It was less than five months ago that US President Donald Trump signed an executive order banning federal funding for international health organizations that perform abortions. Now, the Trump administration is once again attacking women’s reproductive rights with a proposal for a new regulation that allows employers to deny coverage for birth control.
Under the Affordable Care Act (better known as Obamacare), companies are required to provide contraceptive coverage to female staff. One of the only exceptions under the current law is if contraceptives violate the religious beliefs of a private business.
The Trump administration’s proposal allows any employer, university and insurance company to apply for a religious exemption.
The proposal draft would eliminate burdensome paperwork and allow publicly-traded, for-profit businesses to get out of providing coverage. By easing the exemption requirements, businesses can opt out of providing coverage with minimal effort.
The regulation would also allow insurers to opt out of providing birth control coverage to policyholders, and require employers to offer separate plans for employees who don’t want contraceptive coverage.
The move would almost guarantee a court challenge by women’s advocacy groups. In fact, some groups are already preparing to file a suit should the proposal pass. But the move would also raise a lot of questions about women who are already on birth control.
What happens to women who need birth control to balance hormonal issues, but can’t afford to pay for it out of pocket? What about the women who have permanent birth control? Would insurance companies be able to refuse coverage for removing the implanted device?
Under the Affordable Care Act, birth control pills and implanted contraceptive devices are covered. IUDs, like Mirena, need to be removed every five years. Will these women have to pay out of pocket to have their devices removed? What if they can’t afford to pay for the procedure? Leaving the device implanted for longer than the recommended time period could cause serious side effects.
What about women who have implanted, permanent birth control devices that suddenly cause severe, adverse reactions — like Essure? The FDA warned consumers in 2016 that Essure may cause perforation of the uterus or Fallopian tubes and other serious side effects.
If the Trump administration’s proposal is approved, insurance companies may have the right to say they’re not covering the cost to remove Essure because the device violates their religious beliefs. Women who are experiencing debilitating pain and other serious side effects may be forced to pay for their repair surgery – unless they file and win a lawsuit.
There are an estimated 750,000 women across the world who are using Essure, and the majority (70%) are living in the US. According to the FDA, there have been more than 5,000 reports of adverse effects caused by the device.
Religious exemptions, particularly for sensitive issues like birth control, are essential. But we must also ensure that a woman’s health and reproductive freedom is protected.
Trump’s proposed regulation may place an undue burden on women seeking contraceptives, be it for hormonal issues or protection from unwanted pregnancy.