WASHINGTON - The Obama administration on Friday proposed a work-around for religious nonprofits that object to providing health insurance that covers birth control.
The government's new regulation attempts to create a barrier between religious groups and contraception coverage, through insurers or a third party, that would still give women free access to contraception. It wasn't immediately clear whether religious leaders would accept the new approach, or whether it would stem the tide of lawsuits by Roman Catholic charities and other faith-affiliated nonprofits nationwide challenging the requirement to provide such coverage.
The Catholic Health Association, a trade group for hospitals, and the U.S. Conference of Catholic Bishops separately had no immediate reaction, saying they were studying the regulations. Policy analyst Sarah Lipton-Lubet of the American Civil Liberties Union said the rule appeared to meet the ACLU's goal of providing "seamless coverage" of birth control for the affected women.
Health and Human Services Secretary Kathleen Sebelius said in a statement the compromise would provide "women across the nation with coverage of recommended preventive care at no cost, while respecting religious concerns."
The regulation is part of President Barack Obama's health care overhaul, known as the Affordable Care Act. The birth-control rule, first introduced a year ago, became an election issue, with advocates for women praising the mandate as a victory and religious leaders decrying it as an attack on faith groups.
The new health care law requires most employers, including faith-affiliated hospitals and nonprofits, to provide health insurance that includes artificial contraception, including sterilization, as a free preventive service. The goal, in part, is to help women space out pregnancies to promote health.
Under the original rule, only those religious groups which primarily employ and serve people of their own faith - such as churches - were exempt. But other religiously affiliated groups, such as church-affiliated universities, Catholic Charities and hospitals, were told they had to comply.
Roman Catholic bishops, evangelicals and some religious leaders who have generally been supportive of Obama's policies lobbied fiercely for a broader exemption. The Catholic Church prohibits the use of artificial contraception. Evangelicals generally permit the use of birth control, but some object to specific methods such as the morning-after contraceptive pill, which they argue is tantamount to abortion.
Obama had promised to change the birth control requirement so insurance companies - and not faith-affiliated employers - would pay for the coverage, but religious leaders said more changes were needed to make the plan work.
Since then, more than 40 lawsuits have been filed by religious nonprofits and secular for-profit businesses claiming the mandate violates their religious beliefs. As expected, this latest regulation does not provide any accommodation for individual business owners who have religious objections to the rule.
In the latest version of the rule, houses of worship remain exempt, including those that offer social services such as a food pantry directly from their buildings.
At the same time, a mechanism would be set up to provide contraception coverage for women employees of religious employers that is outside of the employer's health insurance plan. It would allow those employees to be covered without their employer "contracting, arranging, paying, or referring for such coverage."
If a nonprofit identifies itself as religious and has private insurance, the private insurer will work directly with women employees to provide coverage for contraception. Many religious nonprofits, however, are self-insured. In those cases, a third party, not the religious employer, would handle the coverage.
Questions remained about how the services ultimately would be funded, but the Health and Human Services department said any additional cost would be covered by a deduction in federal user fees for whoever issues the policy. The federal agency has not tallied an overall cost of the plan, according to Chiquita Brooks-LaSure, an HHS deputy policy director.
In its new version of the rule, the department argued that the change wouldn't impose new costs on insurers because it would save them money "from improvements in women's health and fewer child births."
John Gehring, Catholic program director at Faith in Public Life, a liberal advocacy group based in Washington, called the compromise "a strong signal that the administration is responsive to the concerns of Catholic institutions."
The Alliance Defending Freedom, a conservative religious liberty group which is representing several for-profit businesses in lawsuits over the regulation, said it would continue to press for exemptions for business owners in court. So far, about 10 businesses have obtained temporary injunctions against the regulation while their cases move through the courts.
The latest version of the mandate is now subject to a 60-day public comment period. The mandate takes effect for religious nonprofits in August.