The Biden administration is aiming to end a Trump-era rule that gave employers more flexibility in declining to offer birth control coverage on moral grounds, allowing easier access to birth control for women based on the Affordable Care Act.

The departments of Health and Human Services and Treasury proposed a rule on Monday that would rescind a Trump-era exemption that allowed private health plans and insurers to exclude contraceptive services in their coverage due to moral convictions, while religious exemptions would remain in place.

Employers and private universities with a "sincerely held religious" objection would continue to be exempt from covering contraceptive services, though people who are denied coverage due to a religious exemption would be able to access contraception services directly through a willing provider for no additional cost, under the proposal.

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"Now more than ever, access to and coverage of birth control is critical as the Biden-Harris Administration works to help ensure women everywhere can get the contraception they need, when they need it, and, thanks to the ACA, with no out-of-pocket cost,” said HHS Secretary Xavier Becerra in a statement. “Today’s proposed rule works to ensure that the tens of millions of women across the country who have and will benefit from the ACA will be protected. It says to women across the country, we have your back.”

The Obama-era Affordable Care Act has guaranteed women insurance coverage of contraceptive services without an additional out-of-pocket cost, though rules put in place during the Trump administration allowed employers who had religious or moral objections from providing such coverage. In 2020, the Supreme Court upheld the Trump-era moral and religious exemptions.

The proposed rule would create a new individual pathway for people enrolled in employee-sponsored health plans that object to providing birth control based on religious grounds. Health providers and facilities providing contraceptive services through the pathway would be reimbursed through an agreement with insurers on the Affordable Care Act's federal or state exchanges.

It would also keep in place an optional accommodation for employers and private universities who object on religious grounds from providing birth control coverage to elect to give their employees access to contraceptive services. Regardless, with the addition of the individual pathway, people whose health plans do not cover birth control would continue to have access at no cost.

"If this rule is finalized, individuals who have health plans that would otherwise be subject to the ACA preventive services requirements but have not covered contraceptive services because of a moral or religious objection would now have access," said CMS Administrator Chiquita Brooks-LaSure in a statement.

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Religious exemptions to the Affordable Care Act's contraceptive mandate date back to the Supreme Court's Burwell v. Hobby Lobby decision back in 2014, when the court ruled that the Affordable Care Act's mandated coverage of contraceptives violated for-profit corporations' religious liberty.

The proposed rule is a part of the Biden administration's response to the Supreme Court overturning Roe v. Wade, thus eliminating the constitutional right to an abortion. It will remain open to public comment for 60 days.