Nick Baumann

Nick Baumann

Senior Editor

Nick is based in our DC bureau, where he covers national politics and civil liberties issues. Nick has also written for The Economist, The Atlantic, the Washington Monthly, and Commonweal. Email tips and insights to nbaumann [at] motherjones [dot] com. You can also follow him on Facebook.

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Obama Didn't Cave on Birth Control

| Fri Feb. 10, 2012 12:56 PM EST
President Barack Obama speaks on his birth control policy Friday afternoon.

So did Barack Obama fold?

On Friday, after taking heavy criticism from Catholic groups and the political right over a regulation that would have required religiously-affiliated hospitals and universities (not churches) to offer their employees health insurance that covers birth control (with no copays), President Barack Obama went on live television to announce a shift. Now, insurance companies will have to offer employees of religious organizations the birth control coverage directly, without charging extra for it. (The details of the new birth control coverage plan are here.)

Some media outlets will no doubt call this a surrender by the president. But it's not. Here's why:

  • Everyone who was going to get birth control coverage before will still have access to it. Employees of Catholic schools and hospitals aren't always Catholic, and most sexually active women who aren't trying to get pregnant use birth control. The new rule will not allow the religious views of the leadership of religiously-affiliated organizations to dictate whether birth control is provided to their employees. The intent of the first version of the rule was to make birth control easier to get. The new rule will achieve that goal. "No woman's health should depend on who she is, where she works, or how much money she makes," Obama said in his statement. This policy ensures that.
  • The coverage will still feature no copayments. The insurance companies that are being required to offer birth control coverage directly to the employees of religious organizations will have to offer it for free. There will be no difference in cost between the plan that covers birth control and the plan that doesn't. The Obama administration justifies this by noting that studies suggest that covering birth control is cost-neutral or even saves money for health insurers because it's cheaper than pregnancy; it spaces out pregnancies, leading to healthier kids, and has other beneficial health effects.
  • The policy change still won't satisfy the US Conference of Catholic Bishops, which opposed the birth control provision from the start. It's not a cave if your opponents aren't getting what they actually want. What the bishops desire is for the entire birth control rule to be repealed. They believe that no employer—religious affiliation or not—should be required to offer birth control coverage. UPDATE, Friday 3:45 EST: The bishops have released a statement on the policy change that says they're "studying" it and it's a "first step in the right direction." It's unclear whether they'll ultimately retreat from their original position or simply say this attempt is a good step but not sufficient. 
  • The most important reproductive rights groups—Planned Parenthood, NARAL Pro-Choice America, the American Civil Liberties Union, and so on—all support the policy shift. You can bet that these politically savvy groups would be hollering to high heaven if they thought that women had been betrayed.
  • This whole scuffle was an intriguing policy dilemma, pitting women's health advocates versus faith leaders waving the banner of religious freedom. But with this move, Obama has demonstrated that it's possible to sidestep the red-hot politics of the dispute and work out a reasonable policy outcome that's backed by reproductive rights groups and the Catholic Health Association. It's not likely, though, that the social conservatives who have bashed Obama as an implacable foe of religious freedom will give it a rest.

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Details of the White House "Accommodation" on Birth Control Rule

| Fri Feb. 10, 2012 11:25 AM EST

The White House will change its policy requiring employers to offer health insurance coverage to their employees that covers birth control at no cost. Previously, religiously affiliated employers other than churches—such as Catholic universities and hospitals—would have been required to offer the insurance to their employees. Now, according to senior White House officials, if a religious employer has a religious objection to providing birth control coverage, insurance companies will be required to offer the insurance featuring free birth control directly to the employees.

Planned Parenthood and NARAL Pro-Choice America, the two most important reproductive rights organizations in the US, both support the White House's compromise, which ensures that women who work for religious organizations other than churches will have access to birth control without a copay. Sister Carol Keehan, the head of the Catholic Health Association, the main Catholic hospitals group, also supports the deal. Keehan and the CHA were key supporters of Obama's health care reform legislation, which the US Conference of Catholic Bishops opposed as written. 

Obama's plan is unlikely to win the support of the bishops. In September 2010, when the policy was first being developed, the USCCB wrote a letter opposing requiring any employer—not just religious ones—to offer birth control coverage. Anthony Picarello, the USCCB general counsel who signed the letter, told USA Today on Wednesday that the bishops still oppose the entire policy.

Picarello told USA Today the bishops are worried about the problems the law creates for "good Catholic business people who can't in good conscience cooperate with this," and noted that if he opened a Taco Bell, he'd be forced to offer birth control to his employees. Only something like Sen. Marco Rubio's (R-Fla.) "Religious Freedom Restoration Act"—which would allow any employer, not just religious ones, to cite a religious objection and thereby avoid covering birth control—is likely to satisfy the bishops on this front.

Here's the full text of the White House's fact sheet on its decision:

Catholic Bishops Want Entire Birth Control Rule Repealed, Not Just the Religious Exemption

| Thu Feb. 9, 2012 11:11 AM EST
"Now close your eyes and think of Rome."

The US Conference of Catholic Bishops, the national political lobby for the Catholic Church in America, has been waging war on President Barack Obama's new rule requiring health insurers to cover birth control at no cost to women. The religious exemption in the Obama rule allows churches an exemption to birth control coverage, but still requires religiously affiliated schools and hospitals to provide insurance to their employees that includes contraception without a co-payment.

The bishops claim that exemption is too narrow. But they don't just want the religious exemption widened. They want the whole policy repealed. (Never mind that most employers have been required to cover birth control for years.) This USA Today story sort of buries this fact, but at least it acknowledges it:  

The White House is "all talk, no action" on moving toward compromise, said Anthony Picarello, general counsel for the U.S. Conference of Catholic Bishops. "There has been a lot of talk in the last couple days about compromise, but it sounds to us like a way to turn down the heat, to placate people without doing anything in particular," Picarello said. "We're not going to do anything until this is fixed."

That means removing the provision from the health care law altogether, he said, not simply changing it for Catholic employers and their insurers. He cited the problem that would create for "good Catholic business people who can't in good conscience cooperate with this."

"If I quit this job and opened a Taco Bell, I'd be covered by the mandate," Picarello said.

So in short, the bishops want your Catholic boss to be able to decide whether or not you have to pay full freight for your birth control. Not coincidentally, Sen. Marco Rubio (R-Fla.) has a bill that would do just that.

The problem with this argument is that if taken to its logical extreme, your boss could claim religious exemptions for all sorts of health care issues, whether you worked at Catholic Charities, Taco Bell, or anywhere else. Christian Scientists generally don't believe that people need pharmaceutical medicine at all. Scientologists don't believe in psychiatry. If individual employers are allowed exemptions to the birth control coverage mandate, the law could quickly be rendered meaningless.

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