The Biden administration has canceled proposed changes to the Obamacare birth control mandate, keeping in place broad Trump-era exemptions for employers.
The Department of Health and Human Services (HHS) has withdrawn a set of proposed regulations aimed at expanding access to contraception, leaving in place Trump-era rules that allow employers to opt out of providing birth control coverage due to religious or moral objections.
The decision not to move forward with the proposed rules, which sought to narrow the ability of employers to claim exemptions to the Obamacare contraception mandate, was announced by the HHS in a
notice on Dec. 23.
The withdrawn rules, first
proposed in 2023, aimed to limit how employers could avoid covering contraception under the Affordable Care Act (ACA). They would have
barred employers from claiming moral objections and created a system to let employees of religious organizations get free birth control directly from health care providers. At the time, HHS Secretary Xavier Becerra said the changes aimed to expand access to contraception after the 2022 Supreme Court Dobbs decision, which overturned Roe v. Wade and eliminated federal protections for on-demand abortions.
“Now more than ever, access to and coverage of birth control is critical as the Biden-Harris administration works to help ensure women everywhere can get the contraception they need, when they need it, and—thanks to the ACA—with no out-of-pocket cost,” Becerra said in a statement at the time.
The HHS said in Tuesday’s notice that it is stepping back from the proposed changes to focus resources on other priorities and to further consider the extensive public comments it received for its notice of proposed rulemaking. By doing so, the broad exemptions adopted in 2018 under the Trump administration remain in effect.
The Trump-era rules allow nearly any employer, including nonreligious ones, to refuse to provide birth control coverage if they have objections based on their beliefs. The rules also let employers opt out without requiring them to provide an alternative.
Supporters of these rules say they protect religious and moral rights. Critics say this leaves many workers without easy access to contraception.
The announcement drew support from conservative organizations. The Becket Fund for Religious Liberty, which has represented groups like the Little Sisters of the Poor in lawsuits over the ACA’s birth control mandate,
posted on X on Dec. 23: “Christmas came a little early this year.”
The Obama-era mandate took effect in 2012 and spurred dozens of lawsuits from private individuals, religious groups, and businesses that objected to it on moral and religious grounds.
According to a recent Kaiser Permanente
study, the ACA’s birth control mandate allowed millions to gain access to free birth control, leading to fewer “unintended pregnancies” and abortions. At the time, HHS
stated in a note in the Federal Register that it saw requiring employers to cover contraception as a way to improve the social and economic status of women.
In 2018, the Trump administration expanded the ability of employers to claim exemptions to the mandate by issuing two sets of rules—one on
religious exemptions and the other on
moral exemptions. One set allowed employers to opt out of providing contraceptive coverage on the basis of religious objections. This included both religious organizations and private companies that claimed providing such coverage violated their beliefs. The second set of rules extended this opt-out to employers citing moral objections, which did not have to be religious in nature.
