HHS drafts rule to address religious employers' objection to birth-control coverage mandate

President Donald Trump shakes hands with a Catholic nun during a White House Rose Garden press conference earlier this month during which he unveiled a new executive order. (whitehouse.gov)

The Trump administration has taken its first major step toward fulfilling its promise to unwind the Affordable Care Act’s contraceptive coverage requirement for religious employers.

The Office of Management and Budget (OMB) is currently reviewing an interim final rule concerning “coverage of certain preventive services under the Affordable Care Act,” according to the agency’s website.

Earlier this month, President Donald Trump unveiled an executive order aimed at “promoting free speech and religious liberty,” which he touted during a White House Rose Garden ceremony that featured a prominent group opposed to the ACA’s contraceptive mandate, an organization of Catholic nuns known as the Little Sisters of the Poor.

The order says the secretaries of the Treasury, Labor and Health and Human Services (HHS) “shall consider issuing amended regulations, consistent with applicable law, to address conscience-based objections” to the ACA’s preventive care mandate.

Following the release of Trump’s executive order, HHS Secretary Tom Price released a statement indicating that his agency welcomes the opportunity to “re-examine” how the Obama administration interpreted the ACA’s preventive services mandate, FierceHealthcare reported.

The currently pending interim final rule appears to be HHS’ answer to Trump’s call to relax the regulations that require employers to include birth control coverage in their health plans.

Democrats, however, intend to fight such an effort. In a letter (PDF) sent last week to OMB Director Mick Mulvaney, 14 senators urged him to “abandon any proposal that would erode access to affordable preventive healthcare for women, including birth control.”

Thanks to the ACA, the number of women who filled prescriptions for oral contraceptives with no copay nearly quadrupled from 2012 to 2013, they wrote, noting that access to affordable contraceptive is an economic priority for many women.  

The ACA’s contraceptive coverage mandate, however, has been the center of controversy for years. Those opposed scored a major victory in the case Burwell v. Hobby Lobby Stores, in which the Supreme Court ruled in favor of the family-owned chain of craft stores that objected on religious grounds to providing contraceptive coverage to employees.

Facing the possibility of a 4-4 deadlock in another case, Zubik v. Burwell, the Supreme Court remanded it back to the lower courts last May after an attempt to get both sides to reach a compromise failed. That case had centered on whether the government-created exemption to the ACA’s contraceptive mandate, which defers the cost of birth control benefits to the organization's insurance company, still violates employers' religious freedom.