HHS Nominee Could Repeal Free Birth Control Without Act Of Congress
November 30, 2016
Lesley Clark
McClatchy Washington Bureau
Displayed with permission from Tribune Content Agency
WASHINGTON — Donald Trump's choice to lead the Department of Health and Human Services would be able to repeal one of President Barack Obama's most controversial initiatives: free birth control for women under the Affordable Care Act.
If confirmed, Rep. Tom Price, R-Ga., a legislator with a 100 percent anti-abortion voting record, would be able to revoke the contraceptive measure, which is deeply unpopular with abortion foes, without engaging Congress.
Price, who like the president-elect has championed repealing the Affordable Care Act, would not have to wait for the overall law to be targeted by Congress because the contraceptive measure exists due to a rule enacted by the Obama administration.
"This would address the problem and could be effective the day it's proposed," said Martin Nussbaum, a religious institutions attorney and general counsel for the Catholic Benefits Association, which sued the government in 2014 over the provision.
The Affordable Care Act provision requires job-based health insurance plans to provide women with free coverage for all contraceptive services approved by the U.S. Food and Drug Administration and prescribed by health professionals. They include diaphragms, birth control pills and intrauterine devices.
Though certain nonprofit religious employers that object to birth control on religious grounds don't have to provide the coverage, they have contested the provision as an unnecessary government intrusion into their faith.
"It would be beneficial to get rid of it," said Nussbaum. "We've never had so many religious institutions file so many lawsuits."
Price in 2010 questioned the need for health insurers to offer birth control at no cost, saying he didn't believe there were women who couldn't afford coverage.
"Bring me one woman who has been left behind," he demanded in an interview with ThinkProgress. "Bring me one. There's not one."
One option for Price would be to broaden the religious exemption to cover more organizations.
But revising or repealing the provision would be "more complicated than just flipping a switch," said Alina Salganicoff, vice president and director of women's health policy at the Kaiser Family Foundation.
The new administration would be required to follow a formal notice-and-comment period before enacting a new rule. And health insurance plans can't be changed outside the annual enrollment period, meaning any changes could be at least months away.
Repealing the measure would mean reverting to pre-2010 coverage.
More than half of the states — 28 — have laws requiring health care plans to cover birth control, but those states don't all cover every FDA-approved method and do not ban requiring women to pay part of the cost.
Only California, Illinois, Maryland and Vermont have laws that ban cost-sharing and require coverage of a full range of contraceptives, Salganicoff said.
Women's groups say they would fight the administration, arguing that taking away access to birth control could lead to what they said would be a "bitter irony" of an increase in unwanted pregnancies.
"The pro-life crowd dismantling these regulations could lead to the exact result they claim to decry," said Donna Crane, vice president for policy at NARAL Pro-Choice America. "We could go back to the old days where plans didn't have to cover contraception, but there's pretty good evidence that a good number of women have a hard time covering that cost and some choose less effective measures because it's out of reach for them."
The Guttmacher Institute estimates that 20.2 million women in the U.S. were in need of publicly funded family planning services like birth control in 2014, an increase of 1 million since 2010.
Already, Planned Parenthood has said it has seen a "significant increase" in online appointments for birth control, with a more than tenfold increase in people seeking intrauterine devices in the week after the election.
"The Senate should give Rep. Price's record the full examination it deserves," said Cecile Richards, the president of Planned Parenthood Federation of America. "Each senator must decide whether a man who wants take away no-copay birth control coverage from 55 million women is the right choice to serve as the secretary of health and human services."
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