April 25, 2017; Washington Post
There’s a significant amount of fear building around women’s health issues in the Trump presidency: the “global gag rule,” the threats to Planned Parenthood, and of course the general conduct of the president towards women. This week, however, we see a small glimmer of hope, as the Justice Department maintains for now its appeal of a district court decision allowing religious nonprofits to opt out of providing contraception to female employees.
The Affordable Care Act requires employer-sponsored health insurance plans to provide preventative care, including contraception. Churches are exempt from this requirement for reasons of religious freedom. Religiously affiliated nonprofits, like universities or shelters, do not themselves have to pay for this service but must provide access for their employees to third-party administrators or alternative health plans that “would arrange for a health insurance issuer to provide contraceptive coverage to plan participants and beneficiaries without cost sharing, premium, fee, or other charge to plan participants or beneficiaries or to the eligible organization or its plan.”
Some groups say this doesn’t go far enough and would like nonprofits to be categorized with churches so they don’t have to deal with contraception at all. The most recent court ruling was in their favor, but the Justice Department asked the U.S. Court of Appeals for the 5th Circuit “for an additional 60 days to negotiate with East Texas Baptist University and several other religious groups objecting to a requirement to which they are morally opposed,” according to the Washington Post.
While women’s rights advocates may celebrate a Justice Department fighting for their rights, it is confusing why a department led by the notoriously hardline conservative Jeff Sessions would do this.
President Trump had initially indicated that he supported the groups campaigning against providing any kind of contraception. In a letter to Catholic leaders a month before the presidential election, he wrote:
Hillary Clinton supports forcing The Little Sisters of the Poor, who have taken care of the elderly poor since 1839, pay for contraceptives in their health care plan (even though they have never wanted them, never used them and never will), and having the government fine them heavily if they continue to refuse to abide by this onerous mandate.
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That is a hostility to religious liberty you will never see in a Trump administration.
Despite this statement, Trump has neither asked the Justice Department to drop the appeal nor sought a change to the rules from the Department of Health & Human Services.
Though abortion is a divisive issue, contraception is less so. According to a study from the Guttmacher Institute, “More than 99 percent of women aged 15–44 who have ever had sexual intercourse have used at least one contraceptive method.” Most people who use contraception are married women, and the group putting itself at greatest risk for unintended conception is teenagers, ages 15-19. Forty-three million American women are at risk of unintended pregnancy if they aren’t able to get contraception.
Trump’s administration is no friend to women’s health access; two weeks ago, he signed a law rolling back an Obama-era regulation and now allows states to withhold federal family planning dollars from healthcare organizations that provide abortions. Since then, 23 states have taken measures to make contraception more easily available to women.
Another study from the Guttmacher Institute showed that “historical research has linked state laws granting unmarried women early legal access to the pill (at age 17 or 18, rather than 21), to their attainment of postsecondary education and employment, increased earning power and a narrowing of the gender gap in pay, and later, more enduring marriages.” Giving women the power to control if and when they have children is in everyone’s best interest.
However, the fact that birth control access is in the rational best interest of millions of people may not stop its being taken away. Who knows what the Justice Department is up to, but nonprofits will need to watch closely.— Erin Rubin