The White House did a quick about-face on Friday after a firestorm of controversy over birth control regulations, publishing a requirement that insurance companies pick up the tab for women's contraceptives if religious employers object to paying for them.
President Obama complained that the issue had become a political football, and his senior aides characterized the move as an accommodation rather than a compromise. But while the move pleased allies, it did not appease Republicans in Congress and conservative Catholic organizations expressed suspicion.
"Under the rule, women will still have access to free preventive care that includes contraceptive services -– no matter where they work," President Obama said on Friday.
"But if a woman’s employer is a charity or a hospital that has a religious objection to providing contraceptive services as part of their health plan, the insurance company -– not the hospital, not the charity -– will be required to reach out and offer the woman contraceptive care free of charge, without co-pays and without hassles."
The much-awaited compromise is meant to appease religious institutions that say federal rules on contraception violate their religious beliefs.
“Insurance companies will be required to provide contraception coverage to these women free of charge,” the White House said in a statement. "Religious organizations will not have to provide contraceptive coverage or refer their employees to organizations that provide contraception," it added. "Religious organizations will not be required to subsidize the cost of contraception."
A senior administration official said that the plan was not a compromise. "This is an accommodation," the official said. "We have been working on this policy for some time."
But the president said recent pressure forced him to speed things up.
"It became clear that spending months hammering out a solution was not going to be an option, that we needed to move this faster. So last week, I directed the Department of Health and Human Services to speed up the process that had already been envisioned," President Obama said.
"We weren’t going to spend a year doing this; we're going to spend a week or two doing this."
HHS Secretary Kathleen Sebelius acknowledged that the controversy forced the administration to make quick changes. "I think the -- a lot of the public outcry was urging us to find an appropriate balance," Sebelius told CNN.
Republicans in Congress have been piling on the administration for days, denouncing the plan to ensure that women get health insurance coverage for contraception free of charge. The administration had offered an exemption to purely religious employers and gave religious-affiliated groups, such as Catholic hospitals, a year to come up with ways to provide the coverage to employees.
The administration official said the White House consulted stakeholders but did not give details of who these stakeholders were. Catholic institutions said they were told of the change but not consulted about it. “While there may be an openness to respond to some of our concerns, we reserve judgment on the details until we have them,” said Cardinal-designate Timothy Dolan, president of the United States Conference of Catholic Bishops.
The proposed rule may put pressure on insurance companies.
Senior administration officials argued that because contraceptives can prevent costly, unwanted pregnancies—one birth alone can cost $12,000, said a White House staffer—that having insurance companies pick up the tab would be cost-neutral.
Insurance companies are sure to complain about the new rule, however, especially during the comment period to the Health and Human Services Department. But most voters don’t love their insurance companies, and those complaints might fall on deaf ears.
It is unclear how religious organizations will accept the news. Under the proposed rule, they will still be paying a piece of employee premiums to an insurance plan that does in fact cover contraception. It’s just that their premium dollars cannot be used to cover the cost of the birth control.
The ACLU and some women's groups immediately approved the plan. “We know that Catholics in the pews support this position, as 98 percent of Catholic women use contraception and 58 percent of Catholics support insurance coverage for contraception,” the ACLU's Louise Melling said in a statement. “The ACLU will defend the health and religious liberty needs of employees and hopes the intense recent debate is now be behind us.”
Judy Waxman, the vice president for health and reproductive rights at the National Women’s Law Center, said that her organization is pleased with the outcome. “There are a number of open questions, but we are very hopeful,” she said.
Margot Sanger-Katz and Sophie Quinton contributed