The Obama administration signaled Friday it's willing to help insurance companies offset the cost of providing free birth control to women working at church-affiliated institutions like hospitals and colleges.
By finding a way to make the middlemen whole, the administration may be able to extricate itself from an unexpected political furor over birth control that has mobilized partisans across the political spectrum a half-century after the advent of the pill.
A 32-page regulatory proposal unveiled Friday offered options for providing free birth control to women whose employers object to contraception on religious grounds. The government now classifies birth control as preventive care, and President Barack Obama's health care law requires health plans to cover prevention at no cost to the consumer.
Churches, synagogues, mosques and other institutions whose primary purpose is to propagate faith are exempt from the mandate. But when the administration sought to impose the requirement on religious nonprofits serving the public, it triggered a backlash. That forced President Barack Obama himself to offer a compromise: insurers, not the religious employers would bear the responsibility.
Friday's proposal lists options for carrying out the president's compromise without forcing insurers to bear the whole cost — or tempting them to engineer backdoor maneuvers to recoup money from religious institutions that object to birth control.
Administration officials are seeking public comment for 90 days and will sift the responses before making any final decision. Reflecting the sensitivity of the issue, officials spoke only on condition of anonymity.
"Our general principle is that we want to maintain the posture that a religious organization that objects to paying for contraception, won't," said an official who briefed reporters.
The basic idea is to use the levers of government policy to reimburse the insurance companies, for example, by providing them credits against fees they would have to pay under another provision of the health care law. Finding a balance will be tricky because of the complexity of the health care law.
Women's groups were generally supportive of the administration's latest move, although it seemed unlikely to please religious conservatives. Catholic bishops have taken a forceful stand opposing the birth control requirement as an affront to religious freedom.
Sister Mary Ann Walsh, a spokeswoman for the U.S. Conference of Catholic Bishops, questioned the timing of the announcement, late Friday on the eve of St. Patrick's Day festivities. She said church leaders will begin studying the proposal immediately, "but now is too soon to know what it actually says."
Administration officials say they don't expect an endorsement from the bishops, but they are hoping the accommodation will work for hospitals, colleges and charitable organizations.
The head of the Catholic Health Association, a trade group representing more than 600 hospitals around the country, also withheld judgment.
"We have to spend time reviewing it," said Sister Carol Keehan.
Her group provided critical support for passage of Obama's health care law through Congress, publicly breaking with the bishops in a dispute over the legislations restrictions on taxpayer funding for abortions.
The insurance industry also said it would need more time to study the proposals.
Additionally, the administration released new rules for student health plans on Friday. Generally, the requirements will lead to more robust coverage. But because of a previously unforeseen gap in federal legislation, not all student plans will have to upgrade. Plans sponsored by religious colleges would be given more time to comply with the birth control coverage provisions.
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