In­sur­ers get the tab

Pro­posed rules ad­dress con­tra­cep­tive con­cerns

Modern Healthcare - - LATE NEWS - Rich Daly

The Obama ad­min­is­tra­tion tried again to re­solve the con­tro­versy over manda­tory em­ployer cov­er­age of birth con­trol, ster­il­iza­tion and post-fer­til­iza­tion drugs by hav­ing in­sur­ers pick up the costs.

In a new set of pro­posed rules is­sued by HHS and the Trea­sury and La­bor de­part­ments, of­fi­cials sought to ad­dress some em­ploy­ers’ re­li­gious ob­jec­tions to cov­er­ing health ser­vices that vi­o­late their core be­liefs by re­quir­ing in­surance com­pa­nies to cover the full cost of such ser­vices for qual­i­fy­ing or­ga­ni­za­tions. In­surance com­pa­nies that in­cur the cost of pro­vid­ing such cov­er­age would re­ceive a re­duc­tion in the fee they will pay for plans that are sold on the up­com­ing fed­er­ally run health in­surance ex­changes.

The new rules are the lat­est ef­fort to re­solve a con­tro­versy that erupted in Fe­bru­ary 2012 when the Obama ad­min­is­tra­tion first pro­posed de­tails of the birth con­trol cov­er­age em­ploy­ers were re­quired to pro­vide as a “pre­ven­tive ser­vice” un­der the 2010 health­care over­haul.

Many Ro­man Catholic hos­pi­tals and univer­si­ties ob­jected that they did not ap­pear to qual­ify for an ex­cep­tion to of­fer­ing cov­er­age for birth con­trol, the use of which runs counter to Catholic mo­ral teach­ings.

The pro­posed rule would re­quire not-for­profit re­li­gious or­ga­ni­za­tions to self-cer­tify that they have re­li­gious ob­jec­tions, sub­mit that in­for­ma­tion to their in­surer and the in­surer would have to ob­tain a sep­a­rate birth con­trol-only pol­icy for any of its plan mem­bers that wanted such cov­er­age.

In the case of self-in­sured plans used by many re­li­gious hos­pi­tals, the rule would re­quire any third-party ad­min­is­tra­tor to ob­tain and pro­vide such poli­cies for any plan mem­bers who wanted it. There was no pro­vi­sion for self-in­sured re­li­gious em­ploy­ers with- out third-party ad­min­is­tra­tors.

The highly con­tro­ver­sial birth con­trol rules elicited more than 200,000 com­ments, ac­cord­ing to HHS. The new pro­posed rules are open for pub­lic com­ment through April 8. A fi­nal rule is ex­pected “some­time this sum­mer,” an HHS of­fi­cial said.

Car­di­nal Ti­mothy Dolan of New York, pres­i­dent of the United States Con­fer­ence of Catholic Bish­ops, said his or­ga­ni­za­tion will “study the pro­posed reg­u­la­tions closely” and is­sue com­ments later. The Catholic Health As­so­ci­a­tion sim­i­larly is study­ing the pro­posed rule, ac­cord­ing to a spokesman, and did not plan an im­me­di­ate re­sponse to its spe­cific pro­vi­sions.

HHS of­fi­cials de­clined to ad­dress whether the pro­posed rule would have any ef­fect on the 44 le­gal chal­lenges that the ear­lier HHS rules on birth con­trol cov­er­age had spawned.

The rule could have the big­gest con­se­quences for for-profit em­ploy­ers be­cause it bars them from seek­ing any ex­emp­tion, re­gard­less of the re­li­gious be­liefs of own­ers or em­ploy­ees. Among the 14 for-profit em­ploy­ers that are su­ing HHS over the man­date, 10 have re­ceived in­junc­tive re­lief, ac­cord­ing to the Becket Fund for Re­li­gious Lib­erty, which is rep­re­sent­ing many of those plain­tiffs.

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