Nevada has joined a coalition of nearly two dozen states asking the courts to block two Trump administration rules allowing employers to deny contraceptive coverage to workers on religious and moral grounds.
Attorney General Aaron Ford and other state attorneys general argued in two amicus briefs filed in federal courts in Pennsylvania and California on Monday that the rules will threaten the health, well-being and economic security of the residents by causing hundreds of thousands of people to lose coverage, resulting in more women relying on the state for contraceptive care. The attorneys general argue that states will be required to spend millions of dollars to provide replacement contraceptive care to residents if the rules go into effect.
The two rules, which were released in November and are slated to take effect on Monday, will allow employers nationwide to exclude contraceptive coverage from health insurance plans offered to employees based on religious or moral grounds. Though the courts previously enjoined a similar set of rules proposed by the Trump administration in 2017, the new rules will supersede the old rules, rendering the prior injunctions moot.
Ford, in a statement, called access to contraceptive coverage “a critical medical need” for many women in Nevada and “essential to furthering women’s health and equality.”
“Contraception also reduces health-care costs for Nevada families, while providing the dignity of planning their future,” Ford said. “I’m proud to be a part of an effort to make contraception as widely available and affordable as possible.”
Gov. Steve Sisolak said in a statement that he was proud of the action the state is taking under Ford. Both men were sworn into office on Monday.
“A woman’s decision about her health and health-care choices is not a luxury, it is a right,” Sisolak said. “The attempts to infringe upon the fundamental right to health and happiness cannot be tolerated.”
The coordination between the two men on the issue represents a stark departure from the relationship between former Gov. Brian Sandoval and former Attorney General Adam Laxalt on similar matters. Laxalt often butted heads with Sandoval after he embroiled the state in legal matters without consulting the governor first.
“AG Ford notified Gov. Sisolak about the existence of this brief. A discussion was had about the value in signing onto it and we moved forward from there,” Sisolak spokeswoman Christina Amestoy said in an email.
In addition to Nevada, Massachusetts, California, Connecticut, Delaware, Hawaii, Illinois, Iowa, Maine, Maryland, Michigan, Minnesota, New Mexico, New York, North Carolina, Oregon, Rhode Island, Vermont, Virginia, Washington and the District of Columbia signed onto the brief in the Pennsylvania suit. Massachusetts, Iowa, Maine, Michigan, New Jersey, New Mexico, Pennsylvania and Oregon joined Nevada in signing onto the brief in the California suit.
Since 2012, the Affordable Care Act has required all private health insurance plans to provide a wide range of contraceptive services without any out of pocket costs to patients. Until now, only “houses of worship” and grandfathered plans have been exempt from those requirements, though the Obama administration created an accommodation for religious nonprofits and closely held for-profit companies in the wake of the U.S. Supreme Court’s decision in the Hobby Lobby case.
The accommodation provides a workaround for women to receive contraceptive coverage even if their employer objects to providing it on religious grounds by having insurance companies offer coverage without contraception to employers while offering separate contraceptive coverage directly to employees and their dependents.
Under the new Trump administration rules, employers will now be able to flatly decline to offer contraceptive coverage to their employees based on religious and moral grounds without any accomodation. (All companies can claim the religious exemption; publicly traded companies cannot claim the moral exemption.)
In a statement accompanying the release of the rules, the Department of Health and Human Services couched the rules as “conscience protections,” saying that some view certain contraceptive methods as “abortifacients and sterilization procedures.”
Under the new rules, employers will have three options: Continue to provide contraceptive coverage to employees, claim the accommodation or claim an outright exemption based on religious or moral grounds.
In Nevada, the federal rules will apply to self-insured plans — those in which the employer assumes the financial risk for providing health-care benefits to employees — because they are regulated under the federal law ERISA (Employee Retirement Income Security Act). Thirty-one percent of Nevadans are covered under self-insured plans.
Other public and private insurance plans regulated under state law, such as small group plans and those offered on the state’s health insurance exchange, will be required to continue to provide contraceptive coverage to employees with no out of pocket costs and with no employer exemptions because of a law passed by the Legislature in 2017 codifying the Affordable Care Act’s contraceptive coverage requirements into state law.
Nevada law does contain a religious exemption for insurers affiliated with religious organizations, though the Division of Insurance has said that no insurance carriers currently utilize that exemption.