Employers in the U.S. are no longer required to provide birth control coverage as part of their health insurance plans, thanks to a new rule issued by President Donald Trump’s administration on Friday.
All employers may now opt out of including birth control in their health coverage for employees for any moral or religious reason, rolling back the Obama-era requirement that guaranteed contraception coverage at no cost to 62 million women.
The measure saved women $1.4 billion on birth control in the first year it went into effect and contributed to an all-time low in unintended pregnancies and the lowest U.S. abortion rate since the procedure became legal in 1973.
The Trump administration, along with supporters of the new policy, framed the rollback as a win for religious liberty.
“Except in the narrowest circumstances, no one should be forced to choose between living out his or her faith and complying with federal law,” Attorney General Jeff Sessions said in a statement.
Opposition to contraception has come to be a rallying cry among conservative Christians, once largely silent and at times even mildly supportive on the issue of birth control. Today, some of the most prominent figures of the anti-contraception movement are evangelicals.
In 2014, the U.S. Supreme Court ruled that the Affordable Care Act mandate requiring closely held, for-profit corporations ― like Baptist family-owned crafts store chain Hobby Lobby ― to pay for insurance coverage for birth control violated religious freedom protections. The Hobby Lobby case propelled evangelicals to the forefront of the anti-contraception movement.
But they had the Roman Catholic Church to thank for setting the stage.
Contraception and abortion didn’t become major issues in the American evangelical community until around the 1980s, as even Albert Mohler, president of The Southern Baptist Theological Seminary, will admit. At that time a coalition of conservative Christians was forming around a number of matters, including abortion, gay rights and school prayer.
A scan through the Southern Baptist Convention’s resolutions from the early ’70s to the early ’80s shows a dramatic shift in the evangelical group’s stance on the issue of contraception.
“The evangelical conscience was awakened in the late 1970s, when the murderous reality of abortion could not be denied,” Mohler wrote in a 2012 article titled “Can Christians Use Birth Control?”
“We should look closely at the Catholic moral argument,” he continued, for guidance on the issue.
He wrote evangelicals would “find themselves in surprising agreement” with “Humanae Vitae,” an encyclical released by Pope Paul VI in 1968.
“Humanae Vitae” came on the heels of a 1965 U.S. Supreme Court ruling that upheld individuals’ private rights to use birth control. As journalist Patricia Miller wrote in her book Good Catholics: The Battle Over Abortion In The Catholic Church, many Catholics at the time expected the church to roll back an earlier decree by Pope Pius XI that said birth control violated the “law of God and nature” and that contraceptive use constituted “a deed which is shameful and intrinsically vicious.”
But Paul VI doubled down on the church’s ban on artificial birth control and reiterated Catholic teaching on gender roles.
He wrote: “The fundamental nature of the marriage act, while uniting husband and wife in the closest intimacy, also renders them capable of generating new life — and this as a result of laws written into the actual nature of man and of woman.”
It expressed “a very conservative worldview about women, basically saying women are expected to be mothers,” Miller told HuffPost on Friday.
The theological basis for opposition to birth control derives primarily from two Biblical passages. First is God’s commandment to “Be fruitful and multiply,” and second is the story of Onan, who God killed for “spilling his semen” and failing to impregnate his sister-in-law.
“The bottom line is they believe that the sperm are sacred,” Miller said. “That’s based on early misunderstandings that the entire human being was contained in the sperm and that the woman was like an incubator.”
As a result, Miller noted, Catholic doctrine asserted that “every act of sex has to be open to human life.”
But Catholic women largely don’t comply with the contraceptive ban. And a majority of young Americans overall are on the side of choice.
The church had struggled throughout the 20th century to obstruct access to contraception through various measures. By the end of the century, U.S. Catholic bishops discovered that insurance could be an effective avenue, as Miller suggested, “to prevent by law what it couldn’t prevent from the pulpit: women from using birth control.”
Efforts to increase contraception coverage in private health insurance plans started gaining traction in the 1990s. Catholic bishops rallied against any measures to include birth control in health plans, at times even filing lawsuits to frame contraception coverage as an insult to their faith.
One of the main arguments leveraged by Catholic leaders and adopted by conservative evangelicals is that some forms of contraception, including the IUD and the morning-after pill, are akin to abortion. By that logic, requiring companies to offer contraception coverage amounted to forcing them to condone abortion.
“To suggest that your religious liberty is infringed upon by a woman in your health plan using birth control is a radical reinterpretation of the issue."”
In 2011, Cardinal Daniel N. DiNardo, then-chairman of the U.S. Conference of Catholic Bishops’ Committee on Pro-Life Activities, claimed in his opposition to the contraceptive mandate that drugs like ella, which delays ovulation through the inhibition of progesterone, can act as abortifacients. (Researchers do not classify ella or other emergency contraceptives in this way.)
“The pro-life majority of Americans ― Catholics and others ― would be outraged to learn that their premiums must be used for this purpose,” DiNardo wrote.
The Hobby Lobby decision made companies with religious objections to contraception coverage eligible for an accommodation already in place for certain nonprofits. But several subsequent Supreme Court cases, including one brought by an order of Catholic nuns called the Little Sisters of the Poor, argued that even filling out a form to ensure their employees can access contraception coverage through alternate means constituted a breach of religious liberty.
“Judges aren’t qualified to tell nuns what the right answers are on question of moral complicity,” said Mark Rienzi, a lawyer with the Becket Fund, which represented the Little Sisters. The Supreme Court sent the Little Sisters’ case, and others like it, back to the lower courts in 2016.
When the Trump administration handed down its contraception coverage rollback on Friday, U.S. bishops called it a “return to common sense.”
Cardinal DiNardo and Archbishop William E. Lori said in a joint statement: “A government mandate that coerces people to make an impossible choice between obeying their consciences and obeying the call to serve the poor is harmful not only to Catholics but to the common good.”
If the Hobby Lobby ruling wasn’t enough, then Friday’s announcement offered further proof of the impact Catholic leaders had on framing contraception as a religious freedom issue.
“The traditional meaning of religious liberty in this country is that you are free to practice or not practice your faith as you see fit,” Miller said. “To suggest that your religious liberty is infringed upon by a woman in your health plan using birth control is a radical reinterpretation of the issue.”