The Obama administration proposed yet another compromise on Friday in an effort to address the concerns of religious organizations that object to its policy requiring health insurance plans to cover contraceptives for women at no charge.
Kathleen Sebelius, the secretary of health and human services, said the proposal would guarantee free coverage of birth control “while respecting religious concerns."
Churches and religious organizations that object to providing birth control coverage on religious grounds would not have to pay for it.
Under the proposal, the administration said, “eligible organizations would not have to contract, arrange, pay or refer for any contraceptive coverage to which they object on religious grounds." Female employees of such organizations would receive contraceptive coverage through separate individual health insurance policies, without having to pay premiums or co-payments.
The proposed rule is somewhat ambiguous about exactly who would pay the costs. Insurers would bear the initial cost but would save money in the long run because they would “experience lower costs from improvements in women’s health and fewer childbirths," the administration said.
The White House has struggled for more than two years to balance its commitment to women’s rights and health care for all with the need to protect religious liberty. The contraception plan provoked a furor during last year’s presidential campaign, and the administration was forced to say it would provide an accommodation for groups with religious objections.
The new health care law generally requires employers to provide women with coverage at no cost for “preventive care and screenings." Under this provision, the administration says that most health plans must cover contraceptives for women free of charge.
Specifically, the administration says, employers must cover sterilization and the full range of contraceptive methods approved by the Food and Drug Administration, including emergency contraceptive pills, like those known as Ella and Plan B One-Step. Employers who do not provide such coverage will be subject to financial penalties.
The administration on Friday proposed a complicated arrangement to finance contraceptive coverage for employees of religious organizations that serve as their own insurers. The federal government would require health insurance companies to defray the cost indirectly, by paying higher fees for the privilege of selling health insurance to millions of Americans in new online markets run by the federal government.
The federal government was already planning to charge user fees to pay for operation of those marketplaces, known as insurance exchanges. The cost of the fees can be passed on to consumers.
Administration officials also proposed a new definition of “religious employers" who can be exempted from the requirement to provide contraceptive coverage. The exemption would be available to churches, other houses of worship and certain affiliated organizations. Under the original standard, a religious employer could not have qualified for the exemption if it employed or served large numbers of people of a different faith, as many Catholic hospitals, universities and social service agencies do.