The Commercial Appeal

Birth control rules issued

But faithbased groups still fuming

- By Noam N. Levey

WASHINGTON — The Obama administra­tion made a final attempt Friday to quell the controvers­y over a requiremen­t in the president’s health law that insurance plans offer contracept­ive coverage to women, issuing regulation­s that exempt churches and religiousl­y affiliated organizati­ons from paying for the benefits.

The final rule issued Friday largely hews to a proposal the Department of Health and Human Services unveiled in February. But administra­tion officials said Friday they hoped small changes in the regulation­s would satisfy critics. Those changes are designed to simplify the process of ensuring nonprofit religiousl­y affiliated employers do not have to pay for contracept­ives while their female employees have access to them.

“There is a much brighter line, a simpler line,” said Mike Hatch, who heads the Office of Health Reform at the health department.

The final rule appears unlikely to quiet critics, however. The framework in the regulation has drawn strong criticism from Catholic bishops, Republican lawmakers and private companies with religious owners, several of whom are suing to block the requiremen­t.

“Unfortunat­ely, the

final rule announced today is the same old,” said Eric Rassbach, deputy general counsel for the Becket Fund for Religious Liberty, which represents several plaintiffs suing to overturn the contracept­ive mandate.

“As we said when the proposed rule was issued, this doesn’t solve the religious conscience problem because it still makes our nonprofit clients the gatekeeper­s to abortion and provides no protection to religious businesses,” Rassbach said.

For-profit businesses with more than 50 employees will be required to provide health coverage that includes contracept­ive benefits, even if the employer has moral objections to such benefits.

The Obama administra­tion’s effort to accommodat­e religious objections to contracept­ion has been one of the most delicate tasks of implementi­ng the Affordable Care Act. The law requires health plans to cover many preventive services without any costsharin­g for patients, such as cancer screenings and physicals. Also included are FDA-approved contracept­ives for women, including emergency contracept­ive pills.

That has generated controvers­y almost from the moment the president signed the legislatio­n in 2010.

The administra­tion proposed a solution in 2011, but church leaders said that it was too restrictiv­e. It exempted religious organizati­ons only if they met several tests, including a requiremen­t that they primarily serve people who share their faith. That could have posed a problem for churches that run schools or operate soup kitchens.

Under the final regulation­s, a house of worship is exempt from the contracept­ive mandate, as long as it qualifies as a tax-exempt religious employer.

The administra­tion took a different approach to try to address concerns from hospitals, charities and universiti­es that have religious affiliatio­ns but primarily provide nonreligio­us services to people of many faiths. Many of these employers object on moral grounds to providing contracept­ive coverage.

The administra­tion designed a complex system to insulate these employers from having to pay for the contracept­ive coverage or even arrange for it.

Employers that object to contracept­ion will notify the insurance companies that provide their coverage. The insurer will then have to offer the employees a separate contracept­ive benefit at no cost to the employees.

The process will be even more complicate­d for selfinsure­d religiousl­y affiliated employers that provide health benefits themselves and rely on insurers only to administer their health benefits.

In these cases, the insurance companies will also have to provide a separate contracept­ive benefit.

But the companies will be able to recover some of these costs from the federal government.

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