Until now, religiously affiliated charities and family-owned companies had to sign a form saying they didn't want to provide coverage, triggering a process where someone else would step in and offer coverage for free contraception.
Under the new rules, publicly traded for-profit companies can opt out of the so-called contraception mandate by citing a religious or a moral belief, whether or not the company has a religious objective. It would be up to states to determine how companies should make these decisions. It's apparent they believe that Friday's new rule is more substantial.
Doctors' groups that were instrumental in derailing Republican plans to repeal the health law expressed their dismay. The officials requested anonymity during a Friday call with reporters.
"By taking away women's access to no-cost birth control coverage, the rules give employers a license to discriminate against women", said Fatima Goss Graves, president of the National Women's Law Center.
That said, Mendelson said he worries the new rule will set a precedent for weakening ACA requirements that basic benefits be covered. That changed with the first Supreme Court challenge to the provision, Burwell v. Hobby Lobby in 2014, which led to the exceptions for religious employers. Women working for those companies would be able to get morning-after pills and IUDs from other sources, such as the government or private insurers.
"Birth control is a medically necessary resource; it is indispensable for family planning, treating menstrual cramps, endometriosis, polycystic ovarian syndrome, and quite literally saves lives", said Shaunna Thomas, co-founder of UltraViolet, a leading women's advocacy organization. "Reducing access to contraceptive coverage threatens to reverse the tremendous progress our nation has made in recent years in lowering the unintended pregnancy rate".
The shift would broaden an Obama-era religious exemption from providing contraception coverage to more for-profit corporations and others not included in an earlier workaround.
"With this rule in place, any employer could decide that their employees no longer have health insurance coverage for birth control", she said in the statement. Twenty-nine percent of women report that they have tried to save money by using their birth control method inconsistently, while more than half of young adult women have said that they do not use their birth control method as directed because it was cost-prohibitive to do so.
The ACA's guarantee of coverage for FDA-approved contraceptives without out-of-pocket costs stands as one of the most important advancements in women's health in a generation.
It may be a costly change too. Birth control is generally quite cheap; the Pill's average cost is between $20 and $50 a month without insurance coverage. No one is controlling your sexuality. These people are unaffected by Friday's rules.
The Affordable Care Act's contraception mandate has been updated about 10 times over the last six years, as the Obama administration sought to address religious concerns related to birth control. HHS, however, estimated the number of impacted women at roughly 120,000. Most of all, the administration says that the requirement puts a "substantial burden" on the free exercise of religion by the employers who object to it, which seems to be the heart of the matter. The group obtained the information through a Freedom of Information Act request.
The White House says employers do not have notify the government that they are going to forego the coverage; they have only to notify their employees of the decision.