Donald Trump’s government has issued a ruling that allows employers to opt out of providing free birth control to millions of Americans.
The rule allows employers and insurers to decline to provide birth control if doing so violates their “religious beliefs” or “moral convictions”.
Fifty-five million women benefited from the Obama-era rule, which made companies provide free birth control.
As a candidate, Mr Trump had pledged to eliminate that requirement.
The mandate had been a key feature of so-called Obamacare – President Obama’s efforts to overhaul the US healthcare system.
It included a provision that permitted religious institutions to forego birth control coverage for their employees.
But the Department of Health and Human Services (HHS) said on Friday it was important to expand which organisations can opt out and deny free contraceptive coverage.
“We should have space for organisations to live out their religious ideas and not face discrimination because of their religious ideas,” said one HHS official, who did not wish to be named.
The new rule, which is effective immediately, was criticised by women’s rights groups and Democrats in Congress.
Speaker of the House Paul Ryan, the top Republican in Congress, praised the decision as “a landmark day for religious liberty”.
The American Civil Liberties Union (ACLU) and the National National Women’s Law Center have announced that they will sue the federal government over the decision.
The American Congress of Obstetricians and Gynecologists was blunt. They said the decision undermined the best interests of their patients and turned back the clock on women’s health.
Another women’s advocacy organisation, UltraViolet, said employers and insurers now needed to pick a side, asking if they stood “with Donald Trump and his attacks on women,” or “the women who depend on your coverage?”
The administration says only a limited number of women will be affected.
Whether or not that is true, the president is being criticized for politicising women’s bodies and health to score political points with his base.