Donald Trump is allowing more employers to opt out of providing no-cost birth control to women on religious or moral grounds - rolling back an Obamacare provision.

The long-anticipated move extends an exemption already given to religious institutions to every commercial enterprise.

Rights groups and physicians have expressed outrage, while the American Civil Liberties Union has threatened to sue the US government.

The ruling expands "exemptions to protect moral convictions for certain entities and individuals whose health plans are subject to a mandate of contraceptive coverage" under the Affordable Care Act, according to the US Department of Health and Human Services.

Millions of US women who had the cost of their contraception reimbursed under the scheme could be affected.


Don't be fooled. Targeting 62.4M women's access to birth-control coverage shows the Trump admin's disdain for women’s health & lives. pic.twitter.com/KIfS2E9IQg — Planned Parenthood (@PPact) October 6, 2017

In 2014, the US Supreme Court ruled that family-owned private companies could choose not to provide contraception to female employees on religious grounds.

In May, President Trump signed a decree on religious liberty ordering his administration to take into account objections of conscience on matters of contraception.

It is not immediately clear how many women will be affected by the new ruling.

The Trump administration, based on estimates of the number of employees who had previously filed lawsuits on the Obamacare requirement to fully cover the costs of birth control, claimed it would only be around 120,000 women.

But a 2016 government study said the Obamacare provision had guaranteed 55.6 million women with private insurance access to free birth control.

The American Civil Liberties Union said it was "suing the Trump administration to block new rules allowing employers to deny insurance coverage for birth control".

Reproductive health care firm Planned Parenthood added the new rule "puts our birth control coverage at risk".

The American Congress of Obstetricians and Gynecologists said the decision would threaten women's health.

But the White House framed it as an issue of religious liberty.

Press secretary Sarah Huckabee Sanders said: "The President believes that the freedom to practise one's faith is a fundamental right in this country and that's all today was about.

"The Supreme Court has validated this decision, certainly many times over, and the President is somebody who believes in the constitution."

Repealing Obamacare was one of Mr Trump's campaign promises, but his Republican Party has repeatedly failed in efforts to overhaul it.