Controversy Surrounds HHS Contraception Mandate

In  the face of criticism over the administration’s decision to require employers to provide health coverage for contraception, advisors to President Obama signaled yesterday that the administration continues to “work with” religious organizations that object to the impending requirement. 

“We certainly don’t want to abridge anyone’s religious freedoms, so we’re going to look for a way to move forward that both guarantees women that basic preventative care that they need and respects the prerogatives of religious institutions,” stated Obama campaign advisor David Axelrod yesterday on MSNBC’s “Morning Joe” show.


White House Press Secretary Jay Carney also noted yesterday that President Obama “takes seriously the religious convictions that are behind the concerns that have been raised.”   In his daily press briefing, Carney stated that the administration pledges “to continue to work with religious groups to try to allay their concerns as we implement a policy that provides this coverage to women across the country.”


The administration’s response comes in the face of heated criticisms from religious leaders and Republicans over a statement announced last month by the Department of Health and Human Services (HHS) that it will require full insurance coverage of women’s preventive health services. The HHS’s final rule will closely resemble an interim final rule the agency issued last summer, in that it will retain a controversial provision requiring employers to pay for insurance coverage of all FDA-approved contraceptives.


The Affordable Care Act of 2010 required HHS to identify and create a rule mandating full coverage of a set of preventive health services targeted specifically to women. The services enumerated in the rule track recommendations from an HHS-commissioned Institute of Medicine (IOM) report. Under the HHS rule, health insurance issuers must provide coverage for interventions such as HPV testing, lactation counseling, and contraception – all without co-pays, deductibles, or other cost-sharing measures.


According to the IOM report, it is well-documented that contraception use reduces the rate of unintended pregnancies and multiple closely-spaced births, both of which are associated with poor health outcomes for mothers and their children. Contraception is currently covered by Medicaid, all federal employee health insurance plans, and 85% of large group health insurance plans in the US, but most of these plans currently require cost-sharing.  The Obama Adminstration notes that more than half the states have requirements that contraception coverage be included in health plans.


The HHS rule will include a conscience exemption which would apply primarily to houses of worship, but not to religiously-affiliated institutions such as universities and hospitals. Such religious institutions that do not qualify for the exemption may defer compliance for one additional year after the rule goes into effect.


Women’s health advocates and reproductive rights groups, such as the National Latina Institute for Reproductive Health and Planned Parenthood, have praised the rule. “This decision is grounded in sound medical science and health policy and protects access to affordable birth control for millions of women,” said Planned Parenthood in a statement.


However, religious groups such as the National Association of Evangelicals criticized the rule for violating freedom of religion. Timothy M. Dolan, the president of the U.S. Conference of Catholic Bishops, indicated that the group may raise legal challenges to the rule, stating that “Catholic bishops are committed to working with our fellow Americans to reform the law and change this unjust regulation.”


Republican presidential candidates have denounced the rule. Mitt Romney’s campaign has created an online website to solicit opposition to the HHS decision. Rick Santorum has condemned the Obama Aministration for what he perceives to be its “hostile” stance toward religioun.


HHS Secretary Kathleen Sebelius responded to the recent criticism in an op-ed in Monday’s USA Today explaining that her agency’s rule aims to “strike the right balance between respecting religious beliefs and increasing women’s access to critical preventive health services.”


Speaker of the House John Boehner (R-OH) today pledged congressional action to overturn the HHS rule if the administration does not reconsider.

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