“Obamacare's controversial contraceptive mandate.” “One of the health care law's most controversial provisions.” “A controversial mandate in the Affordable Care Act.”
Coverage of the contraceptive mandate — the Obama-era requirement that employer health insurance cover birth control without a copay — has framed it as a contentious, hot-button issue. But a recent survey shows that birth control access has broad support among American voters — and the Trump administration’s new exemptions to the mandate are far more controversial.
In a survey of 1,058 registered voters conducted in late November by the polling firm PerryUndem, large majorities of respondents supported access to birth control as a general matter. Ninety-six percent of respondents said they supported women having access to contraception. Ninety percent said it was an important aspect of women’s ability to control their bodies, lives, and futures, and 78 percent said it was part of basic health care for women. Seventy-seven percent of those polled did not think of birth control as a controversial issue, and 90 percent said it was not a religious issue for them. Previous polling on birth control has yielded similar results; a 2016 Gallup poll, for example, found that 89 percent of Americans think contraception is morally acceptable.
A majority of respondents — 71 percent — supported the mandate that employers offer copay-free insurance for birth control. This is in line with other polling on the subject — a poll conducted by the Kaiser Family Foundation in June found that 68 percent of people, including 81 percent of Democrats, 68 percent of independents, and 54 percent of Republicans, supported the mandate.
As with abortion, the way pollsters phrase questions about birth control matters. When PerryUndem framed questions about the contraceptive mandate in terms of employers’ ability to control employees’ health care, support for the mandate went up. When asked, “do you think employers should be able to deny employees coverage for things like birth control, if they personally disagree with it,” 78 percent of respondents said no. And 82 percent of respondents said women “should be able to get birth control coverage through their health insurance” even if their bosses morally oppose contraception.
The Trump administration’s changes to the mandate, which allow any employer to seek an exemption on moral or religious grounds, were far less popular with respondents than the mandate itself. Sixty-seven percent of those polled opposed granting employers an exemption for moral reasons; 32 percent supported such exemptions. Meanwhile, 61 percent of respondents said they would be less likely to vote for an elected official who supported the moral exemption; 11 percent said they would be more likely to vote for such a candidate, and 28 percent said their votes wouldn’t change.
Reproductive health advocates have been concerned in recent months that the Trump administration may shift funding from comprehensive family planning programs to those that promote the “rhythm method” of contraception, in which a woman avoids intercourse during the most fertile part of her menstrual cycle. An internal White House “wish list” obtained by Crooked Media in October included such a funding shift.
According to Planned Parenthood, the rhythm method (also called fertility awareness) is between 76 percent and 88 percent effective, less than birth control pills or IUDs. And according to the PerryUndem survey, putting federal dollars behind programs centering on the rhythm method would be an unpopular move — 82 percent of respondents opposed promoting the rhythm method over other types of birth control.
Overall, 51 percent of respondents said the health care policies pursued by the president and Congress would negatively affect women. Twenty-seven percent said these policies would affect women both positively and negatively, and just 15 percent said women would be positively affected.
Despite its reputation for being controversial, the contraceptive mandate has been popular — and birth control access in general has even broader support. The Trump administration’s efforts to weaken the mandate, by contrast — and potential future efforts to promote less effective forms of birth control — face a lot of opposition from voters, according to PerryUndem’s data.
Some employers — like the University of Notre Dame, which recently reversed its decision to drop birth control coverage for students and employees — are still figuring out how to respond to the Trump administration’s policies on contraception. And many members of Congress and state legislators will have to address the issue as they move closer to the 2018 elections. They may find that in their communities, opposing birth control access is a losing strategy.