Stuffed in the 900-page Project 2025 playbook, among the strategies to ban abortion pills and gut federal agencies, are
several proposals to limit access to birth control. One of the groups on the
advisory board of Project 2025 is Alliance Defending Freedom, a right-wing Christian legal organization that
wrote the Mississippi abortion ban the Supreme Court
used to overturn
Roe v. Wade in 2022 and thereby end the federal right to abortion.
That same day, Justice Clarence Thomas wrote that the court should
reconsider the right to birth control. Now that Donald Trump is back in the White House, ADF has been busy doing things like arguing that states have free reign to
kick Planned Parenthood out of Medicaid for providing non-abortion services like birth control. Their latest stunt is trying to get the Trump administration to start chipping away at insurance coverage of contraception.
Last week, ADF sent a
letter urging the Department of Health and Human Services to
end any federal agreements it has with the American College of Obstetricians and Gynecologists (ACOG), which it derided as a “pro-abortion” organization. ACOG was
founded in 1951 as a professional association for providers of full-spectrum reproductive healthcare for women; it has 60,000 members across the U.S.
ACOG and its related foundation have two government grants: The first funds an advisory panel that recommends which
preventive services, like contraception and health screenings, health insurance should cover without cost-sharing, known as the Women’s Preventive Services Initiative, or WPSI. The second funds the creation of protocols to make childbirth safer and generally improve maternity care—this is through a program called Alliance for Innovation on Maternal Health, or AIM.
ADF claims that this preventive maternity care work ACOG does for HHS
violates Trump’s executive orders banning the use of federal funds to promote gender identity, DEI policies, and abortion. As ADF senior counsel and director of regulatory practice Matt Bowman said in a
statement, “We urge the HHS to withdraw funds to ACOG and ensure federal money is promoting actual health priorities for Americans, not funding left-wing activism.” (Bowman worked in HHS during the
first Trump administration, where he assisted in the effort to block migrant girls in U.S. custody from getting abortions.)
Let’s break this down, starting with the birth control part. The Affordable Care Act says insurance companies have to cover a range of women’s preventive health services without cost-sharing like co-pays or deductibles. The law doesn’t name which services, but rather tasks an HHS agency to determine what services have strong evidence showing health benefits. That agency gave a contract to ACOG, which convenes the WPSI panel that includes representatives from its membership and three other major professional organizations. One of the panel’s
recommendations is that “adolescent and adult women have access to the full range of contraceptives and contraceptive care to prevent unintended pregnancies and improve birth outcomes.” So insurance in the U.S. has to cover birth control pills, patches, rings, implants, IUDs, and tubal ligation without additional costs beyond people’s monthly premiums.
Groups like ADF do not like this requirement—especially the mandated coverage of IUDs and emergency contraception like Plan B or
Ella. Conservatives falsely claim that these methods block implantation of fertilized eggs, which they believe is tantamount to abortion. (ADF represented one of the
plaintiffs in the 2014
Hobby Lobby case who objected to covering these methods.) “This mandate has included a coverage requirement for contraception, including some items that can prevent the implantation of embryos after conception,” the ADF letter
notes. “The failure to offer robust religious and moral exemptions to that mandate led to years of litigation and repeated trips to the U.S. Supreme Court.” Yes, they want employers to be able to object to covering birth control in their insurance plans for either religious or
moral reasons, which could really mean anything, including sexist and eugenic objections to single women or people with disabilities being sexually active.