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Religious Group Employers Required to Offer Contraceptive Coverage

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Employers whose religious beliefs are the basis of them not offering contraception to employees as a part of their insurance plan may find themselves required to do otherwise by the federal government after August 2013, according to a new rule.

In its final rule on preventive health services care, the Department of Health and Human Services (HHS) has decided to give nonprofit employers who, based on religious beliefs, do not currently provide contraceptive coverage in their insurance plan, an extra year to comply with a new rule that will require most health insurance plans to cover contraceptive services as part of preventive care for women, without charging a co-pay, co-insurance or a deductible. 

But they must comply after that, which is likely to cause a firestorm of protest among some groups, given how controversial this debate has been. Some religious beliefs hold that medical or other contraception is a violation of religious tenets.

The Catholic bishops of the United States have already called the decision “literally unconscionable,” and said that now sterilization, abortifacients and contraception are to be included in virtually all health plans.

“In effect, the president is saying we have a year to figure out how to violate our consciences,” said Cardinal-designate Timothy M. Dolan, archbishop of New York and president of the U.S. Conference of Catholic Bishops.

The final rule will have no impact, however, on the protections that existing conscience laws and regulations give to health care providers themselves.

HHS acted after evaluating comments, but did not let the religious nonprofits off the hook. Nonprofits have until Aug. 1, 2013, to comply with the new law. 

Employers wishing to take advantage of the additional year must certify that they qualify for the delayed implementation. In the former interim rule, non-profit religious employers that offered insurance to their employees were given the choice of whether or not to cover contraceptive services.

“This additional year will allow these organizations more time and flexibility to adapt to this new rule,” HHS Secretary Kathleen Sebelius stated. 

HHS said that the final rule on preventive health services designed ensures that women with health insurance coverage will have access to the full range of the Institute of Medicine’s recommended preventive services, including all FDA-approved forms of contraception. 

Beginning Aug. 1, 2012, most new and renewed health plans will be required to cover these services without cost sharing.  

HHS said that the  rule is consistent with the laws in a majority of states which already require contraception coverage in health plans, and includes the exemption in the interim final rule allowing certain religious organizations not to provide contraception coverage. 

The required services are based on recommendations from the Institute of Medicine (IOM), Washington. In addition to services such as well-woman visits and contraception, group plans and individual policies must cover screening for gestational diabetes, sexually transmitted infection counseling, breastfeeding supplies and counseling, and domestic violence screening and counseling, HHS officials said in August.

HHS went out of its way to justify its decision, saying health was uppermost in its thought process.

“Scientists have abundant evidence that birth control has significant health benefits for women and their families, it is documented to significantly reduce health costs, and is the most commonly taken drug in America by young and middle-aged women,” Sebelius stated.  

“This decision was made after very careful consideration, including the important concerns some have raised about religious liberty. I believe this proposal strikes the appropriate balance between respecting religious freedom and increasing access to important preventive services. The administration remains fully committed to its partnerships with faith-based organizations, which promote healthy communities and serve the common good,” she stated.