The White House today announced an update to its widely supported and yet hotly contested decision not to expand the religious exemption for no-cost contraceptive coverage. At stake was whether religiously affiliated organizations such as Catholic hospitals and universities should also be excluded from the health-insurance requirement, even though many of their employees aren’t Catholic. (Houses of worship were already exempt).
Here’s how it will work. Insurers will create policies that do not include contraceptive coverage for religious organizations that object. That same insurance company must then simultaneously offer contraceptive coverage to all employees directly, and can not charge an additional premium or fee for that coverage. These will not be riders, that is, the contraception remains in the insurance benefits provided. This means all women get free contraceptive coverage.
Administration officials emphasized that their rule requires insurance companies, not religious institutions, to “reach out directly and offer her contraceptive care free of charge. The religious institutions will not have to pay for it.” Additionally, women will not have to opt in or opt out of coverage because contraceptive care will be part of the basic package of benefits offered to everyone. That right there is the non-discrimination in services mandate of the Affordable Care Act, and it is not going away.
In fact, the accommodation is a better rule than what administration officials had earlier considered. “We are actually more comfortable having the insurance industry offer and market this to women than religious institutions,” said the White House, because insurers “understand how contraception works” to prevent unintended pregnancy and reduce health care costs. “This makes sense financially.”
It’s also a good solution for insurance companies. Offering contraception is cost-neutral. Insurance companies understand there are tremendous cost benefits in spacing pregnancies and limiting unintended pregnancies, not to mention other health benefits of contraception.
The rule will be applied to all but the original institutions that were exempted. Exempted institutions are those for which religious inculcation is their primary purpose, so churches. Exemption institutions will not be expanded to include hospitals and social services organizations, meaning women who happens to work at a hospital or some other organization that services people of all faiths in work that is not principally about religious inculcation will retain access to contraceptive coverage at no additional cost.
And it will absolutely not, according to White House officials, exempt private employers–an important distinction since the Bishops have made it clear their goal is eliminating all contraceptive coverage in health reform entirely.
Cecile Richards of Planned Parenthood Federation of America applauded the move, as did Sister Carol Keehan of the Catholic Health Association and NARAL Pro-Choice America. No word yet from the Bishops.