Trump administration, states take aim at coverage rules for birth control and abortion

While the push for a major healthcare policy overhaul has petered out, some narrower changes are emerging—specifically, those targeted at coverage rules for reproductive services.

At the federal level, officials are preparing to issue a rule that targets the requirement that all employer-based health plans must provide coverage for birth control, according to The Wall Street Journal.

Though the Supreme Court ruling in the Hobby Lobby case gave certain private companies a way to get around the contraceptive coverage mandate, the new rule would offer a wider array of employers to opt out—which is likely to ignite even more litigation.

On the state level, a federal appeals court on Wednesday lifted (PDF) an injunction that barred Arkansas from cutting off Medicaid funds to Planned Parenthood, a move it had made after the release of controversial videos recorded by an anti-abortion group.

Three patients responded to the state’s decision with a lawsuit, arguing that the Medicaid Act gives them the right to choose any “qualified” provider that offers the services they seek. But while a lower court did side with their claim, the appeals court ruled that the federal law in question doesn’t “unambiguously” give individual patients the right that the plaintiffs are asserting.

Arkansas was not the only state to restrict access to abortion services this week. On Tuesday, Texas Gov. Greg Abbott signed a measure that requires women to pay an added premium if they want their health plan to cover an abortion that isn’t a medical emergency.

“As a firm believer in Texas values I am proud to sign legislation that ensures no Texan is ever required to pay for a procedure that ends the life of an unborn child,” Abbott said. “This bill prohibits insurance providers from forcing Texas policy holders to subsidize elective abortions.”

However, because the bill doesn’t include exceptions for instances of rape or incest, some Democrats say it forces women to pay extra for “rape insurance,” Reuters notes.

Oregon, meanwhile, took a step in the opposite direction.

On Tuesday, Gov. Kate Brown signed a bill that requires that insurers provide cost-free reproductive health coverage—including abortions—to thousands of residents regardless of income, citizenship status or gender identity, according to the Associated Press.

Supporters hail the law as America’s most progressive reproductive health policy, but say that it forces taxpayers, including those who have moral objections to abortions, to subsidize the costs for such services. The measure was introduced primarily in response to congressional Republicans’ push to repeal the Affordable Care Act, the article notes, as the federal law mandates minimum coverage for reproductive services.

Oregon is far from the only state to enact such a measure—or at least consider doing so. In June, New York Gov. Andrew Cuomo issued emergency regulations aimed at keeping a slew of ACA-style protections intact in the state regardless of what happens to the healthcare law.