was still strong enough that the reasoning was contraception and pregnancy prevention was better than a bunch of single mothers. It was also easy and hassle free to obtain an abortion back then. How things have changed.
In addition to what is happening in the courts, it is possible that an executive order could greatly expand exemptions for companies with religious or moral objections. A leaked draft of an executive order, first obtained by The Nation and Reveal earlier this month, would significantly weaken the contraception guarantee.
The order would appear to exempt any “closely held for-profit corporations” with moral or religious objections to meeting the requirements of the provision and lets them exclude coverage for contraception. Under the Obama administration’s religious accommodation, insurance companies have to provide separate coverage to women at no additional cost. Kinsey Hasstedt, senior policy manager for the Guttmacher Institute, said the draft is cause for concern, even though an official order has not been released.
“The leaked draft executive order would expand accommodations so it would be simpler for employers to reject some or all birth control options,” Hasstedt said. “It would be a dramatic expansion of exemptions.”
This draft uses broad terms to define religious freedom and requires the Department of Justice to defend “religious freedom.” It does specifically mention objections to abortion, contraception, and premarital sex, however.
The Religious Reich Republicans have been salivating for ages over the chance to kill off accessible, affordable contraception, and it looks like that chance has arrived. Think Progress has the in-depth coverage on this issue.