Insurers get the tab
Proposed rules address contraceptive concerns
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.