Trump administration to revise exemptions to contraception mandate

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The Trump administration is modifying religious exemptions and accommodations against mandatory employer health care coverage of contraception, after federal judges blocked the administrations rules in December.

“The United States has a long history of providing conscience protections in the regulation of health care for entities and individuals with objections based on religious beliefs and moral convictions,” the Office of Management and Budget said. “These final rules expand exemptions to protect religious beliefs for certain entities and individuals whose health plans are subject to a mandate of contraceptive coverage through guidance issued pursuant to the Patient Protection and Affordable Care Act.”

It added that the rules “leave the accommodation process in place as an optional process for certain exempt entities that wish to use it voluntarily.”

The New York Times reported Oct. 30 that the revised rules will be issued by the departments of Health and Human Services, Labor, and the Treasury.

Judge Wendy Beetlestone of the Federal District Court in Philadelphia issued a preliminary injunction against the Trump administration's initial rules Dec. 15, 2017.

She said Pennsylvania could suffer “serious and irreparable harm” from the rules, because a lack of cost-effective contraception would mean that women would either forgo contraception or choose less effective methods and result in “individual choices which will result in an increase in unintended pregnancies.” This would create economic harm for the state because “unintended pregnancies are more likely to impose additional costs on Pennsylvania’s state-funded health programs.”

Shortly after Beetlestone's ruling, Judge Haywood Gilliam Jr. of the Federal District Court in Oakland also blocked the Trump administration's rules, saying they would “transform contraceptive coverage from a legal entitlement to an essentially gratuitous benefit wholly subject to their employer’s discretion.”

Under Trump, the Justice Department has argued that “a woman who loses coverage of her chosen contraceptive method through her employer may still have access to such coverage through a spouse’s plan … or she may otherwise be able to pay out of pocket for contraceptive services.”

The 2010 Affordable Care Act, and resulting rules issued by the Obama administration’s Department of Health and Human Services mandated that employer health plans cover sterilization and contraception, including drugs that can cause abortion. The mandate drew opposition from Catholics and others.

The Trump administration established new rules in October 2017 allowing companies with religious or moral objections to contraception to opt out of the mandate.

The administration has appealed the rulings by Beetlestone and Gilliam, and other judges have issued rulings favorable to exemptions and accommodations to the contraception mandate.

In April, District Court Judge David Russell issued a permanent injunction and declaratory relief against the mandate for members of the Catholic Benefits Association.

Russell also ruled that the mandate violates the Religious Freedom Restoration Act by attempting to force employers to provide contraception and sterilization in violation of their sincerely held religious beliefs.

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