Attorney General Bonta Leads Coalition of 22 States in Support of Increased Access to Birth Control Coverage

Tuesday, April 4, 2023
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OAKLAND — California Attorney General Rob Bonta today co-led a coalition of 22 states in urging the Biden Administration to scrap dangerous Trump-era rules that allow employers to interfere in the reproductive health decisions of their employees. These dangerous rules took away contraceptive coverage from women who should have been entitled to complete coverage under the Affordable Care Act (ACA). However, the new rules, issued in 2017 and 2018, added broad, unreasonable exemptions that allowed nearly all types of employers to deny birth control coverage to their employees based on religious or moral objections. Today, in a letter welcoming the Biden Administration's proposal to rescind parts of the Trump-era rules, the coalition of attorneys general highlight that expanding access to birth control would help people live healthy, happy, and empowered lives.

“Whether or not to use birth control should be a decision made between a patient and their doctor — not their boss,” said Attorney General Bonta. “By allowing employers to meddle in their employees’ healthcare choices, the Trump Administration trampled on people’s rights, and endangered their health and future. I applaud the Biden Administration's effort to fix these dangerous Trump-era failures, and urge it to increase contraceptive coverage for all Americans. The data is clear: Access to birth control is crucial to women's mental and physical wellbeing. My office will continue leading and supporting the fight to protect and expand access to all forms of reproductive care in California and beyond.”

The ACA’s contraceptive coverage mandate was signed into law in 2010 to correct historic inequities in women’s health care. It required all employers and sponsors of health plans to cover the cost of preventive services necessary for women’s health, including contraceptive services. It is estimated that more than 62 million women have benefited from the ACA’s birth control coverage mandate. Studies have shown that access to contraceptive care supports people's ability to control their own reproductive health, and promotes access to education, jobs, and financial empowerment.

After the Trump Administration issued broad religious and moral exemptions that allowed employers to stop providing contraceptive coverage if they had religious or moral objections, between 70,500 and 126,400 women are estimated to have lost birth control coverage. The exemptions did not even require the employees to be informed before they lost coverage — the employer could simply object and never let the employee know.

In February, the Biden Administration proposed new regulations to correct these problems. The proposed regulation would:

  • Rescind the Trump-era moral exemption rule;
  • Retain the Trump-era religious exemption rule; and
  • Create an Individual Contraceptive Arrangement (ICA) to ensure that patients enrolled in health plans or coverage sponsored by objecting entities would still have the opportunity to obtain contraceptive services at no cost.

In the letter, addressed to U.S. Health and Human Services Secretary Xavier Becerra, U.S. Treasury Secretary Janet Yellen, and Acting U.S. Labor Secretary Julie Su, the coalition of attorneys general welcome the Biden Administration proposal to restore access to cost-free contraceptive coverage for all Americans. The coalition letter further supports rescinding the moral exemption, and urges the Biden Administration to narrow the religious exemption, and make necessary improvements to the ICA, including:

  • Expanding the ICA to include a wider spectrum of individuals who are excluded from contraceptive coverage;
  • Carrying out a publicity and outreach campaign to inform patients and providers about the ICA and help them enroll in it; and
  • Providing additional protections to secure patients’ privacy, safeguard them from retaliation, and create a process for contesting medical bills.

Today’s comment letter was led by California Attorney General Rob Bonta, Massachusetts Attorney General Andrea Joy Campbell, Pennsylvania Attorney General Michelle Henry, and New Jersey Attorney General Matthew J. Platkin. They were joined by the attorneys general of Arizona, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Michigan, Minnesota, Nevada, New York, North Carolina, Oregon, Rhode Island, Vermont, Washington, and the District of Columbia.

A copy of the comment letter can be found here.

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