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Key Facts

If your daughter has recently started taking birth control pills or is thinking about taking them, you probably have some questions and worries of your own. Adolescent girls and young women are frequently prescribed birth control pills (also called oral contraceptive pills, hormonal pills, or simply "the Pill") for irregular or heavy menstrual periods, menstrual cramps, acne, PMS, Primary Ovarian Insufficiency (POI), endometriosis, and hormone replacement therapy. For example, girls diagnosed with Polycystic Ovary Syndrome (PCOS) - a hormone imbalance which causes irregular menstrual periods, acne, and excess hair growth, are prescribed birth control pills to lower their hormone levels (to the normal range) and regulate menstrual periods. Girls with acne that are not responding to simple measures are often prescribed birth control pills. Girls whose ovaries are not producing enough estrogen (due to the effects of radiation or chemotherapy, a genetic condition such as Turner's Syndrome, or stress) often take birth control pills to replace estrogen. If the lack of periods are caused by low weight or an eating disorder, the best treatment is weight gain to a normal healthy weight. Girls with endometriosis are also often prescribed birth control pills, in cycles or continuously, to suppress the condition. Normal estrogen levels and healthy weight are important for healthy bones. Last but not least, birth control pills are used for birth control.

Does the birth control pill have health benefits?
Yes. The Pill has many health benefits, such as:

Regulation of menstrual periods

Decreased menstrual cramps

Treatment for acne

Treatment for polycystic ovary syndrome (PCOS)

Lowered risk of anemia

Lowered risk for some cancers

Are there any serious side effects from the Pill?

Most young women who take birth control pills have few or no problems. However, birth control pills with estrogen may cause a slight increase in the risk of developing blood clots in the legs, eyes, and lungs. If your daughter develops any of the following problems, call her health care provider right away or take her to the closest emergency room:

Abdominal or stomach pain (severe)

Chest pain (severe), cough, shortness of breath

Headache (severe), dizziness, weakness, or numbness

Eye problems (vision loss or blurring), speech problems

Severe leg pain (calf or thigh)

Remember: ACHES

Does the birth control pill cause blood clots?

There is a very slight risk of developing blood clots in the legs, but much less than the risk during pregnancy. Among adolescent girls who do not take the Pill, 1-10 in 100,000 will develop blood clots each year. Among girls who take combined oral contraceptive pills, the risk increases 3-5 fold or to 5-50 per 100,000 per year. For women who are pregnant, the risk of developing blood clots is twice as high as Pill users and 4.3-10 fold compared to nonusers.

Is there any way my daughter can lower her risk of getting blood clots while taking the Pill?

Make sure you let your daughter know (and her health care providers) if any of her blood relatives have had blood clots, especially when they were young (in their 20s, 30s, or 40s). There are other factors that can contribute to the likelihood of whether a teen or adult woman develops blood clots such as a diagnosis of Factor V Leiden, trauma, or surgery, being overweight and smoking.

If your daughter smokes, encourage her to quit. If she is planning a flight or long car ride (especially if 6-8 hours or longer), remind her to get up and walk around and drink lots of fluids to lessen the risk of blood clots. If she is having surgery (and will be immobilized an don bed rest for a period of time), talk to her health care provider about whether she should go off the Pill 3-4 weeks before the surgery.

Does the birth control pill cause heart attacks or strokes?

There is no increase in the risk of heart attack or stroke in healthy young women who take birth control pills and don't smoke. If your daughter is a smoker, encourage her to quit smoking. She can still take the Pill if she smokes, but if she quits smoking, she'll be healthier for life and her risks from taking the Pill will be less.

Does the birth control pill cause cancer?

The truth is that the Pill actually protects against cancer of the ovaries and cancer of the lining of the uterus. A woman is half as likely to get cancer of the uterus or ovaries if she has taken birth control pills. Most experts believe that taking the Pill does not cause any increased risk of getting breast cancer. Even girls with a family history of breast cancer can take the Pill.

Does the birth control pill cause birth defects?

Birth control pills do not cause birth defects or affect the health of future children that your daughter may have.

Is there any trouble getting pregnant after using the birth control pill?

There is no change in fertility with using the birth control pill. Regular periods and ovulation usually start up again right away. However, girls who were very irregular before starting the pill may be irregular after they stop the pill. Girls who have PCOS or lose weight on the pill are particularly likely to be irregular, not because of the Pill, but because of their medical condition.

If your daughter was using the Pill for birth control, she should use another birth control method right away if she doesn't want to get pregnant. She should talk to her health care provider before she actually stops taking the birth control pill.

How long is it safe for my daughter to be on birth control pills?

It's safe for your daughter to be on the Pill for years, whether she's on it to regulate her menstrual cycles, cramps, hormone replacement, or if she's simply using it for birth control.

Does my daughter need to take a break from the Pill?

There is no medical reason that your daughter would need to take a "break" from the Pill. There are no medical benefits from taking a break. If your daughter were to stop taking the Pill and then go on it again, she could have the same side effects that she already experienced during the first few months of pill use. Also, your daughter would not experience the many medical (non-contraceptive) benefits that the Pill offers.

Will my daughter gain weight from taking birth control pills?

It's unlikely that your daughter will gain weight on the Pill. Research trials have not shown a connection between birth control pills and weight gain among women who take birth control pills. Some teens gain weight, some lose weight, but most teens stay exactly the same weight when they are taking the birth control pill. Many times a young woman thinks she has gained 5-10 pounds, but when weight is actually measured, there's no change. If your daughter thinks she may have gained weight due to the Pill, she should see her health care provider and get her weight measured. Encourage your daughter to eat a healthy diet. Suggest that she eat 5-7 servings of fruits and vegetables a day, reduce her portion sizes, avoid fast foods and simple carbohydrates such as cookies, cake, sugary cereal, etc. Also, encourage her to be active and exercise or take part in an activity that she enjoys as she will be more likely to do.

Will the birth control pill have any negative effects on my daughter's growth?

No, the birth control pill will not affect or hinder your daughter's growth if she has already started her period. By the time she has her first period, she is already at 95% of her final height. A girl grows about 2 inches in the 2 years after her first menstrual period.

Will the Pill make my daughter's cramps better?

For girls who experience severe menstrual cramps and over-the-counter medications do not help, birth control pills may be the solution. Birth control pills can help to decrease menstrual cramps. Because the combined birth control pills prevent ovulation, they also get rid of pain that your daughter may experience with ovulation in the middle of her menstrual cycle.

Will the Pill make my daughter's menstrual periods more regular?

For girls whose menstrual periods are irregular (too often or too late), birth control pills can help to regulate the menstrual cycle to every 28 days. Birth control pills can also reduce the amount and length of menstrual bleeding.

What if my daughter's period is very light while she's taking birth control pills?

Your daughter's period may be so light when she is taking birth control pills that she may only have a brown smudge on a tampon, pad, panty shield, or her underwear. The hormone doses in birth control pills are very low. This means that the lining of your daughter's uterus doesn't become very thick, so very little blood needs to come out each month.

Will the birth control pill make my daughter's acne better?

Birth control pills usually improve acne. For moderate to severe acne, which over-the-counter and prescription medications haven't cured, birth control pills may be prescribed. The hormones in the birth control pill can help stop acne from forming. It doesn't usually matter which type of birth control pills your daughter takes, since most of them can be used to treat acne. Encourage your daughter to be patient though, since it may take several months to see a difference with her acne.

What if my daughter has PCOS? How do birth control pills help?

If your daughter has PCOS, you're probably already aware that it can cause irregular menstrual cycles, excess hair growth, and acne. One of the treatments prescribed for PCOS are birth control pills (oral contraceptives), because the hormones (estrogen and progestin) in the pill regulate menstrual cycles. Birth control pills allow the endometrial lining to be shed every four weeks so your daughter's menstrual period will be regular. Because birth control pills cause women to menstruate regularly and shed the endometrial lining on time, they reduce the risk of endometrial cancer. Birth control pills also improve acne and lessen excess hair growth, which is another reason they are used to treat PCOS.

What if my daughter has endometriosis? How do birth control pills help?

Hormonal treatment such as birth control pills either taken in cycles or continuously are felt to relieve symptoms associated with endometriosis in 8 out of 10 patients. The Pill does not cure endometriosis, but when prescribed continuously, it will stop your daughter's period along with the pain that is often associated with it and lessen the chance of the endometriosis growing.

Will my daughter start having sex if she goes on birth control pills for acne or any other medical reason?

Your daughter will most likely not start having sex if she goes on the Pill for reasons other than birth control. If she goes on the Pill for one of the medical reasons, she is probably just thinking about treating whatever the problem is. Her decision to have sex will likely be completely independent from her decision to go on the Pill at this time. Your daughter will choose to start having sex when she is ready, which involves much more than just when birth control is available.

What other medical benefits does the pill have?

Because there is less menstrual bleeding with the use of birth control pills, your daughter is less likely to get anemia (low number of red blood cells, which carry oxygen from the lungs to the tissues). Birth control pills also decrease the chance of getting endometrial (lining of the uterus) cancer, ovarian cancer, and ovarian cysts.

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Key Facts If your daughter has recently started taking birth control pills or is thinking about taking them, you probably have some questions and worries of your own. Adolescent girls and young women are frequently prescribed birth control pills (also called oral contraceptive pills, hormonal pills, or simply "the Pill") for irregular or heavy menstrual periods, menstrual cramps, acne, PMS, Primary Ovarian Insufficiency (POI), endometriosis, and hormone replacement therapy.

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WASHINGTON - The Trump administration on Friday moved to expand the rights of employers to deny women insurance coverage for contraception and issued sweeping guidance on religious freedom that critics said could also erode civil rights protections for lesbian, gay, bisexual and transgender people.

The twin actions, by the Department of Health and Human Services and the Justice Department, were meant to carry out a promise issued by President Trump five months ago, when he declared in the Rose Garden that "we will not allow people of faith to be targeted, bullied or silenced anymore."

Attorney General Jeff Sessions quoted those words in issuing guidance to federal agencies and prosecutors, instructing them to take the position in court that workers, employers and organizations may claim broad exemptions from nondiscrimination laws on the basis of religious objections.

At the same time, the Department of Health and Human Services issued two rules rolling back a federal requirement that employers must include birth control coverage in their health insurance plans. The rules offer an exemption to any employer that objects to covering contraception services on the basis of sincerely held religious beliefs or moral convictions.

More than 55 million women have access to birth control without co-payments because of the contraceptive coverage mandate, according to a study commissioned by the Obama administration. Under the new regulations, hundreds of thousands of women could lose those benefits.

The contraceptive coverage mandate, issued by the Obama administration under the Affordable Care Act, removed cost as a barrier to birth control, a longtime goal of advocates for women's rights. But the mandate ensnarled the federal government in more than five years of litigation, which overshadowed many other aspects of the health care law.

The rules issued on Friday prompted more lawsuits and threats of lawsuits. The attorney general of Massachusetts, Maura Healey, and the attorney general of California, Xavier Becerra, filed lawsuits to block the new rules, which took effect immediately.

Both said the rules violated the First Amendment, which bars government action "respecting an establishment of religion."

But some conservatives and religious groups said the new rules would allow them to live out their religious beliefs. Speaker Paul D. Ryan of Wisconsin hailed the rules as "a landmark day for religious liberty." The rules were also welcomed by groups like the Little Sisters of the Poor, an order of Roman Catholic nuns who had resisted the Obama administration's mandate because, they said, it would make them "morally complicit in grave sin."

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Nuns from the Little Sisters of the Poor last year after arguments at the Supreme Court. A lawyer representing the group said the administration wasn't "going to force Catholic nuns to provide contraceptives." Credit Saul Loeb/Agence France-Presse - Getty Images

"The new administration isn't going to force Catholic nuns to provide contraceptives," said Mark Rienzi, senior counsel at the Becket Fund for Religious Liberty, who represents the Little Sisters of the Poor. "We've been on a long, divisive culture war because the last administration decided nuns needed to give out contraceptives."

The new initiatives came a day after Mr. Sessions changed the Justice Department's position on a related issue: whether a ban on workplace discrimination on the basis of "sex" in the Civil Rights Act of 1964 encompasses discrimination on the basis of gender identity. The Obama administration had adopted the view that it does cover transgender people, but Mr. Sessions said the department should take the position in court that it does not.

Mr. Sessions's guidance issued on Friday directs federal agencies to review their regulations with an eye to expanding their protections for religious believers. Conservative religious individuals and organizations have objected for years to nondiscrimination laws that have affected whom they can hire and fire, whom they can serve and how they can operate. The new directive affords them far broader latitude.

In issuing the new directive, Mr. Sessions reinterpreted the Religious Freedom Restoration Act, which was adopted by Congress in 1993 with broad support from across the religious spectrum. It says the government could limit the free exercise of religion only if there was a "compelling" reason, and must do so in the least restrictive way possible.

Among the possible results of the guidance, legal directors at liberal advocacy groups said, religious charities or schools that receive government funding could fire an unmarried employee who becomes pregnant, or an employee who marries a same-sex partner. Religious contractors that administer foster care programs could refuse to place foster children with gay couples, even in states that have nondiscrimination laws.

Houses of worship that have been damaged in hurricanes could receive grants from the Federal Emergency Management Agency to rebuild - even if they are using the taxpayer funds to hire only staff members who share their religious beliefs, rather than making the positions open to all.

In addition, David Stacy, government affairs director for the Human Rights Campaign, said that clerks with the Social Security Administration or the Department of Veterans Affairs who do not agree with same-sex marriage could refuse, under this guidance, to process paperwork to provide benefits to a widow in a same-sex marriage.

"This is a very sweeping expansion of religious discrimination by the federal government, and we think it goes beyond where federal law is," he said.

Vanita Gupta, a top civil rights lawyer at the Justice Department during the Obama administration, said: "The freedom of religion is a fundamental right, but it is not an absolute right. It cannot be used as a shield to permit discrimination against L.G.B.T.Q. Americans, just as federal courts a half century ago denied the ability of businesses and employers to use their religious beliefs as a basis to discriminate against African-Americans." She also called the new contraception policy "a direct attack on women's rights."

But Representative Diane Black, Republican of Tennessee, said the new rules on contraception were "a resounding victory for true-believing Americans." They will, she said, end the "persecution of ordinary Americans who for years have been seeking only the freedom to live in accordance with their faith, free from government interference."

Justice Department officials said Friday that Mr. Sessions had simply pointed to existing law and was not making a policy change.

Still, officials at the Department of Health and Human Services said Mr. Sessions's memos provided support for the new contraception rules.

The Obama administration generally required employers to cover all forms of birth control approved by the Food and Drug Administration, including pills that critics say may cause fertilized eggs to be aborted.

"No American should be forced to violate his or her own conscience in order to abide by the laws and regulations governing our health care system," said Caitlin Oakley, a spokeswoman for the Department of Health and Human Services.

But Richard B. Katskee, the legal director of Americans United for Separation of Church and State, an advocacy group that plans to challenge the rules in court, said they imposed an impermissible burden on female employees who want cost-free contraceptive coverage and may be unable to get it.

"Religious freedom is the right to believe and worship as you see fit," Mr. Katskee said. "It's never the right to use government to impose costs, burdens or harms on other people. You can't use the government to make other people pay the price for your religious beliefs or practices."

The Trump administration on Friday also notified health insurance companies that it would vigorously enforce provisions of the Affordable Care Act regulating coverage of abortion services. The health department reminded insurers that if they cover abortion, they generally cannot use federal funds for that purpose, but must collect separate payments from consumers and must deposit the money in special accounts used exclusively for coverage of abortion services.

Under the new rules, exemptions to the contraceptive coverage mandate would be available to many kinds of employers, including publicly traded companies that said they had religious objections to covering some or all types of contraception.

The Trump administration said that some people would, as a result of the new rules, not receive "coverage or payments for contraceptive services."

"The government's legitimate interests in providing for contraceptive coverage do not require us to violate sincerely held religious beliefs" or moral convictions, the administration said. But, it said, officials "do not have sufficient data to determine the actual effect of these rules," the extra costs that women might incur for contraceptives or the number of unintended pregnancies that might occur.

Robert Pear and Rebecca R. Ruiz reported from Washington, and Laurie Goodstein from Boston.

A version of this article appears in print on , on Page A1 of the New York edition with the headline: Trump Relaxes Employers' Role On Birth Control. Order Reprints | Today's Paper | Subscribe

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Trump Administration Rolls Back Birth Control Mandate

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WASHINGTON - The Trump administration on Friday moved to expand the rights of employers to deny women insurance coverage for contraception and issued sweeping guidance on religious freedom that critics said could also erode civil rights protections for lesbian, gay, bisexual and transgender people.

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Birth control is the means by which woman attains basic freedom quote. Find all the best picture quotes, sayings and quotations on PictureQuotes.com.

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On Friday, the Trump administration issued new rules that allow a wide range of employers and insurers to be exempt from the Affordable Care Act's provision that grants women contraceptives without additional payments. The move may appeal to social conservatives who object to contraception, but is it a good idea from a medical perspective?

Birth control pills, shots and other devices - especially the still-ubiquitous little pink or blue pills - are about much more than preventing pregnancy. Many women suffer from major hormonal fluctuations in their monthly cycle. This can lead to irregular periods, menstrual pain, depression and acne flare-ups. It is also a risk factor for serious conditions such as endometriosis, in which the tissue that lines the uterus may grow into the fallopian tubes or ovaries, and polycystic ovary syndrome PCOS, in which a woman's eggs may not develop or be released as they should be.

While hormone treatment with birth control pills isn't a cure for any of these conditions, it can manage hormone levels so that they are less-serious issues. In the case of endometriosis, it can keep the abnormal tissue growth from expanding and in PCOS, a combination hormonal contraceptive - with estrogen and progestin - helps prevent a complication that involves the build up of the uterine lining.

This is one reason the original authors of the Affordable Care Act considered contraception a basic part of women's health care, which is a basic part of medical care, which the law guarantees. In fact, the Guttmacher Institute's Rachel K. Jones estimates that more than half, or 58 percent, of women who use oral contraceptive pills use them "at least in part for purposes other than pregnancy prevention" - including menstrual pain, acne and endometriosis. About 14 percent of women - or about 1.5 million in 2011 when Jones's report was published - use oral contraceptive pills only for noncontraceptive purposes.

She also found that many women who have never had sex also take the pill. While they only make up a small proportion of the total number of oral-contraceptive users in the United States, they number an estimated 762,000. Nearly all of them report using the pill for reasons other than birth control.

Read more: Melinda Gates decries 'loss of U.S. leadership' in global aid Was the big paper about the successful editing of human embryo genes wrong? Big city health officials decry Trump administration's cuts to teen pregnancy prevention programs FDA cracks down on company marketing 'three-parent' babies

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The Trump administration's new birth control rule has a big problem, this chart shows

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On Friday, the Trump administration issued new rules that allow a wide range of employers and insurers to be exempt from the Affordable Care Act's provision that grants women contraceptives without additional payments. The move may appeal to social conservatives who object to contraception, but is it a good idea from a medical perspective?

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The Trump administration loosened Obama-era birth control requirements on Friday, saying most providers of health insurance could refuse to pay for an employee's birth control if the provider shows "sincerely held" religious or moral objections.

The new regulations, which take effect immediately, protect religious groups such as the Little Sisters of the Poor from litigation if they refuse to provide contraceptive coverage, but widen the pool of those shielded to include nonprofits, for-profit companies, other nongovernmental employers, and schools and universities.

"These rules will not affect over 99.9 percent of the 165 million women in the United States," the Health and Human Services Department said in a statement.

"No American should be forced to violate his or her own conscience in order to abide by the laws and regulations governing our health care system," HHS spokeswoman Caitlin Oakley said. "Today's actions affirm the Trump administration's commitment to upholding the freedoms afforded all Americans under our constitution."

One of the most controversial - and most welcomed - requirements of the 2010 Affordable Care Act was a regulation for health insurance plans to provide birth control coverage free to patients.

Related: Most Americans Support Birth Control Mandate

The thinking behind it was to lower costs and improve health by helping more women get contraception, because pregnancy is much more expensive and dangerous to a woman's health than using birth control, and because upward of 40 percent of pregnancies in the U.S. are unplanned.

Some religious groups objected and sued. The Roman Catholic Church opposes most methods of birth control, and some other religious groups object to certain forms of birth control.

Related: Birth Control Mandate Next on Trump Agenda

The move fulfills a promise made by President Donald Trump in a Rose Garden ceremony in May when he signed an executive order that he said restored religious freedoms, said Roger Severino, director of the Office for Civil Rights at the Health and Human Services Department.

"By taking away women's access to no-cost birth control coverage, the rules give employers a license to discriminate against women."

"That was a promise made, and this was a promise kept," Severino told reporters. The new rule, he said, provides "relief to those who have been under the thumb of the federal government."

Medical and legal groups immediately objected.

"By taking away women's access to no-cost birth control coverage, the rules give employers a license to discriminate against women," said Fatima Goss Graves, president of the National Women's Law Center. "This will leave countless women without the critical birth control coverage they need to protect their health and economic security. We will take immediate legal steps to block these unfair and discriminatory rules."

The American Civil Liberties Union said it would file suit immediately.

"No woman should ever be denied health care because her employer or university's religious views are prioritized over her serious medical needs," said Kate Rochat, an ACLU member and law student at the University of Notre Dame, a Catholic university, who says she stands to lose access to contraceptive health care because of the rule.

Massachusetts Attorney General Maura Healey also sued.

"Among other things, many women are likely to turn to MassHealth - the state's Medicaid plan - for coverage, which will place a financial burden on the state," Healey's office said in a statement.

"Today's complaint alleges that the new rule is unconstitutional by allowing the federal government to endorse certain religious beliefs over a woman's right to make choices about her own health care."

Most U.S. women use birth control at some point.

"Contraception is a medical necessity for women during approximately 30 years of their lives," said Dr. Haywood Brown, president of the American Congress of Obstetricians and Gynecologists.

"It improves the health of women, children and families as well as communities overall; reduces maternal mortality; and enhances economic stability for women and their families. All Americans deserve the ability to make personal health care decisions without intrusion from their employers or the government."

Related: Yes,You Have to Pay for Birth Control, Feds Say

HHS said it calculated that only organizations that had already sued would take advantage of the new rule.

"The regulation leaves in place preventive services coverage guidelines where no religious or moral objection exists - meaning that out of millions of employers in the U.S., these exemptions may impact only about 200 entities, the number that that filed lawsuits based on religious or moral objections," HHS said.

"Contraception is a medical necessity for women during approximately 30 years of their lives."

But Gretchen Borchelt, vice president for reproductive rights and health at the NWLC, disputed this.

"We don't know how many employers are going to try and get out of the benefit once they know they are allowed to do it," she said.

It works against their interest, Borchelt added, but some employers may incorrectly believe they are saving money. "We know from the past that insurance plans will do whatever they can if they think they can save money," Borchelt said.

"Birth control coverage saves money in the long run because employers don't have to pay for pregnancy and related costs," she added. "We know that when birth control was added to insurance plans, it didn't change the premiums. There shouldn't be cost concerns."

The new rule is part of a broader package changing the federal approach to religious liberty. "Except in the narrowest circumstances, no one should be forced to choose between living out his or her faith and complying with the law," Attorney General Jeff Sessions said in a memorandum sent government wide.

Related: Contraception Fell, Medicaid Births Rose When Texas Defunded Planned Parenthood

Birth control allows people to decide when and whether to have children and is a fundamental right, said Cecile Richards, president of the Planned Parenthood Federation of America.

"The Trump administration just took direct aim at birth control coverage for 62 million women. This is an unacceptable attack on basic health care that the vast majority of women rely on. With this rule in place, any employer could decide that their employees no longer have health insurance coverage for birth control," Richards said.

"Birth control is not controversial - it's health care the vast majority of women will use in the course of their lifetime."

Most Americans get their health insurance through an employer, and most employers voluntarily provide contraceptive coverage, HHS officials noted. "These rules do not alter multiple other federal programs that provide free or subsidized contraceptives for women at risk of unintended pregnancy," the rule, published in the Federal Register, adds.

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Just about anyone can opt out of providing birth control now

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The Trump administration loosened Obama-era birth control requirements on Friday, saying most providers of health insurance could refuse to pay for an employee's birth control if the provider shows "sincerely held" religious or moral objections.

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The Trump administration has made a number of changes to health policy in the past two weeks, raising questions about how consumers will be affected. Will the new rules for birth control coverage affect access to an intrauterine device? Might an association health plan help bring down costs for workers at small businesses? And if you're healthy, doesn't a short-term health plan that is cheaper than marketplace coverage make sense? Here are some answers to those questions.
IUDs are expensive. Will they be unaffordable under the new contraceptive rules announced by the Trump administration? Should people make an appointment to get one now before employers change their minds about coverage?
There is probably no need to rush out to your doctor's office to get an IUD, but you should keep an eye on this issue.

Under the Affordable Care Act, also known as Obamacare, most health plans are required to cover all methods of birth control approved by the Food and Drug Administration without charging women anything for them. Religious employers and some private employers with strong religious objections are exempt from the requirement, but it's a pretty limited group. Or it was until the Trump administration issued new rules during the first week of October that open the door for many companies or nonprofit organizations with religious or moral objections to contraception to stop offering it.

"These new exemptions are sweeping," says Adam Sonfield, a senior policy manager at the Guttmacher Institute, a reproductive health research organization. Essentially, any employer will be able to claim an exemption from the birth control coverage requirement, he says, and there are no provisions to appeal it.

What is not at all clear, however, is how many employers will take advantage of the new rules. The administration says it expected the number to be small, probably just the companies that had brought suit against the old rules.

Even before the ACA passed, many plans covered contraception. They didn't necessarily cover all FDA-approved methods, however, and women typically had to pay a share of the cost.

Several states have laws that protect birth control coverage, says Mara Gandal-Powers, senior counsel at the National Women's Law Center. Some require that if a plan offers prescription drug coverage, for example, it must cover contraceptives. Others have adopted the ACA rules that require coverage of all FDA-approved methods without cost-sharing. But those laws would not apply to employers that pay their employees' health care claims directly rather than buy state-regulated insurance.

The protection from cost-sharing is key, experts say, especially for highly effective methods like the IUD, which might cost $1,000 upfront.

"Even if you've met your deductible, if you have 20 percent coinsurance, that's $200, and for many people, that's not feasible," Gandal-Powers says.

If your employer does decide to stop providing insurance coverage for contraception, in most cases, plans have to give workers 60 days' advance notice of the benefit change, giving you time to get that IUD if you decide to.
Association health plans, which the Trump administration is encouraging, seem like kind of a good idea. If more small companies band together, won't that make coverage cheaper?
President Trump signed an executive order on Thursday that directs several federal agencies to consider proposing rules that, among other things, would allow more employers to buy health insurance through associations.

If you're young and healthy, getting coverage through an association health plan might indeed be cheaper. But you'll likely forgo consumer protections that are required for plans sold on the individual and small-group markets, says Kevin Lucia, a research professor at Georgetown University's Center on Health Insurance Reforms.

Plans currently sold in those markets have to cover 10 so-called essential health benefits. Association health plans would likely sidestep that requirement. (However, implementing federal rules for these plans will take the administration some time, so it's not clear if or when they might be expanded.)

"If you don't cover maternity, mental health or hospitalization, the premiums are going to be lower," Lucia says.

The administration's press release about the executive order says that employers couldn't exclude any employees from joining association health plans or "develop premiums based on health conditions."

But association health plans have been known to use many strategies to cherry-pick employers with healthy workforces, Lucia says.

"The risk is that each individual small-employer's rates would be separately determined based on its employees' medical claims, potentially splitting the market into employers with sicker workers and those whose workers are healthier," he says.
Short-term plans are cheaper than Obamacare plans. If people don't have pre-existing conditions and are willing to pay the penalty under the law for not having minimum coverage, what's the downside?
Trump's executive order that encouraged the expansion of association health plans, discussed above, also aims to expand the availability of short-term plans. Under Obama administration rules, the coverage period of short-term plans was limited to less than three months. This executive order proposes to expand that, perhaps to just under a year.

In addition to not covering pre-existing conditions, short-term plans often exclude certain types of coverage, such as prescription drugs and maternity, and impose dollar limits on coverage. The maximum out-of-pocket spending limits are often higher than coverage in a marketplace plan too.

The potential downside is the possibility that you may develop a medical condition or have an accident that requires expensive medical care while you're covered under this plan, experts say.

"If the reader has a car accident, the insurer wouldn't renew the policy," says Timothy Jost, a professor emeritus of law at Washington and Lee University in Virginia who is an expert on health law. "If coverage is terminated, you're not eligible for a special enrollment period [on the exchange]. So you could just get marooned."
Kaiser Health News is an editorially independent news service that is part of the nonpartisan Henry J. Kaiser Family Foundation. Follow Michelle Andrews on Twitter: @mandrews110

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If You Want An IUD, Take Note Of Trump's New Birth Control Policy

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The Trump administration has made a number of changes to health policy in the past two weeks, raising questions about how consumers will be affected. Will the new rules for birth control coverage affect access to an intrauterine device? Might an association health plan help bring down costs for workers at small businesses?