Benefits and Compensation

Trump Administration Expands Available ACA Exemptions for Employer-Provided Contraceptives

On October 6, the Trump Administration released two interim final rules that vastly expand the availability of exemptions to the Affordable Care Act (ACA) rules requiring employer coverage of contraceptives.


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The ACA requires employers and insurers that offer employees group health plans to cover certain approved contraceptive methods, at no additional cost to the insured, or face stiff penalties. Previously, there had been an exception for grandfathered health plans—those 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 as including 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 accommodation under the ACA intended to protect them from “having to contract, arrange, pay, or refer for” contraceptive coverage.

The contraceptive mandate, and the rules for exceptions to it, have spawned numerous lawsuits.

The interim final rules released on October 6 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 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.

The rules (FR Docs. 2017-21851 and 2017-21852) are expected to be published in the Federal Register on Friday, October 13. Public comments are invited and will be accepted until December 5, 2017.