Trump Administration Enacts Sweeping Executive Order Attacking Access to Birth Control on the Same Day House Votes to “Defund” Planned Parenthood

Washington, DC -- Today Donald Trump signed a sweeping Executive Order that directs the U.S. Department of Health and Human Services (HHS), Treasury Department, and Department of Labor to consider issuing policy that would allow employers, schools, and other entities to refuse to cover women’s preventive health services, including birth control, in their insurance plans on the basis of religious or moral objection. The executive order could result in amending existing regulations to allow entities, including employers and schools, that object to certain required health care services -- like no-copay birth control -- to take away coverage completely. More than 55 million women currently have access to certain women’s preventive health services at no-copay under the ACA, including birth control, STI tests, and well-woman exams. This executive order follows the appointment of several ardent anti-women’s health officials who have publicly voiced opposition to birth control, and comes before a vote by Congress on the worst bill for women’s health in a generation -- that would block low-income patients from coming to Planned Parenthood for care, cut essential health benefits like maternity care, and make being a woman a pre-existing condition.

Statement by Dawn Laguens, Executive Vice President of Planned Parenthood Federation of America:

This is an administration that has had women’s health in its crosshairs since day one. It is unbelievable that in 2017 women’s access to basic health care is still up for debate. In the span of a few hours, DC politicians will have moved to strip women of maternity care, the ability to come to Planned Parenthood, and access to birth control. This is unacceptable.

“This executive order is not about protecting religious liberty -- it is a direct attack on women’s access to birth control. A woman’s health should not be up to her boss or politicians.”

“This executive order comes on the same day the House votes to ‘defund’ Planned Parenthood in the worst bill for women’s health in a generation -- a fact that is not lost on the millions of women at home. We will not stand for this -- and we will not stand by and quietly watch politicians strip us of our basic health or rights.

Background

Facts about birth control:

• We are at an all-time low in unintended pregnancy and in pregnancy among teens because of increased use and more effective use of  birth control.

• The importance of affordable birth control access can’t be overstated: Many of the gains women have made since 1965 — in obtaining education, pursuing careers in increasing numbers, moving closer to pay equity, and in the timing and spacing of children — are the direct result of increased access to birth control. Women have saved an estimated  $1.4 billion in out-of-pocket costs on birth control pills per year since the ACA’s birth control benefit went into effect.

• One-third of the wage gains women have made since the 1960s are the result of access to oral contraceptives.

• Young women’s access to the pill contributes to their educational success: Research shows that women who had access to the pill before age 21 were less likely to drop out of college.

• Bloomberg Businessweek listed contraception as one of the most transformational developments in the business sector in the last 85 years and the Centers for Disease Control and Prevention named family planning, including access to modern contraception, one of the 10 great public health achievements of the 20th century.

• Ninety-nine percent of sexually active women will use contraception at some point in their lifetimes. Birth control should be treated like any other preventive medical care.

Background: The American Health Care Act is the worst bill for women’s health in a generation.

Blocks low-income patients from receiving health care at Planned Parenthood health centers. Every year, 2.5 million women, men, and young people rely on Planned Parenthood for essential health care services, like birth control and lifesaving cancer screenings. Many of these people, particularly those in rural areas and medically underserved areas, will have nowhere else to turn to for care if Planned Parenthood health centers are forced to close their doors. Women should be able to choose their health care provider the same as politicians in Washington, DC. Despite false claims, community health centers simply cannot absorb Planned Parenthood’s patients. States like Texas and Wisconsin have suffered serious public health consequences when communities lost access to Planned Parenthood.

Eliminates protections for the millions with pre-existing conditions. By removing the community rating provision, insurers would be allowed to once again charge people with pre-existing conditions an exorbitant amount for coverage. The community rating provision prohibits people from being charged more based on health status, gender, health status, occupation, and age.

Discriminates against women. Despite the fact that the proposal claims to maintain the current prohibition on gender rating, it still allows insurers to once again discriminate against women. Eliminating the community rating provision disproportionately affects women –insurers can claim having given birth, having had a C-section, or having been a survivor of domestic violence is a so-called pre-existing condition. For example, a woman who had breast cancer could be charged a premium surcharge of more than $28,000 per year for coverage, and a woman who was previously pregnant could face an additional surcharge of more than $17,000 per year for coverage.

Eliminates maternity coverage, newborn care and other Essential Health Benefits (EHB) coverage standards. The bill guts the Essential Health Benefits provision, which requires the majority of health plans to cover services like maternity and newborn care, mental health services, and prescription drugs.  Approximately 13 million women who gained access to maternity coverage under the ACA stand to lose their coverage. Women also benefit from the EHB in other ways; for example, women are more likely to need prescription drugs to manage their health care needs, develop mental health needs, and require lab services to diagnose autoimmune disorders. This is a direct attack on women of all ages, since women disproportionately rely on every one of the EHB standards – not just maternity coverage. (Full list below)

Forces new mothers with Medicaid coverage to find work shortly after giving birth. The bill gives states the option to impose work requirements as a condition of obtaining Medicaid coverage. It also gives states the ability to revoke Medicaid from new mothers if they don’t find work within 60 days of giving birth. Work requirements are generally unnecessary and harmful, as nearly 60 percent of Medicaid enrollees who can work do, and if they don’t work it’s as a result of a major impediment. Work requirements disproportionately impact women as they account for 62 percent of Medicaid enrollees who are not working. Work requirements for new mothers are especially harmful.

Kicks millions of women and men off their insurance. The CBO reports that 24 million people will lose coverage over the next 10 years, 14 million of which will lose Medicaid coverage due to the bill's measures to kick people off of Medicaid.

Ends Medicaid expansion. The AHCA will effectively end the Medicaid expansion, which has provided coverage to at least 11 million people, starting January 1, 2018, and will result in women, disproportionately women of color, losing critical access to care. Approximately 20 percent of women of reproductive age rely on Medicaid to access no-cost, critical reproductive health care such as birth control, lifesaving cancer screenings, and maternity care.

Guts the Medicaid program. The AHCA provides states the option to receive federal payments in the form of a block grant or per capita cap, both of which will slash the amount of federal support states receive today and will force states to either come up with extra money or make difficult decisions about which services, benefits, or eligibility groups to cut. Reduced federal funds for state Medicaid programs will disproportionately harm women -- women of color, in particular. For example, to save money, states may choose to limit coverage of prenatal visits and family planning services, or states may cut people from their programs.

Imposing Additional Costs on Women. The AHCA will require people to pay more for less coverage. First, the bill reduces financial assistance by repealing the existing cost-sharing subsidies that assist with copays and deductibles, and replacing the ACA-created tax credits, which fluctuate by need, with less generous tax credits for low- and middle-income individuals. This will disproportionately impact women, particularly women of color, given the inequities in earnings for women, and exacerbate health care disparities, given insured people of color already report less confidence in being able to afford care.

Reduces women’s access to no-copay birth control. While the bill does not specifically repeal the no-copay birth control benefit, the fact that millions of women will lose coverage means they will no longer have access to no-copay birth control. Under the ACA, more than 55 million women gained access to no-copay birth control in the private insurance market, and approximately 16.7 million women benefit from Medicaid coverage, which also covers birth control at no cost. Paying out-of-pocket for birth control pills can cost a woman up to $600 per year, which is simply unaffordable for many young women and people with low incomes. A recent poll found that 33 percent of women could not afford to pay more than $10 for birth control.

Creates a nationwide ban on abortion coverage. The AHCA will coerce insurance plans to drop coverage of abortion because it will prohibit individuals from using their federal financial help to purchase a plan on or off the ACA Marketplace that covers abortion. At least 870,000 women will lose access to ACA Marketplace insurance plans that cover their full reproductive health care needs, including abortion, and millions more could lose access to abortion coverage in other plans given this provision extends outside of the Marketplace. Insurance plans, when not barred by state law, typically cover abortion. Women, no matter how much money they make or how they get health insurance -- should be able to able to access the full-range of reproductive health care, including abortion and make their own decisions about pregnancy based on their own unique circumstances.

FACT SHEET: Rolling Back the ACA’s Essential Health Benefits Will Hurt Women

1. AMBULATORY CARE: Women make up approximately 60% of outpatient visits.

2. EMERGENCY SERVICES: Women account for 6 in 10 visits to the emergency room.

3. HOSPITALIZATIONS: Women are 70% more likely than men to have had an in-patient hospital stay.

4. MATERNITY & NEWBORN CARE: Approximately 13 million women could stand to lose maternity coverage. Prior to the ACA only 12% of individual market health plans covered maternity care. And, prior to the ACA, some insurance plans did not cover C-sections at all; when they did, they charged women 25 percent more in premiums.

5. MENTAL HEALTH & SUBSTANCE USE: Women are 40% more likely than men to have mental health needs. Additionally, women are roughly 75% more likely than men to report having recently suffered from depression.

6. PRESCRIPTION DRUGS: Women are more likely than men to need prescription drugs to meet their daily health care needs.

7. REHABILITATIVE SERVICES: Women are more likely to suffer from a stroke and require rehabilitative services to help them regain motor or speaking skills.

8. LAB TESTS: Some of the most common lab tests are specifically geared to women, including pap smears, pregnancy tests, mammograms, brca gene testing (breast cancer testing), and many other lab services that are necessary to diagnose and treat conditions that disproportionately impact women like autoimmune disorders, thyroid disorders, and urinary tract infections.

9. PREVENTIVE SERVICES & CHRONIC DISEASE MANAGEMENT: 55 million have received access to no cost birth control, well-woman visits, domestic violence screenings, and STI/HIV screenings thanks to the ACA.

10. PEDIATRIC SERVICES. In two-parent households where at least one parent is a woman, women tend to bear a disproportionate share of childcare and caregiving responsibility for children. In addition, 80% of  single-parent households are headed by women.