HHS has finalized two rules that allow more types of employers to deny birth control coverage for moral or religious reasons.
Employers are now able to get an exemption from offering contraceptive coverage based on "sincerely-held" religious beliefs, according to regulations issued Wednesday.
The rule expands protections now in place for religious organizations and businesses to not-for-profit organizations, small businesses, and individuals that morally object to providing contraceptive services.
The Obama administration had offered a more narrow exemption for churches, religious orders, and organizations that received financial support from religious organizations.
HHS estimates the exemptions will affect no more than about 200 employers. The number of women it will impact was not estimated by the agency since officials don't know which companies will seek the new exemption.
Advocates estimated anywhere between hundreds of thousands to millions of women would be affected.
"This rule will be used as a license to discriminate and represents a chilling return to the days when the government treated women's sexuality, and thus contraception, as immoral, perpetuating harmful stereotypes that have long been used to discriminate against women," Louise Melling, deputy legal director of the American Civil Liberties Union wrote in a statement.
The rule comes a day after Democrats took control of the House. Many of the winners ran on protecting coverage for reproductive health.
"Last night women—led by women of color—sent politicians who had attacked women's health and rights in Congress and statehouses across the country packing," said Dawn Laguens, executive vice president at Planned Parenthood Federation of America in a statement. "Today, in the wake of that loss, Trump issues two rules attacking people's birth control coverage."
The agency declined to extend the expanded protections to publicly traded businesses or government entities, following pushback in public comments. HHS officials felt those companies would not seek the exemption. HHS has never before been sued by publicly traded companies seeking to be excluded from providing contraception coverage. No publicly-traded companies submitted comments on the rule.
In April, a U.S. District Court judge relieved hundreds of Catholic employers from paying $6.9 million in fines for violating the federal mandate to provide coverage of birth control under employee-sponsored health care plans.
The new rules finalized by the Trump administration on Wednesday maintain government programs that provide free or subsidized birth control to low income women. A press release from HHS described that as community health centers.
The rules are effective Jan. 15, 2019.