U.S. Clarifies Policy on Birth Control for Religious Groups
WASHINGTON — The Obama administration took another step on Friday to enforce a federal mandate for health insurance
coverage of contraceptives, announcing how the new requirement would
apply to the many Roman Catholic hospitals, universities and social
service agencies that insure themselves.
The coverage will be provided by the companies that review and pay claims — “third-party administrators” — or by “some other independent entity,” it said.
Kathleen Sebelius, the secretary of health and human services, said the government would guarantee women access to contraceptives “while accommodating religious liberty interests.”
The new proposal escalates the election-year fight over the administration’s birth control policy.
On Friday, the Department of Health and Human Services went a step further and said it would propose a similar requirement for group health plans sponsored by religious organizations that insure themselves.
“It’s a Washington accounting gimmick,” Representative Jeff Fortenberry, Republican of Nebraska, said Friday in an interview. “The administration is twisting itself in all directions to expand the ‘accommodation’ for faith-based institutions. Why is it the government’s role to decide who gets an accommodation? The White House is creating an unnecessary political firestorm.”
Mr. Fortenberry has introduced a bill to let certain employers and insurers opt out of the mandate for contraceptive coverage. More than 220 House members have signed on as co-sponsors.
Administration officials said that final rules for “self-insured employers” would be issued after the November elections but before Aug. 1, 2013, when a transition period is scheduled to end.
A self-insured employer often hires a third-party administrator to handle claims for its employees, in return for fees paid by the employer. The new Obama policy leaves two big questions unanswered:
Who will provide the money to pay the claims for contraceptive drugs and devices? Who will pay the fees normally paid by the employer?
Secretary Sebelius said the money could come from pharmaceutical companies, which sometimes provide discounts to favored customers by paying rebates on drugs. These drug rebates could be used to help pay for contraceptive coverage if a religious organization objects to providing such coverage to employees, she said in a notice to be published next week in the Federal Register.
Alternatively, Ms. Sebelius said, the federal Office of Personnel Management could encourage or require one or more private insurers to provide contraceptive coverage for people in a religious organization’s health plan. Under the 2010 health care law, the personnel office will sign contracts with at least two insurers to offer comprehensive coverage to individuals, families and small businesses in every state.
The administration on Friday also issued a final rule requiring coverage of contraceptives under student health plans offered by many colleges and universities. The requirement applies to health plans underwritten by private insurers like UnitedHealth and Blue Cross and Blue Shield. It does not apply to student health plans at colleges that serve as their own insurers.
“A self-funded student health plan cannot be included in this regulation without a change in law,” the administration said.
Sandra Fluke, a third-year law student at Georgetown University, created a stir last month when she spoke up in support of Mr. Obama’s birth control policy and lamented the fact that contraceptives were not covered under the student health plan there.
Ms. Fluke welcomed the new rule on Friday, but said she was disappointed that, under the Obama administration policy, “religiously affiliated schools and employers may delay a year before offering contraceptive coverage.” Ms. Fluke said colleges should not “delay what is now inevitable” and should provide contraceptive coverage as soon as possible.
In a letter to the president of Georgetown University, John J. DeGioia, 66 members of the law school faculty said Friday that the university should address Ms. Fluke’s concerns and consider providing contraceptive coverage in the student health plan.
“The current policy puts student health at risk,” said M. Gregg Bloche, a professor at the law school, “and with our Jesuit tradition, we should be concerned about that.”
The administration on Friday also issued new rules that will allow millions of people to qualify for Medicaid for the first time.
Cindy Mann, the federal official who supervises Medicaid, said the government would use a single application form to determine whether people qualify for Medicaid or for federal subsidies to help defray the cost of private health insurance.
Luke Sharrett for The New York Times
Kathleen Sebelius, secretary of health and human
services, testifying last week before a Senate Appropriations
subcommittee.
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In such cases, the administration said, female employees and students
will still have access to free coverage of contraceptives.
The coverage will be provided by the companies that review and pay claims — “third-party administrators” — or by “some other independent entity,” it said.
Kathleen Sebelius, the secretary of health and human services, said the government would guarantee women access to contraceptives “while accommodating religious liberty interests.”
The new proposal escalates the election-year fight over the administration’s birth control policy.
President Obama
had previously announced what he described as an “accommodation” for
religiously affiliated organizations that buy commercial insurance but
object, for religious reasons, to covering contraceptives and
sterilization procedures. In these cases, the White House said, the
insurer “will be required to provide contraception coverage to women free of charge.”
On Friday, the Department of Health and Human Services went a step further and said it would propose a similar requirement for group health plans sponsored by religious organizations that insure themselves.
The new proposal did not mollify Republicans in Congress.
“It’s a Washington accounting gimmick,” Representative Jeff Fortenberry, Republican of Nebraska, said Friday in an interview. “The administration is twisting itself in all directions to expand the ‘accommodation’ for faith-based institutions. Why is it the government’s role to decide who gets an accommodation? The White House is creating an unnecessary political firestorm.”
Mr. Fortenberry has introduced a bill to let certain employers and insurers opt out of the mandate for contraceptive coverage. More than 220 House members have signed on as co-sponsors.
The new proposal virtually guarantees that birth control will remain an
issue in the battle for the White House and Congress.
Administration officials said that final rules for “self-insured employers” would be issued after the November elections but before Aug. 1, 2013, when a transition period is scheduled to end.
A self-insured employer often hires a third-party administrator to handle claims for its employees, in return for fees paid by the employer. The new Obama policy leaves two big questions unanswered:
Who will provide the money to pay the claims for contraceptive drugs and devices? Who will pay the fees normally paid by the employer?
Secretary Sebelius said the money could come from pharmaceutical companies, which sometimes provide discounts to favored customers by paying rebates on drugs. These drug rebates could be used to help pay for contraceptive coverage if a religious organization objects to providing such coverage to employees, she said in a notice to be published next week in the Federal Register.
Alternatively, Ms. Sebelius said, the federal Office of Personnel Management could encourage or require one or more private insurers to provide contraceptive coverage for people in a religious organization’s health plan. Under the 2010 health care law, the personnel office will sign contracts with at least two insurers to offer comprehensive coverage to individuals, families and small businesses in every state.
The administration on Friday also issued a final rule requiring coverage of contraceptives under student health plans offered by many colleges and universities. The requirement applies to health plans underwritten by private insurers like UnitedHealth and Blue Cross and Blue Shield. It does not apply to student health plans at colleges that serve as their own insurers.
“A self-funded student health plan cannot be included in this regulation without a change in law,” the administration said.
Sandra Fluke, a third-year law student at Georgetown University, created a stir last month when she spoke up in support of Mr. Obama’s birth control policy and lamented the fact that contraceptives were not covered under the student health plan there.
Ms. Fluke welcomed the new rule on Friday, but said she was disappointed that, under the Obama administration policy, “religiously affiliated schools and employers may delay a year before offering contraceptive coverage.” Ms. Fluke said colleges should not “delay what is now inevitable” and should provide contraceptive coverage as soon as possible.
In a letter to the president of Georgetown University, John J. DeGioia, 66 members of the law school faculty said Friday that the university should address Ms. Fluke’s concerns and consider providing contraceptive coverage in the student health plan.
“The current policy puts student health at risk,” said M. Gregg Bloche, a professor at the law school, “and with our Jesuit tradition, we should be concerned about that.”
The administration on Friday also issued new rules that will allow millions of people to qualify for Medicaid for the first time.
Cindy Mann, the federal official who supervises Medicaid, said the government would use a single application form to determine whether people qualify for Medicaid or for federal subsidies to help defray the cost of private health insurance.
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