While all right-thinking people in the United States were horrified by President Donald Trump’s equivocal statements about the violent white supremacists who killed Heather Heyer and injured at least 19 other counterprotesters in Charlottesville last weekend, Trump was quietly working to sign away one of the most fundamental components of the Affordable Care Act: The contraceptive mandate, which requires insurance companies to provide all forms of birth control to women without a copay. (Pro-choice groups such as NARAL Pro-Choice America condemned Trump’s “both sides are to blame” remarks; anti-choice/”pro-life” groups? Not so much.)
Mother Jones reports on the administration’s plans to eliminate the benefit, by changing rules associated with the ACA so that virtually any company could deny coverage for birth control. The rule change would expand the ACA’s “moral objection” clause, which has been interpreted as applying only to explicitly religious organizations, so that most companies that do not want to pay for birth control could opt out of doing so. Essentially, the new rule would be Hobby Lobby on steroids, and its effect would be that more women who need access to contraception would be forced to pay out of pocket, choose cheaper, less effective methods, or face an unplanned pregnancy.
Two states passed laws this week that illustrate the power state governments have to counteract or worsen Trump-era abortion policy. The first is a familiar battleground for abortion rights advocates: Texas, where Gov. Greg Abbott just signed a bill this week requiring women who anticipate that they may have an unplanned pregnancy (which is basically the definition of an oxymoron) to pay extra for special “abortion insurance.” From now on, private insurance companies will be barred from covering abortion as part of their regular insurance plans, and allowed (but not required) to offer extra abortion insurance to women.
Opponents, the Texas Tribune notes, have dubbed the legislation the “rape insurance bill,” because it doesn’t include any exceptions for rape and incest—that is, in effect, it requires women to anticipate that they will be raped. (Or, even more perversely, that their teenage daughters will be raped or become pregnant through incest.) That’s an effective (and accurate) description, but the fact is, the definition of insurance is that it ensures coverage for unanticipated events. If pregnancy is put in a different category than, say, a broken leg due to a car accident, or a rare and expensive form of cancer, then there’s a strong case to be made that this law discriminates against all Texas women, not just those who may be the victims of rape or incest.
Oregon, very much in contrast to Texas, just passed a law this week that will require all insurance companies to cover abortion and birth control for all women in the state, including undocumented immigrants; it also includes state funding for abortions and brith control for women who are uninsured. According to Broadly, the bill also requires coverage for “STI and pregnancy testing, voluntary sterilization, postpartum care, and a long list of other reproductive health care–related drugs, devices, and services,” including vasectomies.
Pro-choice groups, including NARAL Pro-Choice Oregon, consider the bill a bulwark against future Trump administration crackdowns on access to birth control and abortion, including the possibility that Roe v. Wade is overturned, sending abortion rights back to the states. Washington State has its own law ensuring that abortion will remain legal even if Roe v. Wade is overturned, but efforts to pass legislation requiring abortion and male contraception coverage have failed, thanks to a state legislature narrowly split between pro-choice and anti-choice factions.
Finally, here’s a grim example of what happens when a federal government places draconian restrictions on abortion access—from India, where the laws regulating abortion are not much different than what many Republicans, including Vice President Mike Pence, want to institute in the United States. The New York Times reports that a ten-year-old girl who was denied an abortion after being raped by her uncle—because India’s ban on abortions after 20 weeks has no exceptions for rape, incest, or to save the life of the pregnant person—just gave birth. She was never told she was pregnant; instead, her family told her she was having a kidney stone removed. The pregnancy was especially dangerous because 10-year-old children are not physically equipped for pregnancy and childbirth, and the procedure required the girl to spend a week in the hospital monitored by three gynecologists, two pediatricians, two psychologists, a dietitian and a cardiologist. In service to a law designed to punish women, India’s government forced a 10-year-old who had already endured the trauma of rape to undergo a dangerous pregnancy and an invasive medical procedure. It’s inexcusable. But the US shouldn’t labor under the delusion that it couldn’t happen here.