BOSTON — State Attorney General Maura Healey is suing President Donald Trump over his decision to let employers claiming religious or moral objections opt out of health insurance coverage that provides no-cost birth control to women.

Last week, the Trump administration issued an executive order rolling back provisions of former President Barack Obama’s signature health care law that required most companies to cover birth control for women at no additional cost. The Trump administration’s new rules went into effect Friday.

Healey, who filed the legal challenge in U.S. District Court in Boston, says the rule “discriminates against women and denies equal protection under the law by allowing employers to assert religious beliefs as a justification for denying critical benefits, while leaving coverage for men unchanged.”

“The Trump administration’s actions are a direct attack on women’s health and the right to access affordable and reliable contraception,” she said.

Additionally, Healey said the new policy will force more Massachusetts women onto MassHealth — the state’s beleaguered Medicaid program — to get birth control coverage, thus placing a financial burden on the state.

More than 1.4 million Bay State women now have access to birth control with no out-of-pocket costs through the Affordable Care Act, called Obamacare by many Republicans.

Conservatives celebrate

Conservative groups, which for years have fought the Obamacare birth control mandate, celebrated Trump’s directive as a victory.

The Catholic Action League of Massachusetts praised Trump for “keeping his campaign promise to defend religious freedom.”

“No one has a moral or a constitutional right to demand that someone else pay for their contraceptives, abortifacients or sterilizations,” said C.J. Doyle, the group’s spokesman.

Doyle also took a shot at Healey for challenging the rule in court, saying she “believes that Catholics have no right to choose when it comes subsidizing other people’s birth control.”

Among the birth control methods approved by the U.S. Food and Drug Administration and covered by the ACA is the morning-after pill, which religious conservatives refer to as an abortion drug even though the medical community says it has no effect on pregnant women.

Andrew Beckwith, executive director of the Massachusetts Family Institute, also welcomed the Trump administration’s directive and argues there will be “no harm” from it because it only restricts who pays for contraception, not access to medical treatment.

“People still have the right to purchase as much contraception as they want,” he said. “The difference is they won’t be forcing other people to pay for it.”

Beefing up Bay State coverage

On Beacon Hill, Trump’s directive has given added impetus to a proposal that would require coverage without co-pays for emergency contraception and for all FDA-approved methods of birth control. Massachusetts’ health care law, which went into effect in 2006, doesn’t include such a mandate.

The proposal, backed by at least 70 lawmakers and the Massachusetts Association of Health Plans, also would require insurers to cover a year’s supply of birth control after an initial three-month prescription, which is not required by the federal law.

It includes an exemption for religious and moral beliefs, similar to the federal health care law, allowing a “church or qualified church-controlled organization” to opt out of birth control coverage.

Trump’s directive expanded the list of entities that may claim religious objections to providing contraceptive coverage. They will now include nonprofits and for-profit companies, as well as colleges and similar institutions that provide health insurance for their students and employees.

Recent studies show the federal birth control mandate, in place since 2013, has increased use of contraception and reduced out-of-pocket medical costs, particularly for long-acting methods such as intrauterine devices.

From 2011 to 2014, out-of-pocket spending on birth control in Massachusetts dropped 81 percent, according to the state’s Health Policy Commission.

Rising premiums

A study by the state Center for Health Information and Analysis last year determined that requiring insurance plans to include birth control coverage would raise monthly premiums by 15 to 30 cents. The center is studying the latest proposal to determine its potential costs.

Twenty-eight states — including California, Maryland and Vermont — require insurers to provide low- or no-cost coverage of FDA-approved contraceptives, according to the National Conference of State Legislatures.

Women’s health care advocates are pressuring lawmakers and Gov. Charlie Baker to approve state-level protections so that women don’t lose coverage.

“Massachusetts women and their families can’t afford to wait until their employer denies them coverage or the ACA is repealed for the state to take action,” Dr. Jennifer Childs-Roshak, president and CEO of the Planned Parenthood League of Massachusetts, said in a statement.

“This extreme, politically motivated rule shows exactly why Massachusetts must be proactive in protecting basic health care access.”

Christian M. Wade covers the Massachusetts Statehouse for North of Boston Media Group’s newspapers and websites. Email him at

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