In President Donald J. Trump’s latest efforts to dismantle the Affordable Care Act, Trump recently gave U.S. employers the right to deny their employees’ birth control insurance coverage based on religious or moral opposition. Trump’s move drew an onslaught of criticism, as well as praise.
The American Civil Liberties Union (ACLU) filed a lawsuit against the Trump administration and claimed the rule violated women’s right to equal protection guaranteed by the Fifth Amendment and “robs women of health coverage that is otherwise guaranteed by law.” Some sociologists and human rights activists question how the rollback will affect low-income women and women of color, who have been the primary purchasers of contraceptives under the Affordable Care Act, according to a 2015 report issued by the Center for American Progress.
“For many women, the Trump administration’s plan to roll back the ACA’s mandate that employers include birth control coverage in their health insurance plans could be disastrous,” Leslie Hinkson, a professor of sociology at Georgetown University, told the AFRO. “I think this policy will disproportionately affect women in the low-wage workforce, as many of them don’t qualify for Medicaid coverage – except in the most generous states – and thus rely on employer-provided health coverage. This means the impact will be felt by women of color more than White women. Black women‘s share of the low-wage workforce is nearly double their share of the overall workforce.”
Meanwhile, religious groups such as Little Sisters of the Poor, an order of nuns, have publicly supported Trump’s decision to axe the birth control mandate and said the executive decree protected nuns’ “religious freedom,” according to their website.
According to a report issued by the Obama administration, more than 55 million women had access to birth control at no cost under the ACA mandate. The Guttmacher Institute, a research and policy organization focused on sexual and reproductive health and rights, conducted a study that found the ACA extended affordable health insurance to more than 20 million Americans who were previously uninsured, including a large portion of Black and Latinx women. The study also found “under the ACA, the proportion of Black and Hispanic women of reproductive age without health insurance fell by 36 percent and 31 percent, respectively.”
Brigitte Amiri of the ACLU’s Reproductive Freedom Project, said the mandate has delivered myriad of savings to low-income women, who would otherwise have limited or no access to birth control coverage.
“The rules will undermine the Affordable Care Act’s guarantee of coverage for birth control without a copay. The birth control benefit allows women to choose any Food and Drug Administration-approved birth control method free of cost. It has been a game changer for women since taking effect in 2012 — it’s estimated that women saved more than $1 billion on birth control pills alone in 2013,” Amiri said in a blog post on the ACLU’s website.
Trump’s decision to repeal Obamacare mandates also raises questions about other elements of the ACA, including coverage of preventative care, Planned Parenthood, pregnancy care and the Title X family planning program – a federal grant that provides family preparation and preventive health services. The Guttmacher Institute’s research showed Medicaid covered 51 percent of all U.S. births. However, Republican policymakers may institute sweeping cuts to the program, which could leave millions of women without care.
The institute also said the Trump administration’s rollbacks could be devastating to child-bearing Black women, who have historically experienced higher deaths related to pregnancy than women of other races. Additionally, the ACA enhanced privately insured women’s access to preventative services with no co-pays. This includes cancer screenings, well woman visits and more than 15 contraceptive methods.