After weeks of uproar from Catholic bishops over the Obama administration's rule that would require Catholic universities and hospitals to cover contraceptives in their health care plans, on Friday the White House announced an accommodation measure.
As originally stipulated by the Affordable Care Act, churches and organizations closely tied to a religious mission are exempt from providing insurance coverage that includes birth control. But large religiously affiliated institutions like hospitals, universities and charities, which rely heavily on federal money and hire people outside the faith, would be required to offer health insurance that covers contraception. Catholic leaders and politicians denounced the law as an attack on religious freedom.
In response to the outcry, President Obama announced a compromise that he believes will both protect religious beliefs and ensure that women have access to contraceptives. Moving forward, Catholic universities, hospitals and charities will be allowed to exclude contraception coverage from their employee insurance plans. But the insurance company (not the employer) will be required to reach out directly to those employees and offer contraception free of charge, without cost sharing.
As a White House fact sheet summarizes, under this policy:
* Religious organizations will not have to provide contraceptive coverage or refer their employees to organizations that provide contraception.
* Religious organizations will not be required to subsidize the cost of contraception.
* Contraception coverage will be offered to women by their employers' insurance companies directly, with no role for religious employers who oppose contraception.
* Insurance companies will be required to provide contraception coverage to these women free of charge.
The Obama administration said that the rule does not present an issue of commingling funds between a Catholic employer that pays for insurance and an insurance company that provides free contraception independently. "We do think this a cost-neutral benefit," said a senior administration official in a conference call, explaining that they drafted the rule with insurance experts and economists who found no extra charge for contraception. "The typical cost of a pregnancy is around $12,000, and that provides a whole lot of contraception if you're preventing an unwanted or unplanned pregnancy, in terms of the number of contraceptive services you can offer."
Some Catholic leaders, before the compromise was even announced, said that nothing less than fully eliminating the rule would suffice. Anthony Picarello, general counsel for the U.S. Conference of Catholic Bishops, has called to remove contraceptive coverage from the Affordable Care Act altogether, including for secular businesses. "If I quit this job and opened a Taco Bell, I'd be covered by the mandate," he said in explanation of why, in any form, the law violates Catholics' religious beliefs.
But other Catholic organizations, including Catholics United and the Catholic Health Association, have expressed support for the compromise.
"Catholics United has been calling on both sides of this heated debate to work towards today's win-win solution," said James Salt, executive director of Catholics United. "President Obama has shown us that he is willing to rise above the partisan fray to deliver an actual policy solution that both meets the health care needs of all employees and respects the religious liberty of Catholic institutions."
Women's health organizations, including Planned Parenthood and NARAL Pro-Choice America, have also applauded the Obama administration's action.
"We believe the compliance mechanism does not compromise a woman's ability to access these critical birth control benefits," said Planned Parenthood president Cecile Richards. “However, we will be vigilant in holding the administration and the institutions accountable for a rigorous, fair and consistent implementation of the policy, which does not compromise the essential principles of access to care."
While the compromise won't satisfy everybody, it looks as if President Obama is still banking on most Americans — including most Catholics — to back him up on this. A poll this week by the Public Religion Research Institute found that 55 percent of all Americans agree that employers should be required to provide their employees with health care plans that cover contraception and birth control at no cost. Among Catholics, 58 percent believe that employers should be required to provide their employees with health care plans that cover contraception. Meanwhile, a Guttmacher Institute study (pdf) found that 98 percent of Catholic women have used contraception.
"I understand some folks in Washington may want to treat this as another political wedge issue, but it shouldn't be," President Obama said on Friday of the compromise. "This is an issue where people of goodwill on both sides of the debate have been sorting through some very complicated questions to find a solution that works for everyone. With today's announcement, we've done that. Religious liberty will be protected, and a law that requires free preventive care will not discriminate against women."
Cynthia Gordy is The Root's Washington reporter.