On October 6, the Trump administration released two interim final rules that will vastly expand the availability of exemptions to the Affordable Care Act’s (ACA) rules requiring employer coverage of contraceptives.
The ACA requires employers and insurers that offer group health plans to employees to cover certain approved contraceptive methods—at no additional cost to employees—or face stiff penalties. Previously, there were exemptions for grandfathered health plans (i.e., plans in existence at the time of the ACA’s adoption) as well as for group health plans sponsored by religious employers. “Religious employers” were narrowly defined to include churches and related entities as well as religious orders.
Organizations that objected to the contraceptive mandate but did not qualify for the religious-employer exemption could qualify for an ACA accommodation intended to protect them from “having to contract, arrange, pay, or refer for” contraceptive coverage. The contraceptive mandate and the rules for exemptions have spawned numerous lawsuits.
The interim final rules released on October 6 would expand the availability of exemptions to entities and individuals with “sincerely held religious beliefs” or “moral convictions” objecting to contraceptive or sterilization coverage. The rules also would make the accommodation process optional for eligible organizations.
In practical terms, the broad language means that nearly any employer may choose to opt out of providing contraceptive coverage.