This Friday, the Obama Administration through the Department of Health and Human Services issued a final rule for ensuring that employees religiously affiliated institutions would receive insurance coverage for birth control. As a compromise between the beliefs of religious employers and preventative services for women, the administration allowed religious employers to opt out paying directly for employees' contraceptives, but required that the services be provided through their health policy.
Women employees and students of religious employers will receive contraception with no additional cost-sharing, such as co-pays, receiving the same benefits as employees and students of organizations without a religious affiliation. Health insurers or third-party insurance providers are required to notify employees and students about birth control benefits and provide direct payments that cover the cost of contraceptive services.
Offering birth control and contraceptive counseling has been opposed by a number of religious groups since the debate over health reform begain in 2009, saying that the mandate for employers to offer such services was a violation of religious freedoms. Certain denominations, most notably the Catholic church as represented by the U.S. Conference of Catholic Bishops, equate contraception, such as the morning-after pill or condom use, with abortion.
"The health care law guarantees millions of women access to recommended preventive services at no cost," said Health and Human Services Secretary Kathleen Sebelius. "Today's announcement reinforces our commitment to respect the concerns of houses of worship and other non-profit religious organizations that object to contraceptive coverage, while helping to ensure that women get the care they need, regardless of where they work."
Expanded access for women's services, including well-woman visits, sexually transmitted infection screening and counseling, contraception and contraceptive counseling, with cost-sharing for women, was required of employers and health plans as part of the Affordable Care Act since August 2012, by the recommendation of the independent Institute of Medicine. Over 99 percent of U.S. women have relied on birth control at some point in their lifetime, but more than half between ages 18-34 have struggled to afford it.
For proponents of women's health services and increased access to contraception, the rule has been lauded as a victory.
"Birth control is basic healthcare for women, and this policy treats it like any other kind of preventive care," said Cecile Roberts president of Planned Parenthood.
It's unclear whether religious groups who opposed the original implementation of the rule will be satisfied with the compromise.
"We have received and started to review the 110-page final rule," said New York Cardinal Timothy Dolan said in a statement. "It will require more careful analysis. We will provide a fuller statement when that analysis is complete."
Although the rule officially begins on August 1, the Department of Health and Human Services is allowing a 5-month adjustment period, requiring health insurers to enact the benefit by January 1.
The number of employees and students affected by the new rule is significant. According to the U.S. Department of Education, Catholic colleges educated more than 940,000 students during the 2011-2012 year, many of whom are supported by student health insurance plans administered by colleges. According to Catholics for Choice, here are 611 Catholic hospitals in the U.S., representing 12 percent of total U.S. hospitals, employing over 600,000 people.
These figures do not include employees of Catholic nonprofits, K-12 schools, or churches, or employees, nor do they include employees and students of other religious denominations that oppose contraception.
However, these numbers do include a number of men and women who do not share the same views on contraception as their employers. President Obama has said it's "not fair" for Catholic institutions to deny their female employees who many not share their views access to birth control.
For more information on women's preventive services coverage and non-profit religious organizations, visit the Centers for Medicare and Medicaid Services' FAQ.