But the architects of the Trump contraceptive reversal, Ms. Talento, a White House domestic policy aide, and Mr. Bowman, a top lawyer at the Department of Health and Human Services, have the experience and know-how that others in the administration lack. As a lawyer at the Alliance Defending Freedom, Mr. Bowman assailed the contraceptive coverage mandate on behalf of colleges, universities and nonprofit groups that had religious objections to the rule. Ms. Talento, a former aide to Senator Thom Tillis, Republican of North Carolina, spent years warning about the health risks of certain contraceptives, especially birth control pills.
Ms. Talento, a Harvard-trained epidemiologist, mused two years ago on talk radio that she understood why doctors prescribed cancer chemotherapy drugs, despite their horrible side effects: The disease is worse. But why, she asked, would they prescribe the birth control pill?
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According to the National Cancer Institute, some oral contraceptives can lower the risk of endometrial and ovarian cancer and may contribute to a slight increase in the risks of breast, cervical and liver cancer. Some of the data came from older studies of the pill that had formulations and dosages different from what is commonly used now.
In theory, the contraceptive coverage mandate removed cost as a barrier to birth control, a longtime goal of advocates for women’s rights and experts on women’s health. But to critics like Mr. Bowman and Ms. Talento, the rule was an egregious example of federal overreach. The new policy could take effect soon after it is issued in coming weeks.
The Affordable Care Act says insurers must cover certain preventive services at no cost. But the Trump administration says the law does not explicitly require coverage of contraceptives — an argument Mr. Bowman made for plaintiffs in court cases.