Guest blog by Ann Danforth, Progressive States Advocacy and Policy Manager at Raising Women’s Voices-NY. It’s no secret that since day one, the current administration and the Republican-led Congress have been dead set on chipping away at the gains we’ve made to women’s health under the Affordable Care Act (ACA). Republicans have pushed forward a number of ACA repeal bills, but all of them have one thing in common: they would be devastating for women at every age across our life span. These proposals have included provisions that would gut Medicaid, defund Planned Parenthood, and impose restrictions on abortion coverage in private insurance. And in early May, the President attacked women’s health through administrative channels, signing an Executive Order that opens the door for broad religious or conscience-based exemptions to the ACA’s contraceptive coverage mandate. (For more on the ACA’s contraceptive coverage mandate, see RWV’s blog post on the topic here.)

Since the Executive Order, rumors have circulated about an interim final rule – said to be currently undergoing review – which would allow employers of any size, location, or business type to refuse to provide birth control to their employees based on their religious or moral objections (read the leaked draft here). This would undermine the ACA’s contraceptive coverage benefit, undoing one of the most popular features of the ACA, and one that has provided coverage without co-pays to more than 55 million women across the United States. Of course, not all employers would choose to deny contraceptive coverage to their employees, and women’s health groups are standing ready to call on employers to maintain this coverage.

Luckily, regardless of what happens down in D.C., New York has moved to protect contraceptive coverage without co-pays in our state. Recognizing the value of the ACA’s contraceptive coverage benefit, the threat posed by a hostile federal administration, and the inconsistent implementation of the contraceptive mandate by New York insurers (identified by RWV-NY in our 6/26/14 and 3/1/16 letters to NY State of Health and NYS Department of Financial Services), the Cuomo Administration issued draft regulations to expand contraceptive coverage protections in New York. These regulations, which we wrote about in a previous HCFANY blog post, were finalized last month. They require coverage without co-pays for one type of contraception in each of the 18 FDA-approved categories (the federal ACA standard), and allow for the dispensing of 12 months of contraception after an initial three-month allotment (June 28, 2017 Register: Page 13, Notice of Adoption).

In addition, and as part of their efforts to secure coverage for a full range of reproductive health services in New York State, the Cuomo Administration finalized another regulation that requires private insurance coverage for medically necessary abortions without cost sharing (June 21, 2017 Register: Page 18, Notice of Adoption). While the draft regulation included an overly broad religious exemption – which would have followed the disturbing national trend of allowing employers to use their personal religion to discriminate against employees – the finalized regulation includes a much narrower religious exemption, reflecting that of the NY Women’s Health and Wellness Act. The change came in response to hundreds of comments that individuals and organizations like RWV-NY and HCFANY submitted in support of the proposed regulations, and urging the Administration to narrow the scope of the overly broad religious exemption.

It is worth noting the serious implications of the potential conflict between New York’s new abortion regulation and the ACA repeal proposals’ restrictions on abortion coverage. In both the House-passed and Senate versions of ACA repeal, individuals would be banned from using federal subsidies to buy health plans that cover abortion. Since New York’s new regulation requires all New York health plans to cover abortion, this provision, which we are likely to see in future attempts to repeal the ACA, would mean that no one – not just women – could use federal subsidies to buy a health plan in New York.

Given the potential implications of ACA repeal for women’s health, it is critical that New York remain a leader in ensuring access to reproductive health care. HCFANY and RWV-NY will continue to work to protect New Yorkers from harmful federal policies that threaten the well-being of women, LGBTQ people, and our families.