The Trump administration, which is stacked with officials who oppose contraception, will now allow any employer or for-profit company, regardless of whether they are religious, to refuse to include the coverage in their health insurance plans for moral reasons.
The Affordable Care Act deemed contraception an essential part of women's preventive health care for the first time in history, requiring that it be covered under most insurance plans, along with prenatal care, breast exams and well-woman visits.
National Women's Law Center president and CEO Fatima Goss Graves added in a press release, "Today's outrageous rules by the Trump Administration show callous disregard for women's rights, health, and autonomy". The Obama administration's push for the law resulted in an avalanche of lawsuits filed against the action by right-wing and religious organizations.
The change is the Trump administration's latest challenge to the ACA. This could mean that tens of thousands to hundreds of thousands of women in the United States will once again have to pay out of pocket for birth control. The new guidelines, which are expected to provide many more contraceptive coverage exemptions, could be announced as early as Friday.
Now, exemptions to the mandate are available to any nongovernmental employer, including owners of publicly traded companies. "This is an unacceptable attack on basic health care that the vast majority of women rely on", Richards said in a statement.
At a time when Trump finds himself embattled on many fronts, the two directives - issued nearly simultaneously on Friday - demonstrated the president's eagerness to retain the loyalty of social conservatives who make up a key part of his base. The religious exemption would cover a religious affiliated nonprofit employer, such as a church, school or charity.
The National Women's Law Center estimates that almost 2 million in North Carolina and 62.4 million women nationwide have insurance coverage of birth control without out-of-pocket expenses.
Americans will remain free to make their own decisions about, and purchase or find coverage for, the drugs and devices at issue in the mandate, and entities with objections will not be forced to be complicit in choices that would violate their religious or moral convictions. Before the contraception coverage rule, birth control accounted for 30-44% of a woman's out-of-pocket healthcare costs. Some of the cases reached the Supreme Court and were the object of nationwide attention, such as the Hobby Lobby ruling in 2014. "Simply put, you don't need nuns to give out contraceptives", Rienzi said, referencing Becket's clients, the Little Sisters of the Poor.
"Any move to decrease access to these vital services would have damaging effects on public health and women's health", said Haywood Brown, director of the American Congress of Obstetricians and Gynecologists. The administration acknowledges that the law, the Religious Freedom Restoration Act, "does not provide protection for nonreligious, moral conscientious objections".