In her final state of the city address on Thursday, City Council Speaker Melissa Mark-Viverito pledged her commitment to ensuring free birth control for every woman in New York City, despite efforts in Washington to repeal the Affordable Care Act—and with it, the right to copay-free contraception—as well as President Donald Trump's commitment to anti-abortion Supreme Court judges.

"The Council will work to provide all women in New York City with free access to birth control, including City workers who are currently in 'grandfathered' plans," her office announced. "The Council will also continue its support of a stand-alone fund for birth control."

The speaker's plan targets women who slip through the cracks of the already imperiled ACA: those who are uninsured, undocumented, or have old "grandfathered" insurance plans that don't adhere to ACA guidelines. It could also offer an alternative to women who don't feel comfortable using a family plan for contraceptives.

The concept is to expand an existing City Council fund for IUDs and other long-acting reversible contraceptives (LARCs) instated last year, following a 2016 proposal from Mark-Viverito's Young Women's Initiative. The speaker is going to push for this money to be "baselined and expanded," her office said. IUDs, an alternative to oral contraception, are no small investment without insurance. The total cost of the medical exam, IUD insertion, and followup visits ranges from $500 to $900, according to Planned Parenthood. Removal can cost up to $300.

Emily Kadar, who manages government affairs for the National Institute for Reproductive Health, told Gothamist that she believes that the speaker's proposal is a strong and attainable one, considering that insurance policy is decided at the State level. But she added that it would hardly cover the city's demand if the ACA were to be repealed.

Legislation currently pending at the state level would likely make up the difference. The Comprehensive Contraception Coverage Act, recently passed by the Assembly, would require insurers in New York to provide copay-free coverage for all FDA-approved contraceptives. Emergency contraception like Plan B, which typically costs at least $50 without a prescription, would be covered over the counter—an expansion on the ACA. Male contraceptives would be covered, as well.

But the CCCA also has to pass the Republican-majority state Senate, where it stalled last year.

Governor Andrew Cuomo added his two cents late last month, drafting an insurance code regulation that would require insurers to provide most contraception and abortion services without a copay or deductible. But the draft regulation has a significant exception for "religious employers and qualified religious organization employers": the logic upheld in the Supreme Court's Hobby Lobby decision.

Cuomo's regulation is still pending, and could go into effect next month following a 45-day comment period.

A spokeswoman for the governor didn't immediately comment on the decision to include a religious exception.

The State Assembly has also passed, for the second time, the Reproductive Health Act—legislation that would codify Roe v. Wade at the state level, protecting, and expanding, the right to abortion in New York in the face of conservative Supreme Court appointments.

It, too, has historically been shut down in the Senate. Mark-Viverito has pledged to lobby for the RHA, calling it "more important now than ever."

[UPDATE 5 p.m.]: "The regulations put forward ensure access and coverage for all contraceptive drugs and devices for women in New York," said Cuomo spokeswoman Abbey Fashouer in a statement, adding that the religious exemption "simply mirrors federal law" and requires the insurer to provide coverage if an employer opts out.