February 10, 2012
Obama Acts to Calm Furor on Birth Control Coverage Rule
By HELENE COOPER, NY TIMES
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WASHINGTON — President Obama, seeking to dampen a runaway political furor over birth control and religious liberty, unveiled a plan on Friday that is meant to calm the right’s ire about a new administration rule that would require health insurance plans — including those offered by Roman Catholic hospitals, universities and charities — to provide free birth control to female employees.

Casting himself as both “a citizen and a Christian” trying to balance individual liberty versus public health, Mr. Obama announced what administration officials called an “accommodation” that they said sought to demonstrate respect for religious beliefs. It will be similar to the path taken in several other states — particularly Hawaii — that have similar rules, but would require that insurance companies, and not religious institutions, offer contraceptive coverage at no cost.

“Religious liberty will be protected, and a law that requires free preventive care will not discriminate against women,” Mr. Obama told reporters in the White House briefing room. He said the “political football” his foes were making of the new rule prompted him to speed up work on a solution. “It became clear that spending months hammering a solution was not going to be an option.”

But administration officials also acknowledged that the revision announced Friday would most likely fail to mollify the Catholic bishops who have waged war against the rule or, for that matter, Republicans in Congress and on the presidential campaign trail who have joined the fight. At most, the compromise could potentially help the president shore up support among wavering Democrats, who have also expressed doubt about the rule, along with more liberal religious organizations and charities, who oppose the rule but not as vehemently as the Catholic leadership.

In a statement, Archbishop Timothy M. Dolan of New York, the president of the United States Conference of Catholic Bishops, called the move a “step in the right direction,” but said the bishops would reserve judgment on the plan until they had the details.

The administration plan most closely resembles Hawaii’s, in which employees at religious institutions whose health insurance plans do not offer free contraception can get birth control through side benefits. The difference, though, is that whereas in Hawaii the employees nominally pay for the benefits, the Obama proposal would shift the cost to insurers. Administration officials hope that insurers will not object because in the long run, they argue, contraceptives end up saving more money than they cost because they prevent unwanted pregnancies.

The administration’s move won an important endorsement from Sister Carol Keehan, president and chief executive officer of the Catholic Health Association of the United States, whose support the White House sees as essential to show that the policy is backed by some religious organizations. In fact, Sister Carol’s endorsement was so important that Mr. Obama called her Friday morning — along with Archbishop Timothy M. Dolan of New York and Cecile Richards, the president of Planned Parenthood — to inform her of the compromise.

“The Catholic Health Association is very pleased with the White House announcement that a resolution has been reached that protects the religious liberty and conscience rights of Catholic institutions,” Sister Carol said in a statement. “The framework developed has responded to the issues we identified that needed to be fixed.”

Abortion rights groups also seemed open to the White House shift and blamed the controversy on conservative efforts to undermine the president.

“We’re reassured that it appears that no woman, no matter where she works, will lose birth control coverage, but it’s outrageous and disheartening that this important step forward for women became a target of the far-right,” said Stephanie Schriock, president of Emily’s List.

Nancy Keenan, president of Naral Pro-Choice America, said the Obama administration’s action represented a reaffirmation of the commitment to ensuring contraceptive coverage. “Unfortunately, some opponents of contraception may not be satisfied,” she said.

The administration announced the birth-control rule last month, and since then, Republican presidential candidates and conservative leaders have sought to frame it as an example of the administration’s insensitivity to religious beliefs, prompting Mr. Obama’s aides to explore ways to make it more palatable to religious-affiliated institutions, perhaps by allowing some employers to make side insurance plans available that are not directly paid for by the institutions.

Statement by Cecile Richards, President of Planned Parenthood Federation of America, on Obama Administration Announcement on Birth Control Coverage Benefit:
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“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.

“We believe the compliance mechanism does not compromise a woman’s ability to access these critical birth control benefits.

“However 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.

“The individual rights and liberties of all women and all employees in accessing basic preventive health care is our fundamental concern.

“Planned Parenthood continues to believe that those institutions who serve the broad public, employ the broad public, and receive taxpayer dollars, should be required to follow the same rules as everyone else, including providing birth control coverage and information.

“As a trusted health care provider to one in five women, Planned Parenthood’s priority is increasing access to preventive health care. This birth control coverage benefit does just that.

“The birth control benefit underscores the fact that birth control is basic health care, and is fundamental to improving women’s health and the health of their families.

“That’s why women have consistently applauded the Obama administration for one of the greatest expansions for women’s health in decades.

“Unfortunately there are significant and immediate threats to women’s health and access to birth control in the House and Senate that would completely take away access to birth control and severely undermine women’s health.

“One bill, the Rubio-Manchin bill, would allow any business or corporation, on the basis of personal religious belief or moral conviction, to take away birth control coverage from their employees.

“Employers should not be allowed to impose their personal beliefs on employees regarding birth control coverage or basic health care.

“Another bill, sponsored by Senator Blunt (R-MO), would drastically undermine women’s health and allow any employer or health plan to refuse to cover any health care service they object to on religious or moral grounds.

“That’s why Planned Parenthood, and women across the country, won’t let up for one minute in our fight to protect the birth control benefit and women’s health.”

Planned Parenthood is the nation’s leading sexual and reproductive health care provider and advocate. We believe that everyone has the right to choose when or whether to have a child, and that every child should be wanted and loved. Planned Parenthood affiliates operate nearly 800 health centers nationwide, providing medical services and sexuality education for millions of women, men, and teenagers each year. We also work with allies worldwide to ensure that all women and men have the right and the means to meet their sexual and reproductive health care needs.

Contacts
Planned Parenthood Media Office, 212-261-4433

February 10, 2012
N.Y. Law on Contraceptives Already in Place, and Catholic Institutions Comply
By JOSEPH BERGER, NY TIMES
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Although Archbishop Timothy M. Dolan of New York has been leading the national fight against requiring Roman Catholic hospitals, universities and charities to cover birth control in their health insurance plans for employees and students, some Catholic institutions in his own diocese and others throughout New York State have for 10 years been complying with state law mandating precisely that coverage.

The state began requiring contraception coverage in 2002, and Catholic institutions, after losing a court battle over the issue, have followed the law. Historically Catholic institutions like Fordham University, which is run by a lay board of trustees in the tradition of the Jesuit religious order, provide contraception coverage for employees and students.

Fordham, which has 15,000 undergraduate and graduate students, seeks to comply with Catholic teaching by prohibiting its student health center from prescribing or dispensing birth control pills unless they are used for conditions like severe acne or endometriosis, according to Bob Howe, Fordham’s director of communications. Students who seek birth control pills to prevent pregnancies must obtain prescriptions from a private doctor or a service like Planned Parenthood, and the college’s insurance carrier will then cover the pills under its standard reimbursement schedule.

“We currently follow New York State law,” Mr. Howe said. “For employees and students, we provide insurance coverage that includes contraception. That’s the law.”

New York is one of the 28 states that require insurance companies to cover contraception. According to the White House, Colorado, Georgia and Wisconsin have no exemptions from that requirement, while California, New York and North Carolina have limited religious exemptions, identical to the limited exemptions the Obama administration proposed to put in place nationally.

Joseph Zwilling, a spokesman for the Archdiocese of New York, referred questions about the archdiocese’s practices to Dennis Poust, a spokesman for the New York State Catholic Conference, who did not immediately return a call. But Mr. Poust was quoted in The Buffalo News as saying of the state’s requirement: “In many cases, there was no other choice but to comply under protest. None of it is voluntary. It is all under duress.”

There are no longer any Catholic hospitals in New York City; St. Vincent’s in Greenwich Village closed in 2010, and Mary Immaculate Hospital in Jamaica, Queens, closed in 2009. A spokesman for Catholic Health Services of Long Island, which administers six hospitals, including St. Francis in Roslyn and Good Samaritan in West Islip, said, “It is the policy of Catholic Health Services not to comment on political issues.”

Representatives of several other Catholic institutions in the region seemed leery about discussing how their insurance plans operated.

“The college’s institutional policies and practices are consistent with Catholic teaching,” said Lenore Carpinelli, director of college relations for the College of New Rochelle, which was founded in Westchester County in 1904 by the Ursuline Sisters as the first college in the state for Catholic women. “We will be reviewing and evaluating the new regulations respectful of our commitment to our Ursuline Catholic mission and identity.”

February 15, 2012
Self-Insured Complicate Health Deal
By KATIE THOMAS, NY TIMES
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The Obama administration thought it had found a way to ease mounting objections to a requirement in the new health care act that all employers — including religiously affiliated hospitals and universities — offer coverage for birth control to women free of charge.

It would make the insurers cover the costs, rather than the organizations themselves.

But the administration announced the compromise plan before it had figured out how to address one conspicuous point: Like most large employers, many religiously affiliated organizations choose to insure themselves rather than hire an outside company to assume the risk.

Now, the organizations are trying to determine how to reconcile their objections to offering birth control on religious grounds with their role as insurers — or whether there can be any reconciliation at all. And the administration still cannot put the thorny issue to rest.

“We’re all kind of waiting and seeing,” said Jim Liske, chief executive of the Prison Fellowship, a Christian charity that insures itself and objects to offering the morning-after pill to its employees.

The administration has remained mostly silent on how self-insured institutions will be treated, other than to say that the details will be worked out in meetings with religious leaders in the days and weeks to come.

“This policy will be developed collaboratively so that the ultimate outcome works for religious employers, their workers and the public,” an administration official said Wednesday.

But some expressed skepticism that any satisfactory solution could be reached. “That’s quite a trick,” said Richard M. Doerflinger, associate director of “pro-life activities” at the United States Conference of Catholic Bishops, which has been among the most vocal critics of the birth control mandate.

“Putting the obligation on the insurer and not the employer doesn’t help much if they are the same person,” he said.

The Obama administration announced in January that it would require most health insurance plans to cover contraceptives for women free of charge as part of putting the federal health care law in place. Although the rule allowed churches to opt out for religious reasons, it did not extend the exemption to religious-affiliated institutions like hospitals or universities. The compromise plan, presented last Friday, has been embraced by some Catholic groups but opposed by others.

Nicholas P. Cafardi, dean emeritus and professor of law at Duquesne University, a Catholic institution, said that President Obama gave the bishops exactly what they asked for.

“The only serious issue left is self-insurance,” he said Wednesday on a conference call with reporters. “But the Obama administration has said it wants to work with these organizations so they’re not required to violate their conscience. I’m sure they mean that in good faith.”

Employers that self-insure provide health insurance directly to employees, paying the health care claims of their workers. Large employers often choose to self-insure because they can spread the risk across hundreds or thousands of workers. The option is often more economical and can allow an organization to tailor its plan to the specific needs of its employees. Many such employers contract with an insurance company to administer the plan.

Nationwide, 60 percent of workers with health insurance were covered by a self-funded plan in 2011, according to the Kaiser Family Foundation’s annual survey of employer health benefits. Among large employers, the number is even higher. Eighty-two percent of covered workers at companies of more than 200 employees had self-funded plans.

Insurance industry experts and Catholic groups said they did not know how many religiously affiliated organizations self-insure, but they said the number was likely to mirror the national trend. Many of the organizations are large employers, including hospital systems and universities.

Several religiously affiliated organizations already offer coverage for contraceptives to their workers, often to comply with state birth control mandates. Among these are Dignity Health, which was affiliated with the Catholic Church until this year, and Fordham University, which is run in the tradition of the Jesuit religious order.

In a curious twist, several Catholic organizations have chosen to self-insure in recent years to avoid the requirements of the state mandates, said Michael Galligan-Stierle, president of the Association of Catholic Colleges and Universities.

“There’s been a promise to have a conversation, but we haven’t heard about when it’s going to be,” he said. “We’re waiting for that.”

Now those who self-insure say they worry that they will find themselves caught between following the law and following their consciences.

“It seems to me that they’ve given a pretty clear signal that we are going to have to do something different,” said Mr. Liske, of the Prison Fellowship, which employs 200 workers, 110 of them women.

The organization views the morning-after pill as a form of abortion, which it opposes. And although Mr. Liske said he was heartened that the administration said it would work with groups like his to reach a solution, “anything that would put us in a situation where we would be directly or indirectly funding abortions would not be acceptable to us.”

One interest group that is likely to keep a low profile in the public debate is the insurance companies. “They don’t want to get in the middle of this firestorm,” said Robert Laszewski, a health care industry consultant and former insurance executive. “You can’t please anybody. Who do you want to offend — women’s health advocates or the Catholic Church?”

Reed Abelson and Laurie Goodstein contributed reporting.