Oct 7, 2017
Facts Matter

55 million people have access to free birth control under ACA

Illustration: Sam Jayne / Axios

On Friday, the Trump administration cleared the way for all nonprofit organizations as well as for-profit companies, including publicly-traded ones, to deny employees insurance coverage for free birth control based on religious or moral objections.

Why it matters: The immediate rollback of the Affordable Care Act's contraceptive mandate significantly broadens its original exemptions, which included churches. Now, companies will be able to exempt themselves based on "non-religious moral objections," instead of expressly demonstrated religious beliefs.

The numbers:

  • More than 55 million women have access to birth control free of charge under the ACA mandate, per an Obama administration report.
  • The percentage of women between the ages of 15 and 44 who paid out-of-pocket for oral contraceptive pills dropped from 21% in 2012 to 3.6% in 2014, after the ACA was passed, according to a Kaiser analysis.
  • The most commonly used form of birth control is the oral contraceptive pill, which around 27% of women who use contraception rely on, per Kaiser.
  • 58% of women who use the pill cite non-contraceptive reasons for doing so: 31% use it for menstrual cramps, 28% to regulate the menstrual cycle, 14% to treat acne and 4% for endometriosis, the Guttmacher Institute reports.

The facts:

  • The ACA mandate required employers' health insurance to cover at least one of 18 forms of birth control approved by the FDA, allowing exemptions for certain religious organizations, such as churches.
  • In its 2014 decision in Burwell vs. Hobby Lobby, the Supreme Court ruled that Hobby Lobby should get an exemption from the mandate for religious reasons. But the court "limited its decision to companies that are closely controlled by a few people. Hobby Lobby, for example, already closed on Sundays and otherwise reflected the faith of its owners," per Axios' Sam Baker.
  • The new Trump administration rules apply to all companies who can demonstrate "sincerely held" religious beliefs or moral objections — that's a much wider pool.
  • The Department of Health and Human Services says "99.9% of women" will retain access to free birth control after a new batch of companies claim exemptions under the new Trump rules. Their analysis is based on the number of companies that have filed lawsuits over the mandate, per the Washington Post.
  • But "the breadth of the Trump rollback may encourage hundreds, even thousands more employers to drop contraceptive coverage, given the ease with which the rule allows a change in coverage to be executed," Michael Hiltzik of the LA Times writes.
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