In context, this mandates that health care providers no longer have to provide access to contraception without patient co-payment, or indeed at all. This would also reverse the 2000 rule from the Equal Employment Opportunity Commission that insurance that provides coverage for prescription drugs must include birth control in what they cover. Additionally, going back to requiring a co-pay would likely put highly effective forms of birth control, such as IUDs, financially out of reach for some women, which could result in more unwanted/unintended pregnancies.

Severino goes on to argue for expanding inclusion of “fertility awareness”-based methods. This would be things like pulling out or the rhythm method, which are far less effective options.

“Using the rhythm method as a form of birth control doesn’t pose any direct risks. However, it’s considered one of the least effective forms of birth control. How well the rhythm method works varies between couples. In general, as many as 24 out of 100 women who use natural family planning for birth control become pregnant the first year. The rhythm method doesn’t protect you from sexually transmitted infections.”

Full contextual analysis of Section 3.5: Department of Health and Human Services here.