Earlier this week, a version of the interim final rule (IFR) from the Trump administration regarding the birth control mandate of the Affordable Care Act (ACA) was leaked to Vox.
The rule made headlines because it would allow any employer to file for an exemption from providing contraception coverage due to the employer’s personal religious beliefs. Previously, such exemptions were offered only to religiously affiliated employers (like the Catholic Church).
“Leaked Trump proposal would give employers unprecedented power over women’s lives,” read the headline on a story by Amanda Marcotte at Salon, while Olga Khazan at the Atlantic wondered, “Is this the end of free birth control?”
Social conservatives countered that there are options for women denied coverage by their employers written into the rule: On page 37 of the rule’s text, it’s noted that “there are multiple Federal, state, and local programs that provide free or subsidized contraceptives for low-income women, including Medicaid (with a 90% Federal Match for family planning services), Title X, health center grants, and Temporary Assistance for Needy Families. According to the Guttmacher Institute, government-subsidized family planning services are provided at 8,409 health centers overall.”
But here’s the sneaky part: While all of the above is factually true, what’s conveniently left out is that many of the above programs are being drastically slashed by the Trump administration’s proposed federal budget and by the administration’s replacement for the ACA, the American Health Care Act (AHCA).
Trump’s budget restricts federal funding to Planned Parenthood, which serves 41 percent of all Title X patients. By prohibiting the organization from participating in Title X, the Trump budget effectively dismantles the program without having to drastically reduce its budget line item.
“It’s true that the funding level for Title X was held the same as it was in 2016, but that level of funding is still not meeting the needs of women who need access to contraception,” Jamila Taylor, a senior fellow at the Center for American Progress and an expert on women’s health policy, tells Yahoo Beauty. “And on top of that, there are the huge cuts to Medicaid.”
The Trump budget cuts approximately $800 billion from Medicaid over the next 10 years, greatly reducing the amount of coverage provided for those enrolled in the federal health care program for the lowest-income Americans.
One in five women of reproductive age is insured through Medicaid, and women comprise the majority of Medicaid beneficiaries. As the Trump budget commits to the repeal of the ACA through its replacement of the AHCA, it also commits to rolling back the Medicaid expansion that 31 states and the District of Columbia opted into as a result of the ACA’s passage.
Beyond the budget, if the AHCA passes and Planned Parenthood is “defunded” — or barred from serving as a Medicaid provider — the patients who rely on Title X, health grants, and Medicaid for their contraception stand to see their access further restricted.
A Senate Democratic aide noted to Yahoo Beauty that the leaked IFR is broader than what many in Congress anticipated, allowing not just religious organizations but any employer with a moral objection to contraception to cease coverage of birth control for their employees.
Even though the IFR is coming from the Office of Management and Budget (OMB), it has been reviewed by all relevant agencies — including the Department of Health and Human Services.
Secretary of Health and Human Services Tom Price, who prior to his appointment was a congressman from suburban Atlanta, has long been vocal about his opposition to the contraceptive mandate of the ACA. Price once infamously stated on the record that “there’s not one” woman in America who cannot afford birth control.
Read more in Yahoo Beauty + Style:
- Trump’s ‘Religious Liberty’ Order Threatens Women’s Health, Experts Say
- 6 Threats to Women’s Health Baked Into Trump’s New Budget
- Better Birth Control Access Could Drop Abortion Rate by 67%, Save $12 Billion