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Jonathan P. Baird: Trump vs. the pill



For the Monitor
Sunday, November 05, 2017

It is utterly backward that birth control has re-emerged as a controversial issue. For the past 50 years, there has been little controversy about it, other than opposition from the Catholic Church. Cost has been a factor but the need for accessible birth control has not been widely questioned. Eighty-six percent of Americans support policies that make it easier to get birth control.

So how can it be that the Trump administration proposes rules that will make it harder for many women, especially those with low income, to access birth control?

It is a slap in the face of modernity, as well as to women.

In early October, the Trump administration released new rules that allow employers more exemptions from Obamacare’s contraception mandate. Employers can now opt out of the requirement to provide contraception if they have “religious” or “moral” reasons.

Under the Affordable Care Act, company health care plans had to cover contraception at no cost to the insured. Obamacare required that health insurance plans fully cover preventive health benefits for women.

The Trump administration rule change will adversely affect hundreds of thousands of women.

The National Women’s Law Center has stated that as of September 2017, 62.4 million women had insurance that covered contraception without having to pay out-of-pocket. There will be plenty of women, given economic realities, who will not be able to afford birth control, whether birth control pills, IUDs or other methods.

One study found that the Obamacare contraception mandate saved women $1.4 billion in 2013 in the cost of birth control. That gives a ballpark figure for the yearly economic value of the contraception mandate.

The Kaiser Family Foundation found that under the mandate the percentage of privately insured women who paid out of pocket for contraception dropped from 20 percent to 4 percent.

Blowing a hole in the contraception mandate by allowing more exemptions effectively guarantees less access to birth control and more unplanned pregnancies. Contrary to Trump administration assertions, there will be a widespread impact.

In May, Trump opened the door to an attack on birth control when he signed an executive order directing his administration “to address conscience-based objections” to covering birth control. This came in the aftermath of the U.S. Supreme Court decision in Hobby Lobby that granted corporations with a “closely held” ownership structure the ability to opt out of the contraception mandate.

The new Trump rules do not define the basis for moral objections to contraception. The vagueness will allow all kinds of entities – public and private – to assert their personal objection to birth control.

These entities could be employers, insurance plans, universities or individuals.

Under the Trump rules, these entities would have no obligation to notify the government if they stopped providing contraception coverage. They would only have to notify their employees.

This is much different from the Obamacare rules, for which companies with a religious objection had to notify the government as part of the accommodation.

The Trump rules use religious liberty as a license to discriminate against women. The employer’s religious beliefs are granted a higher value than their employee’s right to reproductive health care.

The rules are shockingly anti-worker. They also raise constitutional questions about separation of church and state.

It is easy to take the benefits of birth control for granted. Just to be able to plan when to have children is immensely important. Family planning goes hand in hand with school, work and career planning. There is also the human benefit of having a sex life without the constant fear of pregnancy when that is not desired.

In this context, it must be mentioned that there are an estimated 1 million women who use contraception for medical reasons. For example, the pill is used to prevent and treat endometriosis and polycystic ovarian syndrome, as well as treatment for painful periods, a condition called dysmenorrhea. The Trump rules do not account for women who have been prescribed birth control for non-contraceptive medical reasons.

One question jumps out: Why is the Trump administration on its anti-birth-control kick? It’s not a mystery. It ties in to the political marriage of strange bedfellows.

You have The Donald, who is a graduate of the Roger Ailes-Bill O’Reilly-Harvey Weinstein School of Sexual Predation, and you have the far, far right, which includes fierce anti-birth-control zealots who inspired Margaret Atwood’s A Handmaid’s Tale. These folks see birth control access as encouraging risky sex and promiscuity.

Talk about an unholy alliance!

Trump made the calculation that he needs the anti-birth-control reactionaries. They are part of his base, and with the new rules he is throwing them some red meat. As crazy as it may seem, the anti-birth-control fringe has embedded itself in the Trump administration, especially Health and Human Services.

Trump has systematically filled critical administration positions with individuals who have had long track records opposing women’s health and supporting junk science.

He hired Katy Talento as domestic policy counsel to the White House. Talento believes birth control causes miscarriages and abortions. Trump made Teresa Manning the Title X national family planning overseer. Manning, a former lobbyist for the National Right to Life Committee, claimed in an interview with WBUR that “contraception doesn’t work,” and she stated on C-SPAN that she does not believe the federal government should run family planning programs.

The top spokesperson for Health and Human Services, Charmaine Yoest, who spent years as an anti-abortion extremist, has supported phony claims that abortion causes breast cancer.

Valerie Huber, chief of staff for Don Wright, the acting secretary of Health and Human Services, is an anti-sex education activist. She was CEO of Ascend, formerly known as the National Abstinence Education Association.

Since so many of the Trump appointees come out of the hardcore anti-abortion movement, you might think that anti-choicers would support contraception. After all, contraception is the best tool against conception and abortion. However, you would be wrong to draw that conclusion. For these flat-earthers, contraception is the devil’s workshop. There is a fringe in the anti-abortion movement that is simply anti-sex.

The president of the American Congress of Obstetricians and Gynecologists, Dr. Haywood Brown, nailed it when he said the Trump administration was “focused on turning back the clock on women’s health.”

The ACLU, the National Women’s Law Center, California, Washington, Pennsylvania and Massachusetts have all filed lawsuits against the Trump birth control rules. Opponents to the rule have strong substantive and procedural grounds to object. Hopefully, the courts will stop this.

In 2017, it seems unbelievable to me that we still have to fight for birth control – but we do.

(Jonathan P. Baird of Wilmot works at the Social Security Administration. His column reflects his own views and not those of his employer.)