On Oct. 6, the Trump administration issued two rules that allow employers with religious or moral objections to deny women insurance coverage for contraception — and because there is no required process for employers to certify their religious or moral beliefs, virtually any employers can take advantage of these exemptions.
The rules, a direct rollback of the ACA’s contraceptive coverage mandate requiring access to birth control without additional cost, are considered a fulfillment of a promise Trump made to the religious community at a speech in the Rose Garden five months earlier, stating, "We will not allow people of faith to be targeted, bullied, or silenced anymore."
But one of his biggest opponents is an evangelical Christian.
Meet Alicia Baker, the 28-year-old seminary graduate who is suing the Trump administration. Baker is plaintiff in a lawsuit filed on Oct. 31 by the National Women’s Law Center (NWLC) and Americans United for Separation of Church and State (AU), which argues that the administration’s rules are unconstitutional.
After graduating from Fuller Theological Seminary in 2015, Baker moved to Indianapolis to work at a faith-based organization. She met her husband Josh shortly after. While preparing for the wedding, Baker visited a doctor to talk about birth control options — the couple agree they want to wait several years before having children. Though Baker says they both chose to remain virgins until their wedding night, she had previously been prescribed hormonal birth control for health reasons, and knew her body responded poorly to it. She had a non-hormonal, copper IUD inserted instead, and thought nothing else of it.
But a few days before the wedding, Baker says she was notified her insurance would not be paying either the cost of the IUD or the cost of the doctor’s visit — leaving her with a $1,200 bill. Since her employer health plan promised complete coverage of all non-abortion-inducing contraceptives, she reached out through her HR department to find out why. Baker’s employer-provided insurance company, GuideStone Financial Services, an evangelical Christian agency, responded by stating that they would not cover the service. Baker says the agency pointed to their objection to abortion-inducing medications, essentially lumping them in with abortifacients instead of contraception.
A copper IUD, like the one Baker uses, prevents pregnancy by causing the sperm to move differently, so that it never reaches the egg. As Baker remarked in our interview, this means that even if you get into the nitty-gritty debates about what conception is, a copper IUD passes the test, blocking fertilization from ever occurring. Additionally, anyone who receives an IUD must first undergo a pregnancy test to ensure they are not pregnant at the time of insertion. Yet despite getting multiple letters from doctors explaining this, GuideStone continued to deny Baker coverage.
The day the Trump administration announced the interim rules narrowing the contraceptive mandate, Guidestone released a press statement praising the administration’s defense of religious liberty, its president O.S. Hawkins saying, “This is indeed good news for all Americans who value the important role of religious liberty in our nation.”
Alicia and Josh eventually paid the $1,200 fees out of pocket.
“I work at a nonprofit, my husband works in freelance, and we’re paying off grad school loans, so this is a huge expense for us,” Baker said. “We were able to scrounge together the money, but at the same time I recognize that not everyone has that opportunity — not everyone is as privileged as we are.”
Baker will face these high costs again when she and her husband do want to have children and she needs to have her IUD removed, and again when they want to return to a period of not-conceiving. She is not alone in this: Married women are the largest consumers of birth control in the United States (77 percent versus 42 percent of never-married women). This makes sense, given that the average desired family size is two children. To achieve this family size, a woman must use contraceptives for roughly three decades.
According to the Guttmacher Institute, the average cost of a full year’s worth of birth control pills is the equivalent of 51 hours of work for someone making the federal minimum wage of $7.25, and the up-front costs of the IUD is nearly a month’s salary for a woman working full-time at minimum wage. With the Trump administration’s new rules, more than 62 million American women are at risk of losing their birth control coverage without out-of-pocket costs.
It’s one of the reasons Baker reached out to the National Women’s Law Center through their CoverHer hotline, a project dedicated to ensuring all individuals get the birth control coverage guaranteed by law, and told her story. Shortly after the Trump administration took office and rumors began circulating that they planned to roll back the contraception coverage mandate, the Center reached out to Baker to notify her that, should this happen, they were planning on suing the administration. They then asked if she wanted to be a plaintiff in the case. Because she is employed full time by an organization that supports her right to birth control and because the suit directly targets the administration rather than her personal insurance company, Baker said she felt this was an opportunity to leverage her privilege.
“I feel like I’m in a very unique situation, because I am a Christian. I see it as an ‘Esther opportunity’ — to be kind of inside the Empire and to help defend the people that need protection,” Baker said. “So much of my life is just wanting to love Jesus and to love others in the best way possible, so being a part of this case is a way to put action to my belief.”
Despite notions that religious affiliation and contraceptive use are antithetical, birth control is the norm for Christians living in the United States. Sixty-eight percent of Catholics, 73 percent of Mainline Protestants, and 74 percent of evangelicals who are at risk of unintended pregnancy report using a highly effective method of contraception (an IUD, the pill or another hormonal method, or sterilization).
“I see this as an opportunity for the church in general to recognize that this is not an ‘us’ vs. ‘them’ issue. This is a human issue, and women from all backgrounds — including people that are probably sitting next to you in church — this is something that they have to deal with,” Baker said.