The Trump administration issued a rule Friday that sharply limits the Affordable Care Act’s contraception coverage mandate, a move that could mean many American women would no longer have access to birth control free of charge.The new regulation, issued by the Health and Human Services Department, allows a much broader group of employers and insurers to exempt themselves from covering contraceptives such as birth control pills on religious or moral grounds. The decision, anticipated from the Trump administration for months, is the latest twist in a seesawing legal and ideological fight that has surrounded this aspect of the 2010 health-care law nearly from the start.Several religious groups, which battled the Obama administration for years over the controversial requirement, welcomed the action.
For months, officials in Republican-controlled Iowa had sought federal permission to revitalize their ailing health-insurance marketplace. Then President Trump read about the request in a newspaper story and called the federal director weighing the application.Trump’s message in late August was clear, according to individuals who spoke on the condition of anonymity to discuss private conversations: Tell Iowa no.
They have threatened to withhold cost-sharing payments from insurers, which has already driven premiums up substantially. They cut the open enrollment period in half. They slashed the budget for advertising to encourage people to enroll by 90 percent, and used some of what was left to create videos meant to discourage people from getting insurance. They canceled contracts with community groups that assist people in the sometimes complicated process of signing up. And in a particularly creative move, they’ll be shutting down healthcare.gov on [every Sunday except one] during open enrollment, for “maintenance.”