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My body, my business: The fate of birth control in the Trump era

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NOVEMBER 05, 2017

On Oct. 6, women across the country released a collective cry of anguish as news outlets announced what seems to be five leaps backward for women’s rights. Holding their breath since the inauguration of President Donald Trump in January, many women have anxiously dreaded the execution of Trump’s promises to roll back the Affordable Care Act.

The most devastating of these promises, Trump’s rollback of Obamacare’s contraceptive mandate, now allows employers to opt out of no-cost birth control coverage for religious or “moral” reasons. These rulings went into effect immediately and seem to nullify the progress made for women’s rights under the Obama administration.

Obamacare’s effects

The Affordable Care Act, dubbed “Obamacare” and passed into law in 2010, included a provision that went into effect in 2012 requiring all employers to provide no-copay birth control coverage to employees for all FDA-regulated contraceptives.

This administration pioneered a new age for women’s rights, affecting the lives of millions of women across the United States. According to the website of the Henry J. Kaiser Family Foundation, in just three years, Obamacare reduced the percentage of women paying out-of-pocket coverage for contraceptives from 21 percent to just 3 percent.

Several companies, however, objected to these federal regulations requiring birth control coverage.

Most notable was Hobby Lobby, an arts and crafts company run by Christian owners. In the 2014 U.S. Supreme Court case Burwell v. Hobby Lobby Stores, Inc., the court exempted some for-profit organizations from Obamacare’s contraceptive mandate if the mandate conflicted with the organization’s religious beliefs. This controversial exemption allowed religious organizations control over their employees’ contraceptive coverage.

“California in particular led the fight to protect women’s rights.”

Several states spearheaded the opposition to these religious exemptions. California in particular led the fight to protect women’s rights.

In response to this controversial Supreme Court ruling, California furiously worked to codify parts of Obamacare into state law, especially the contraceptive mandate. California’s Contraceptive Coverage Equity Act, passed in 2014, required employers to cover at least one type of birth control at no cost for their employees.

This state law defends the rights of all California employees, requiring employers to provide no-cost, FDA-approved contraceptive coverage.

The loophole in this trailblazing state law lies in self-insured companies, according to Planned Parenthood Affiliates of California Creative Organizer Elizabeth Wells. These companies are federally regulated and as a result do not fall under the jurisdiction of individual states. Therefore, such companies can bypass the California state law requiring contraceptive coverage and instead defer to the federal ruling that allows exemptions based on religious grounds.

Such self-insured companies employ 6.8 million people in California. These are the people who are subject to federal sanctions, such as Trump’s recent rollback of Obamacare’s contraceptive mandate.

Trump’s rollback

Trump’s recent rollback of this preventative care coverage allows any business the same exemption granted to Hobby Lobby. Now, virtually any business, even any university, can obtain an exemption from this mandatory contraceptive coverage if it claims a “religious” or “moral” objection.

This rollback manifested itself as a shocking setback to women’s rights. Wells believes that these “shaky moral exemptions” have the power to affect “not only … women, but families, nonbinary folk, men. Everyone.” Across the country, those impacted by the executive order feel as if employers have been given jurisdiction over their own bodies.

Women in particular are worried about the execution of these moral objections. Theoretically, employers now can wield personal morality as weapons, executing corporate control over a woman’s body.

Robin Flagg, a professor of UC Berkeley’s health policy & management department, maintains that companies will “have to weigh their personal beliefs … when trying to attract smart, young, healthy future leaders of the country.”

But how exactly will this rollback affect women?

Realistic effects on women

In California, self-insured companies could potentially take advantage of these new exemptions. Flagg said this mandate will only affect “the companies that choose to put it into effect.”

Wells doubts, however, that many, if any, of these self-insured companies in California will start to deny their previous coverage to employees.

“It’s kind of just saying … ‘Will you stay true to the status quo?’ ” Wells said.

Furthermore, California Attorney General Xavier Becerra is leading the opposition to Trump’s mandate. On the same day that Trump issued his controversial executive order, Becerra filed a lawsuit against the Trump administration, claiming unfair discrimination against women.

Regardless, college-age women seeking employment post-graduation are especially concerned about this new mandate.

Realistically, it seems that almost all of these self-insured companies in California will continue to provide no-cost birth control coverage to employees.

But not all women across the country are in the same position as those in California. In more conservative states, women worry about their future rights to contraceptive coverage.

“In my 20 years as a nurse practitioner, I’ve never seen people say, ‘I want to get this (an IUD) now because I’m concerned about coverage in the future.'”

— Melanie Deal

“California has always had really good coverage for family planning … but other states don’t (have specific mandates for insurance in place),” said Melanie Deal, a nurse practitioner at the Tang Center.

Wells believes that this mandate will encourage young women across the country to pursue long-lasting contraception such as IUDs and implants, especially those who are looking for “a concrete way to make sure that they have birth control coverage for three to 12 years, which outlasts the Trump presidency.”

“In my 20 years as a nurse practitioner, I’ve never seen people say, ‘I want to get this (an IUD) now because I’m concerned about coverage in the future,’” Deal said.

Even though it seems that most California employers will not take advantage of these new coverage exemptions, women around the country still worry about what this means for the future of women’s rights.
So how can we all fight for women’s rights to contraceptive coverage?

The fight for women’s rights

The fate of this ongoing battle for women’s rights relies on the voices of everyone around the country.

California’s writing of contraceptive coverage into state law marks California unique from other states. But the rest of the country needs California to lead the fight for women’s rights to birth control.

“We all have to stand up for ourselves and for all women around the country,” Deal said.

Organizations such as Planned Parenthood in California are already instituting campaigns to protect women’s rights. Wells herself is currently working on a multi-pronged campaign that encourages self-insured companies to remain committed to providing birth control coverage for their employees. This project also involves students on college campuses, encouraging these students to urge campus administrators to continue to cover birth control in student insurance plans.

This activism at the college level is crucial to the success of this fight for women’s rights. Flagg said that in her classes, she constantly reminds all of her students that “we are making decisions that are going to affect your future.”

“We know how to be loud.”

— Elizabeth Wells

UC Berkeley students will be instrumental in making waves across the country.

“(The students at UC Berkeley) know how to do it, they know how to be loud. We know how to be loud,” Wells, a 2016 graduate of UC Berkeley, said.

In the face of President Trump’s mandate, the battle for women’s birth control rights seems to have recently begun a new chapter. There is hope, however, for the future of such rights, as long as people across the country continue to fight for their rights.
As Deal reminds us: “We cannot get complacent.”

Contact Bailey Dunn at [email protected].

NOVEMBER 07, 2017