The Trump administration says it will broaden the scope of an opt-out provision in the Affordable Health Care Act, allowing nonprofits and publicly traded companies to stop offering birth control coverage in the insurance they provide their employees.
The U.S. Department of Health and Human Services issued the new set of rules Friday, effective immediately, that expands the privilege previously given to privately-owned companies that say they have religious objections to birth control.
The rules published Friday in the Federal Register, the government's public archive of official documents, broaden the range of employers allowed to opt out of birth control insurance coverage if they have a "sincerely held religious or moral objection" to the practice. That rule will force women who work for those companies to pay for contraceptive pills and devices themselves.
Health and Human Services officials have told reporters they expect the companies taking advantage of the new rules will be few — perhaps only about 200 companies that have filed suit in objection to Obamacare's birth control coverage requirement.
"This provides an exemption and it's a limited one," said Roger Severino, director of the HHS Office of Civil Rights. "We should have space for organizations to live out their religious identity and not face discrimination."
Health care providers and activists who oppose the new rules, however, say they could provide opportunities for many employers to end the coverage just to save money.
Haywood Brown, president of the American Congress of Obstetricians and Gynecologists, told National Public Radio that "reducing access to contraceptive coverage threatens to reverse the tremendous progress our nation has made in recent years in lowering the unintended pregnancy rate."
Brown added that the change also could affect the maternal mortality, community health, and economic stability of women and families.
Dania Palanker, professor at Georgetown University Center on Health Insurance Reform, told NPR that "it is a huge loophole for any employer that does not want to provide birth control coverage to their employees."
Move follows Trump executive order
Friday's announcement follows an executive order in May vowing to "protect and vigorously promote religious liberty." President Trump made the order in response to a lawsuit by the religious order The Little Sisters of the Poor, who filed their suit during the Obama administration, when the Affordable Care Act, or Obamacare, went into effect.
The Act required employer-provided health insurance policies to include coverage for preventative care, including birth control using all contraceptive methods approved by the federal Food and Drug Administration.
The act included a loophole for churches and other religious employers to opt out of that requirement, in which case the government arranged the coverage directly with the employer's insurance company without employer involvement.
A challenge to that requirement led to the famous Hobby Lobby ruling of 2014, which allowed privately held companies to object to the coverage on religious grounds and deny the Obamacare workaround to their employees.
Reports say HHS is expected to tighten restrictions further in the coming months by cracking down on enforcement of a requirement that federal subsidies not be used for insurance policies that cover abortions. The agency is issuing guidelines for insurers that specify they have to charge women who want abortion coverage at least $12 a year for that coverage.