Pat Greenhouse/Globe Staff
Massachusetts dove headfirst into another legal confrontation with the Trump administration Friday, as Attorney General Maura Healey sued the federal government over newly issued rules giving employers the right to deny women birth control coverage by claiming religious or moral objections.
Hours after the US Department of Health and Human Services issued the two new rules, Healey filed a complaint in US District Court in Boston seeking to block them, charging that they violate both the establishment and the equal protection clauses of the Constitution.
“This is about taking away women’s access to birth control under the guise of religious liberty,” Healey told reporters during a conference call. The suit charges that the new rules “promote the religious freedom of corporations over the autonomy of women.”
The rules, which take effect immediately, effectively end the Affordable Care Act’s five-year-old provision mandating that health insurers cover birth control as preventative care without copayments.
While the mandate left only narrow exemptions, the new policy would let nearly all employers opt out of covering birth control without copayments based on religious or moral objections.
It is so far unclear how many employers would choose to drop birth control coverage in Massachusetts or nationally.
In recent years, that mandate guaranteed birth control coverage for approximately 55 million women, the Department of Health and Human Services calculated in 2015. The National Women’s Law Center estimates that number is now as high as 62 million women.
But religious organizations and employers have been repeatedly and successfully challenging the Obama administration on the rules. The organizations and employers argue that by mandating birth control coverage, the government was forcing them to violate their own beliefs.
“Respect for the religious freedom is what the United States is about,” Archbishop William Lori, chairman of the Catholic Benefits Association, said in a statement Friday. “The regulation issued today honors this value. This is a great victory for our First Freedom.”
In another, separate victory for religious groups Friday, Attorney General Jeff Sessions issued a government directive giving them broad protections to express their beliefs when they conflict with government regulations — even when hiring. And it reverses a directive under the Obama administration that interpreted gender discrimination to include discrimination based on gender identity and to protect transgender people.
The birth control rules represent the Trump administration’s attempt to end the contentious legal dispute, by allowing those who object to birth control as a matter of conscience to opt out of coverage.
While the rules suggest Congress has a history of providing such “conscience clauses” exempting those with strong moral convictions or religious beliefs, opponents argued that the language is ill-defined and ripe for abuse.
“What does that mean? What does ‘moral objection’ even mean?” said Healey. The phrase, she said, opens up a wide array of possibilities “that are really, to be quite blunt, very scary right now if you’re a woman in the United States.”
The announcement also seemed to establish a new front in women’s ongoing battle with Trump. The news came exactly a year after his presidential campaign was upended by the release of an Access Hollywood video that captured him boasting about grabbing women’s genitals. On Friday, Ultraviolet, a women’s group, erected a sordid monument to that spectacle behind the White House: A large screen replayed the vulgar video on a nonstop loop for 12 hours. And some women’s activists indicated they intend to make things personal as they protest the Trump administration’s stance on reproductive issues.
“There’s no doubt President Trump has benefited from birth control, yet he is making it harder and more expensive for millions of women to get contraception and control their own lives,” said Amy Runyon-Harms, the campaign coordinator for Keep Birth Control Co-pay Free, a project of the Women’s Equity Center. That campaign intends to use online advertising and social media to hammer the administration on the issue and is even encouraging voters to challenge politicians one-on-one at town hall meetings to expose hypocrisy on birth control.
Reproductive rights advocates are trying to make the case that birth control is not controversial; Planned Parenthood says it is used by nine out of 10 women at some point in their lives. “News flash to Republicans,” Senator Elizabeth Warren said in a statement. “The year is 2017, not 1917.”
Rebecca Hart Holder, executive director of NARAL Pro-Choice Massachusetts, called the rule “a new low for an administration already committed to interfering with access to comprehensive reproductive health care.”
Religious conservatives, however, praised the Trump administration rule on birth control and the other rule that critics say could override many antidiscrimination protections for LGBT people and others.
‘‘President Trump is demonstrating his commitment to undoing the anti-faith policies of the previous administration and restoring true religious freedom,’’ said Tony Perkins, president of the Family Research Council.
In addition to the states of Massachusetts and California, groups like the American Civil Liberties Union, the National Women’s Law Center, and Americans United for Separation of Church and State say they are filing suits over the birth control rules, arguing that one person’s religious freedom should not supersede another’s health care choices.
In anticipation of the rule change, a coalition of Massachusetts health insurers and reproductive rights groups recently worked together to forge agreement on a bill that would mandate copay-free birth control coverage under state law.
Massachusetts legislators are now considering that bill, called the Advancing Contraceptive Coverage and Economic Security in our State, or ACCESS, bill, as a way of protecting Bay State women from losing free coverage.
Governor Charlie Baker said he supports the state measure.
“The Baker-Polito administration fully supports access to women’s health and family planning services and will protect access to these services in Massachusetts,” said communications director Lizzy Guyton.
But the federal change goes into effect immediately. The rule “will let employers decline to cover birth control for their employees for virtually any reason, starting immediately,” said Hart Holder.
“With these actions, the Trump administration is really saying to employers, ‘If you want to discriminate, the administration has your back,’ ” said Fatima Goss Graves, president and CEO of the National Women’s Law Center. “Our response will be challenging this rule in court.”
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