Trump contraceptive ruling will encounter legislative resistance in Massachusetts

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Birth control coverage was just dealt a blow at the federal level, with Massachusetts women in its crosshairs — for now.

President Donald Trump issued a rule Friday that severely restricts the Affordable Care Act's contraceptive coverage mandate, effective immediately, in a move that has been expected for months.

In Massachusetts, that rule is set to encounter legislative resistance.

A bill pending in the Legislature — the "Advancing Contraceptive Coverage and Economic Security in our State," or ACCESS — would continue the ACA's requirement that birth control largely not be subject to cost-sharing.

The bill provides exemptions for churches and qualified church-controlled organizations.

It would also enable women to receive three months' worth of birth control at one time, then later a year's worth.

"We want to make sure that, no matter what ... federal rules get changed, in Massachusetts, women are protected," said State Rep. Tricia Farley-Bouvier, D-Pittsfield.

Farley-Bouvier, along with Rep. William "Smitty" Pignatelli, D-Lenox, Rep. Paul Mark, D-Peru, and Sen. Adam Hinds, D-Pittsfield, are co-sponsoring the bill, along with dozens of other legislators.

The Trump administration's new interim final rule, issued Friday, allows a much broader group of employers and insurers to exempt themselves from covering contraceptives on religious or moral grounds.

Even publicly traded entities can claim religious exemptions to providing contraceptive coverage to nonprofit organizations and for-profit companies.

Also included are higher educational institutions that arrange for insurance for their students, and individuals whose employers want to provide health plans consistent with their beliefs, The Washington Post reported Friday.

Coverage of birth control is extremely important in Berkshire County, as communities such as Pittsfield have struggled with high teenage birthrates, Farley-Bouvier said.

"The community has come together in a big way to reduce that teen birthrate," she said. "A major part of that success has been no-cost birth control, and we will not go backwards."

The ability to receive 12 months' worth of birth control at a time would make a huge difference in Berkshire County, where many people struggle with transportation issues that could prevent their accessing a pharmacy to get prescription birth control on a monthly basis, she said.

With the number of people living in poverty in the county, coverage of birth control is especially important, said Kristine Hazzard, president & CEO of Berkshire United Way.

"Given our poverty rate and how many people we have living in low-income situations, people are making difficult decisions every day," she said.

Farley-Bouvier strongly expects the bill to pass.

"I think there's widespread support for this bill," she said. "I think it's a really obvious thing that we want to protect women's health."

The state has seen success in covering birth control under the Affordable Care Act, she said.

"We have seen it works under federal regulation," she said. "It's not like this is a new concept for us."

Hinds is also optimistic.

"Now we're at the stage of brokering compromises between the industry and advocates and legislators," he said. "It strikes me that there's considerable progress."

The bill represents a compromise between reproductive rights advocates and the insurance industry.

The ACCESS bill was heard in a hearing Tuesday. Before legislators vote on it, a report must be issued by the state's Center for Health Information and Analysis describing the financial impact of the bill to ratepayers.

The bill must also go through the calendar and reading process, along with floor debates, in both chambers of the Legislature, said House Speaker Pro Tempore Patricia Haddad of Somerset, who proposed the original bill along with Senate Majority Leader Harriette Chandler of Worcester.

The sponsors and co-sponsors would like to have the bill passed before the Christmas break — an aggressive but not unrealistic expectation, Haddad said.

"We've done things in the past that required an aggressive timeline," she said. "That's what I'm advocating for."

Attorney General Maura Healey also testified in support of the bill.

Healey's office released a statement Friday calling the interim final rule "a direct attack on women's health and the right to access affordable and reliable contraception."

Healey's office planned to sue the Trump administration that same day to stop the rule and defend crucial protections for women in Massachusetts and across the country, Healey said in the statement.

Haddad said she trusts that insurance companies, especially those that have been involved in negotiations over the bill, will not stop covering birth control before the bill is passed.

But that doesn't mean an employer would not do that, she said.

"That's certainly a worry," she said. "That some of these women go to work on Monday or Tuesday and find out, 'Oh, we're not going to cover you anymore.'"

The bill originally called for broader coverage, including making the emergency contraceptive known as the morning-after pill free without a prescription, State House News Service previously reported.

Seven other states and the District of Columbia have established laws requiring no-copay coverage of contraception in an effort to guard against changes forecast by the Trump administration, The Boston Globe has reported.

Reach staff writer Patricia LeBoeuf at 413-496-6247 or @BE_pleboeuf.


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