The Biden administration has decided to rescind proposed regulations aimed at improving access to contraception by limiting employer exemptions under the Affordable Care Act (ACA). This decision leaves in place Trump-era rules that broaden employers’ ability to opt out of covering birth control for employees, drawing both criticism and celebration.
What the Withdrawn Rules Would Have Done
The proposed regulations, introduced in early 2023, sought to narrow the grounds for opting out of the ACA’s contraception mandate. Specifically, the rules would have eliminated non-religious moral objections as a basis for exemption.
Additionally, the changes aimed to provide a workaround for employees of religious organizations that refuse to cover birth control. These employees would have been able to obtain contraception at no charge directly from health care providers. The Department of Health and Human Services (HHS) estimated the policy would have made 130,000 more people eligible for contraceptive coverage.
“Now more than ever, access to and coverage of birth control is critical,” HHS Secretary Xavier Becerra said when the rules were proposed.
Why the Rules Were Withdrawn
HHS announced the withdrawal in a Federal Register notice, stating that the administration would instead focus on other priorities during its final days. The department did not elaborate further or respond to media inquiries.
By rescinding the proposed rules, Trump-era policies remain intact, allowing nearly any employer—religious or secular—to claim an exemption from the contraception mandate. These policies also place the burden on objecting employers to opt into accommodations for employees to access contraceptive services.
Reactions to the Decision
The move drew praise from conservative groups, such as the Becket Fund for Religious Liberty, which has consistently opposed the ACA’s contraception mandate. The group celebrated the decision on X (formerly Twitter), calling it an early “Christmas gift.”
However, reproductive rights advocates expressed disappointment. The elimination of federal protections for abortion access in 2022 has increased the urgency for affordable and accessible contraception, making the withdrawal of the regulations a significant setback.
Implications for Access to Birth Control
Contraceptive coverage under the ACA has led to a significant reduction in unintended pregnancies over the last decade. The Trump-era exemptions, however, have allowed private health plans and employers to exclude coverage, leaving many without free access to birth control.
While the ACA mandates insurers cover preventive health services, including contraceptives, at no cost, the ability of employers to opt out has created gaps in coverage, particularly at private colleges, universities, and small businesses.
What’s Next?
With the withdrawal of these rules, reproductive health advocates face new challenges in expanding access to contraception. As the Biden administration winds down, the future of federal contraceptive protections may depend on the next administration’s priorities.
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