The debate over President Barack Obama’s policy on contraceptive coverage is likely to persist, with the two sides struggling to frame the issue as either one over access to birth control or of religious freedom.
A compromise Obama offered last week that would force health insurers, instead of religious-affiliated charities, to pay for contraceptives for employees of those institutions may have moved him off the defensive.
Still, Republicans said it will be an election issue and vowed to push for a measure in Congress to repeal the policy, a vote that could come as early as this week.
Whoever is more successful at defining the dispute is likely to prevail with the electorate on the policy, pollsters and political strategists say.
“How it’s framed is very important,” said Terry Madonna, a political science professor and director of the Franklin & Marshall College poll in Lancaster, Pa. Access to contraception and equal treatment of women in workplace-benefit plans both resonate with college-educated women, he said.
Obama and supporters of his policy say women deserve a way to obtain contraceptive services free of charge and that the president’s revision of the rule should satisfy religious- affiliated institutions because it allows them to avoid paying directly for birth control.
Critics, including Republican presidential candidates and congressional leaders, as well as groups such as the United States Conference of Catholic Bishops, say the policy encroaches on the prerogatives of religious entities.
Among Americans aware of the issue, opinion is evenly divided even with sharp differences based on faith, gender and party: 48 percent support an exemption for religious-affiliated institutions, while 44 percent say they should be required to cover contraceptives, according to a poll conducted by the Pew Research Center Feb. 8-12. Obama announced the changes to his policy halfway through the poll, on Feb. 10, though the survey found little change in responses afterward.
Catholics, white evangelicals, Republicans and men, especially those age 50 and older, were more likely to back an exemption. Women, especially those under age 50, people with no religious affiliation, and Democrats were more likely to oppose an exception. The poll has a margin of error of plus or minus 3.5 percentage points among those who have heard about the federal rule.
Sen. Roy Blunt, a Missouri Republican, said the policy will have traction in the election campaign because it’s an example of the administration overreaching on health care and interfering with religious freedom. Blunt is proposing that those offering health plans be allowed to decline to provide services that are contrary to their religious beliefs.
Senate Majority Leader Harry Reid, a Nevada Democrat, said today he will allow a vote on a repeal of the contraceptives-coverage rule during debate on a pending highway measure, although he said Democrats probably will muster the votes to defeat it by tabling it.
One Senate Democratic leader said Blunt’s proposal is so expansive that any employer could utilize it to reject a host of health services on moral grounds.
“This amendment will allow any employer — a barber, a banker, a multinational corporation — to be given an exemption to not cover contraception or any essential preventive benefit for any religious or moral reason,” said Sen. Patty Murray of Washington.
NARAL Pro-Choice America began airing radio ads Monday in the battleground states of Colorado, Florida, Virginia, and Wisconsin, touting the policy as an example of Obama’s commitment to women. They say Republican lawmakers and presidential candidates who oppose the policy are extremists who want to limit access to birth control.
The Obama campaign team mentioned the contraception policy on a “Truth Team” website it introduced Monday as an online resource to respond to criticisms of the president’s record “and hold the eventual Republican nominee accountable.”
At the same time, a group of 44 conservative leaders, including Tony Perkins, president of the Family Research Council, and Jenny Beth Martin, co-founder of the Tea Party Patriots, issued individual statements of opposition in a “united front” to fight the policy.
John Feehery, a Republican strategist in Washington, said the controversy boosts Republican criticism that the 2010 health-care overhaul backed by Obama was an over-extension of government. “This helps chip away at that accomplishment,” Feehery said.
That message is delivered most effectively when religious groups such as the Catholic Church lead the campaign against the rule, he said. “Having them as the messenger is important to Republicans.”
The Conference of Catholic Bishops said in a blog posting Monday on its website that the group isn’t satisfied with Obama’s compromise and supports legislative efforts to repeal the policy. The group added that “the bishops did not pick this fight in an election year.”
Beth Shipp, NARAL’s political director, said female voters should be worried that Republicans, including presidential candidates Mitt Romney and Rick Santorum, want to take away their access to birth control.
“It’s not about religious freedom and liberty -- it never has been,” Shipp said. “It was about getting at the Affordable Care Act and trying to gut it piece by piece and about not wanting women to have access to contraception.”
In the NARAL ad, a pharmacist tells a woman her birth-control pills are free because of Obama. A narrator says, “We scored an important victory” for women “of all faiths, no matter where they work” and warns that “extremists” in Congress want to undo the benefit.
By announcing that insurers and not the religious employers will be required to offer and pay for the coverage, the president said he hoped to ease concerns of religious groups while keeping his commitment to broadly make contraceptives available to women.
“I understand some folks in Washington may want to treat this as another political wedge issue, but it shouldn’t be,” Obama said. “I certainly never saw it that way.”
An Obama campaign official who spoke on condition of anonymity said the campaign will continue to press the contraception decision as an accomplishment between now and November, through e-mails, at events and in outreach to women.
Out-of-pocket contraception costs do reduce birth-control use among women in financial difficulty even though it is more expensive to raise children, said Lawrence Finer, director of domestic research for the Guttmacher Institute, a nonprofit group that researches reproductive-health issues.
“In some instances, costs can be a barrier,” Finer said. “The co-pay on birth control pills is what needs to be paid now.”
To save money, one out of eight financially struggling women on birth control sometimes don’t use contraception, according to a 2009 survey of women with household income below $75,000 conducted by Guttmacher. Among women on the pill, a quarter of financially struggling ones reported inconsistent use to save money, the survey found.
Catholics constitute about 1 in 4 U.S. voters, according to exit polls. Yet Madonna, of Franklin & Marshall College, said that of a dozen or so battleground states that include Pennsylvania, many female swing voters “are college-educated women who tend to be more liberal on social issues and more fiscally conservative.”
“You find a fair number of college-educated women who, I think, will side with the president on this,” he said. “Particularly the way it was framed as, ‘we compromised,’ making the point it’s still available to women without making the church pay for it.”
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