White House Unveils Contraception Accommodation Plan [UPDATED]

Updates below.

The White House had a conference call with reproductive health advocates this morning, in advance of its planned noon-time announcement of its decision to accommodate religious institutions in their objections to the requirement that their health insurance plans provide co-pay-free contraception to their employees.

According to Sara Hutchinson, policy director for Catholics for Choice, and Jon O’Brien, the group’s president, administration officials told activists on the call that they would require insurance companies (but not the employers) to provide separate coverage for co-pay-free contraceptives, but not as part of the insurance plan that the religious institution pays for. “Essentially they’ve carved out a way for religiously affiliated institutions who supposedly have a religious objection to keep their hands clean,” said Hutchinson.

The details of how this would play out, though, are unclear. For example, the White House did not know how it would enforce the rule for employers who self-insure, rather than purchase group coverage from an insurance company. In addition, Hutchinson and O’Brien said it was unclear how the government would compel the insurance companies to provide the coverage, or how it would be paid for if women were to get the coverage cost-free. Another question that arose on the call was what would happen if the insurance company claimed it had a religious objection to providing the coverage—a question administration officials did not have an answer for.

“We’re taking some comfort from the fact that the White House didn’t completely cave in but there’s a lot of concern that whether women in Catholic-controlled institutions get their contraception or not is basically on a lot of hope and a lot of prayer,” said O’Brien. “The reality is we don’t know all the details.” 

As of late yesterday, reproductive rights advocates I spoke to were unaware that the White House would be announcing the accommodation today. The signers of a letter from 20 religious organizations that supported the contraception coverage rule, without any religious exemptions, were scheduled to host a conference call today at 11:30 a.m. They postponed it after it became clear the White House was set to announce the accommodation today. The letter says the religious conscience of women and the separation of church and state support the requirement for coverage without an exemption for religious institutions.

It’s clear that the White House was not seeking to appease the U.S. Conference of Catholic Bishops, which has already rejected the notion of any compromise, and even has said that it wouldn’t be satisfied until the requirement was eliminated entirely, even for non-religious employers. Rather, Obama was seeking to satisfy the Catholic Health Association, which runs Catholic hospitals and health care providers around the country. Indeed this morning the White House is circulating the statement of the group’s president, Sr. Carol Keehan, saying she is “very pleased” with how the issue was resolved in a way that “protects the religious liberty and conscience rights of Catholic institutions.” 

The way this played out is similar to how the passage of the original health care reform bill did—although the Bishops opposed the final bill because they insisted it did not adequately proscribe coverage for abortion, the Catholic Health Association endorsed the final compromise. That compromise required women to purchase a separate rider for abortion coverage. Because the law has not yet been fully implemented, we still don’t know whether insurance companies will stop offering the coverage because it’s too complicated, Hutchinson said.

Planned Parenthood’s Cecile Richards said in a statement, “In the face of a misleading and outrageous assault on women’s health, the Obama administration has reaffirmed its commitment to ensuring all women will have access to birth control coverage, with no costly co-pays, no additional hurdles, and no matter where they work.” While “we believe the compliance mechanism does not compromise a woman’s ability to access these critical birth control benefits,” said Richards, “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 praising the accommodation as a “reaffirmation of the commitment to ensuring contraceptive coverage,” NARAL Pro-Choice America president Nancy Keenan will be “committed to ensuring that the policy is implemented fully and fairly, so that women receive this basic health-care benefit without unnecessary barriers,” the group said in a statement.

The Bishops, said O’Brien, “were prepared for this a long time ago.” They will see this accommodation as “something they can mark off their shopping list”— referring to the USCCB’s demands from its Ad Hoc Committee on Religious Liberty. “They will come back to the political establishment, Republican and Democrat, to begin carving out the rest of what they want,” said O’Brien. “They have now an entree into being able to demand further from the political establishment knowing that the political establishment will bend the knee once, and looks like they will be bending their knee in the future to religious business interests.”

UPDATE: Sarah Kliff delves into the catch in who will pay for the coverage:

The catch here is that there’s a difference between “revenue neutral” and “free.” By one report’s measure, it costs about $21.40 to add birth control, IUDs and other contraceptives to an insurance plan. Those costs may be offset by a reduction in pregnancies. But unless drug manufacturers decide to start handing out free contraceptives, the money to buy them will have to come from somewhere.

Where will it come from, since neither employers nor employees will be paying for these contraceptives? That leaves the insurers, whose revenues come from the premiums that subscribers pay them. It’s difficult to see how insurance companies would avoid using premiums to cover the costs of contraceptives. They could, perhaps, use premiums from non-religious employers. Those businesses wouldn’t likely object on faith-based grounds, but they probably wouldn’t be keen on footing the bill for people who aren’t on their payrolls.

FURTHER UPDATE: Statement from the USCCB:

The United States Conference of Catholic Bishops (USCCB) sees initial opportunities in preserving the principle of religious freedom after President Obama’s announcement today. But the Conference continues to express concerns. “While there may be an openness to respond to some of our concerns, we reserve judgment on the details until we have them,” said Cardinal-designate Timothy Dolan, president of USCCB.

“The past three weeks have witnessed a remarkable unity of Americans from all religions or none at all worried about the erosion of religious freedom and governmental intrusion into issues of faith and morals,” he said.

On that latter point, Archbishop Dolan might want to consult Fox News: 

The new Obama health care law requires that employer health plans provide birth control coverage as part of preventive services for women. Catholic and other religious-affiliatedhospitals and universities typically have not provided any birth control coverage for their employees, and oppose the new requirement because it violates their religious rights. Overall, do you approve or disapprove of requiring employer health plans to cover birth control for women?

Approve 61%

Disapprove 34

(Don’t know)5

Sarah Posner, author of God’s Profits: Faith, Fraud, and the Republican Crusade for Values Voters, covers politics and religion. Her work has appeared in The Washington Post, The Guardian, The Atlantic, The American ProspectThe NationSalon, and other publications. Follow her on TwitterRSS feed Email