Trump-Pence Administration Released New Rules that Sabotage Stability of the Affordable Care Act

WASHINGTON, D.C. —  This week, the Trump-Pence Administration released its final rules for the 2019 health insurance marketplaces, the Notice of Benefits and Payment Parameters for 2019. This rule sets next year’s insurance marketplace and demonstrates a shift in philosophy around the Affordable Care Act (ACA) that prioritizes state flexibility over policies to help individuals covered by insurance. This antiquated approach to healthcare coverage will lower protections for individuals with pre-existing conditions, increase the cost of coverage, and increase barriers to enrollment. The Latinx community already struggles with increased barriers and higher uninsured rates – these changes threaten to exacerbate disparities for communities of color and those who struggled to obtain insurance coverage in the pre-ACA climate.

Specifically, this rule will provide States with greater flexibility to set coverage within the ACA’s requirements for Essential Health Benefits (EHBs).  This will allow for a lower standard for what must be covered in the EHBs, meaning that even though individuals have acquired health coverage, it may not be there when they need it.

“EHBs are critical for the Latinx community. An attack on EHBs is an attack on life-saving care, including cervical cancer screenings and maternity care. Latinas suffer from cervical cancer at a higher rate than their white counterparts. EHBs provide critical coverage to Latinas across the country and any flexibility given to states only undermines access to vital healthcare services,” said Ann Marie Benitez, senior director of government relations at the National Latina Institute for Reproductive Health (NLIRH).

Furthermore, under the new rule, enrollment assistance will be further weakened. The Latinx community faces numerous linguistic barriers when signing up for healthcare coverage and navigators helped communities understand the complicated nature of the ACA. In a year when there will be even more changes to the ACA and less guidance to help individuals figure out what coverage is most appropriate for them, we are deeply frustrated in this Administration’s continued sabotage of the ACA.   

To add insult to injury, under the new rule, people will be able to avoid paying the penalty by claiming hardship if they live in a county in which the affordable plans cover abortion and there are no alternatives to coverage without abortion. If a person lives somewhere in which abortion is included in the coverage plan, they can decide not to purchase coverage solely because it includes abortion.  In other words, this punishes insurance companies for providing abortion coverage. This anti-choice decision comes just weeks after Republicans sabotaged the Senate health insurance bill over language that would have expanded the Hyde Amendment, a ban blocking federal Medicaid funding for abortion coverage, into the private insurance market.

“This Administration continues to attack access to reproductive healthcare under the guise of religious and moral objections. The fight for affordable healthcare and coverage of comprehensive reproductive healthcare services, including abortion, is not new. However, the philosophy of the Trump-Pence Administration is clear in the inclusion of new hardship exemptions that specifically take a dig at both the importance of the individual mandate and the insurers who provide comprehensive reproductive health services in their plans. We fear this dangerous move will encourage insurance companies to not provide abortion coverage in an attempt to keep individuals on their plans. No one is forced to use the abortion coverage in their plan, but in a country where many women of color disproportionately lack access to critical reproductive healthcare, the attack on abortion coverage will work to further weaken our communities’ already weak health safety net.

These changes compounded with the sabotage this Administration has already engaged in will continue to threaten the stability of the ACA when we should be working to ensure more affordable coverage for communities of color. Since the passage of the ACA, the Latinx community has experienced the largest decline in uninsured rate of any ethnic group. However, sabotage like this will only exacerbate barriers to care and continue the already high uninsured rates that remain in the Latinx community. Our communities cannot afford any more attacks to our care.” Benitez concluded.

For more information on NLIRH’s fight for health, dignity and justice, visit us at or follow us on Facebook and Twitter @NLIRH.


The National Latina Institute for Reproductive Health is the only national reproductive justice organization dedicated to building Latina power to advance health, dignity, and justice for 28 million Latinas, their families, and communities in the United States through leadership development, community mobilization, policy advocacy, and strategic communications

Related News