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The Mirena IUD. Photo courtesy of Sarah Mirk / Flickr via Creative Commons

White House Rolls Back Birth Control Coverage

It's a move in the opposite direction from Colorado's progress in family planning.

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In a move contrary to Colorado’s nationally recognized progress in family planning, the White House on Friday took a step to roll back birth control coverage for women. The Trump administration announced two new rules, effective immediately, to allow any employer with a religious or moral objection to request an exemption from providing birth control coverage in their insurance plans.

“The United States has a long history of providing conscience protections in the regulation of health care for entities and individuals with objections based on religious beliefs or moral convictions,” the rules state. (The move comes as Attorney General Jeff Sessions also announced sweeping religious freedom protections on Friday that could have wide-ranging impacts far beyond health care.)

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Currently, some 55 million women receive birth control with no co-pay as a preventive health service under the Affordable Care Act’s contraceptive mandate. In 2013, women saved $1.4 billion in 2013 on birth control pills alone, according to one study. But it’s the ACA’s coverage of long-acting reversible contraceptive (LARC) methods such as intrauterine devices (IUDs) and implants where the cost savings really add up for women—and for Colorado. LARCS, which last up to 10 years, are 20 times more effective than birth control pills, but can cost up to $1,000 per device.

Colorado’s Family Planning Initiative—a state-administered program— has provided free or low-cost LARC devices for low-income women and teens since 2009. The program saves the state’s Medicaid program about $5.85 for every dollar spent, according to the Colorado Department of Public Health and Environment (CDPHE). From 2009 to 2016, Colorado’s birth rate for young women ages 15 to 19 also fell 54 percent, while the abortion rate fell 53 percent.

Currently, about 13 percent of Colorado women who use CDPHE’s family planning services have employer-based insurance. But if Colorado employers decide to request exemptions, more women may find themselves in need of CDPHE’s services under the new rules. “Colorado’s Title X family planning program will continue to provide contraceptives and other family planning services to all Coloradans who need them, regardless of insurance coverage,” CDPHE executive director and chief medical officer Dr. Larry Wolk said in an emailed statement to 5280 on Friday. “While there is no way to know how much this rule will increase the demand for family planning services, we will continue to monitor that demand so that we can provide the best service possible.”

Meanwhile, women’s health advocates such as the American Civil Liberties Union and the National Women’s Law Center say they are taking “immediate legal steps” to block the new rules. “By taking away women’s access to no-cost birth control coverage, the rules give employers a license to discriminate against women,” Fatima Goss Graves, president and CEO of the NWLC, said in a statement. “This will leave countless women without the critical birth control coverage they need to protect their health and economic security.”

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