In a move lambasted by activists as an attack on women’s health, the Trump administration on Wednesday said it had finalized an Obamacare policy change that allows some employers to deny insurance coverage of birth control for “religious or moral” reasons.

The final rules were issued in spite of the vehement opposition and ongoing legal challenges to the draft version of the regulations, first proposed last year. Women’s rights activists vowed to continue to challenge the change.

“If the Administration thinks it can move these rules forward without a fight, they’re wrong,” Fatima Goss Graves, president of the National Women’s Law Center, told CNN this week. “Countless women depend on this critical birth control coverage for their health and economic stability ― and we will continue to fiercely defend them.”

BREAKING: The Trump administration just followed through on its promise to allow virtually any employer to invoke religion to deny their employees birth control coverage.



We will keep fighting to make sure that religious beliefs are not used for discrimination or harm. pic.twitter.com/7DnzyoEVlq — ACLU (@ACLU) November 7, 2018

The Affordable Care Act obligates most employers’ health plans to cover birth control at no charge as a preventive service. But Trump health officials announced two interim rules in October 2017 that permitted employers to opt out of providing such coverage for “religious or moral objections.”

The proposed rules were roundly denounced by civil rights and women’s health organizations, and were targeted by multiple lawsuits. Two of those suits, filed separately by the attorneys general of California and Pennsylvania, led to federal judges in those states granting nationwide injunctions against the rules. Both cases are now before appellate courts.

Despite the ongoing legal battle, the Department of Health and Human Services announced Wednesday that the policy change had been finalized and would take effect in about two months.

The final rules would apply to religious organizations, nonprofits and small businesses, the department noted, and not to publicly traded businesses or government entities.

The exemptions to the contraceptive mandate “should affect no more than approximately 200 employers with religious or moral objections,” HHS said. Department officials told The Washington Post that the “coverage of birth control for perhaps 6,400 women” would be affected by the change.

Women’s health advocates warned it’s impossible to predict just how many people will be affected. Brigitte Amiri of the American Civil Liberties Union’s Reproductive Freedom Project told the Post that “tens of thousands or possibly hundreds of thousands of women” could be impacted. The National Family Planning & Reproductive Health Association said the number could be in the “millions.”

Hundreds of Catholic hospitals, nonprofits and other organizations could choose to seek exemptions,Tim Jost, emeritus professor at the Washington and Lee University School of Law, pointed out to CNN.

Experts also noted that many women use birth control for reasons not related to pregnancy prevention, including the treatment of hormonal imbalances.

Also on Wednesday, HHS proposed new rules targeting Obamacare plans that cover abortions, AP reported. The proposed rules would require insurers to send a separate bill to consumers for coverage related to abortion services.