Vox leaked a draft regulation last May revealing the Trump administration’s plans to “gut the Obamacare contraception mandate,” according to The Rolling Stone. The leaked draft, which is currently being reviewed by the Office of Management and Budget, states that it aims to “expand exemptions for religious beliefs and moral convictions” for companies whose health care plans would otherwise be subject to a mandate of contraception coverage.
Because the draft regulation is labeled as an interim final rule, it could take effect “as soon as it is published in the Federal Register,” potentially “in coming weeks,” according to The New York Times’ Robert Pear.
If the draft is published, it will become significantly easier for companies to exempt themselves from providing health insurance that covers birth control - they need only claim religious liberty or ‘conscience rights’. Trump will abolish the law “currently ensuring that most women’s insurance covers contraception without a copay,” according to Dylan Scott and Sarah Kliff for Vox.
A friend once told me that without free access to birth control, men and women can never be completely equal. At the time I thought she might be exaggerating a little, but now I realize the truth of that statement. Until access to birth control is widely accepted as a necessary health service, women will never achieve equal opportunity in the workplace or equal respect as independent beings.
The Affordable Care Act, according to a segment by Rebecca Hersher on NPR’s All Things Considered, has increased the number of people using contraception. “One reason more girls and women are using birth control is that the Affordable Care Act requires insurers to fully cover prescribed contraception. That includes the pill, implanted hormonal birth control and intrauterine devices,” Hersher said.
However, if the American Health Care Act becomes law, the Department of Health and Human Services will likely eliminate contraception from its “list of essential preventive services that must be covered by insurance without cost sharing,” wrote Lydia Pace and Eve Rittenburg for The Boston Globe. This means an increase in deductibles, coinsurance, and copayments for birth control: increasing the amount that women will have to pay out of their own pockets.
A study published in Health Affairs by Nora Becker revealed that women spent $248 more on average for an IUD and $255 more annually for oral contraceptive pills before the Affordable Care Act went into effect, and that’s the reality we’re soon to return to. Not everyone can afford such costs.
Those who see birth control as a non-essential health service, however, oppose the contraception mandate with force: Douglas Wilson, opinion contributor for The Hill, called the mandate a “six-year assault on religious employers” and later a “six year attack on those American principles.”
Opponents may be under the impression that birth control is used only to prevent pregnancy, which is simply inaccurate. It’s also used to treat conditions like diabetes, high blood pressure, heart disease, and much more. I personally know many people who take birth control for alternative health reasons.
But still, those who need assurance that birth control isn’t just used to prevent pregnancy in order to support the contraception mandate are misguided. Everyone benefits from women being able to control how many kids they have - overpopulation is an issue that affects all of us, due in large part to lack of knowledge about or access to birth control in developing countries. The US should not follow suit.
I recently read The Handmaid’s Tale, a novel about a dystopian future America in which reproductive-aged women serve to combat a declining birth rate. They are given no freedom and valued only for their ability to produce children. The novel serves as less of a prediction for the future and more of an exaggeration of what women currently face: great difficulty in being granted value as independent people and not as mechanisms by which to continue the human race.
No time was this more apparent to me than when, driving past the Planned Parenthood in my home town last summer, I was shocked to see a group of religious-right protesters standing out front, sporting anti-abortion and anti-birth control signs. I live in a relatively small town and somehow thought those kinds of people only made appearances in big cities or news articles or Snapchat protest features. Sadder to me than the fact that those people thought they were doing something good for society was the fact that any woman going into the building with intent to take control of her own life or prepare for her future would be confronted with signs calling her evil simply for not wanting to have kids.
With the legalization of the birth control pill in 1960, Becker wrote that women who had access compared to those who didn’t “had better financial outcomes, better educational outcomes, and that their children actually had better educational and financial outcomes.” There’s really no one who doesn’t benefit from women having access to affordable birth control, unless you’re counting potential future children who haven’t actually come into existence yet as people.
Those who support Trump’s plan fail to understand, or maybe just don’t care, how much this actually matters for women. Gutting the mandate is not just about making birth control more expensive, it’s about allowing other people to potentially cause serious harm to your wellbeing for their own misconceptions about the multi-functionality of birth control or their own moral beliefs. Dr. Anne Davis, an OB/GYN and consulting medical director for Physicians for Reproductive Health, told Jacqueline Howard for CNN that following Trump’s inauguration, many women were “shaken with worry” and “had tears in their eyes this week as they waited in her office.”
It’s easy for some people to see birth control as a small medical concern or unnecessary luxury good rather than what it is: something that plays a vital role in most women’s lives and a vital role in allowing women to pursue careers and fulfilling lives outside of parenthood. My mom is a lawyer, and I remember her telling me when I was much younger, maybe 10 years ago, that women in her law firm were given fewer promotions and less respect than men in general because they were assumed to be more committed to their families than the job. It was assumed that all of them would inevitably have kids and leave the law firm behind.
Hopefully the increase in use of birth control since then has changed that perception, but the truth, as evidenced by this leaked document, is that many people still do not respect the use of birth control as a necessary health service. Making it possible for companies to exempt themselves from fully covering contraceptives in their health care plans is a significant step backward in the accessibility of birth control and a sign that the lives of unborn or not-yet-conceived children are still valued more by legislators than the lives of living women.