Today, the White House did the right thing for women, public health and human rights. Despite deep concerns, including my own, based on what transpired in the past under health reform, the White House has decided on a plan to address the birth control mandate that will enable women to get contraceptive coverage directly through their insurance plans without having to buy a rider or a second plan, and without having to negotiate with or through religious entities or administrations that are hostile to primary reproductive health care, including but not limited to contraception.
Under this plan, every insurance company will be obligated to provide contraceptive coverage. Administration officials stated that a woman's insurance company "will be required to reach out directly and offer her contraceptive care free of charge. The religious institutions will not have to pay for it."
Moreover, women will not have to opt in or out; contraceptive care will be part of the basic package of benefits offered to everyone. Contraceptive care will simply be "part of the bundle of services that all insurance companies are required to offer," said a White House official.
"We are actually more comfortable having the insurance industry offer and market this to women than religious institutions," said the White House official because they "understand how contraception works" to prevent unintended pregnancy and reduce health care costs. "This makes sense financially."
The way it works is this: Insurers will create policy not including contraceptive coverage in the contract for religious organizations that object. Second, the same insurance company must simultaneously offer contraceptive coverage to all employees, and cannot charge an additional premium. This provides free contraceptive coverage to women. The reason this works for insurance companies is because offering contraception is cost-neutral; companies realize the tremendous cost benefits of spacing pregnancies, and limiting unintended pregnancies, planned pregnancies and health benefits of contraception.
White House officials, speaking on background, said that the accommodation--which they stress is not a compromise--fulfills two principals. One is that all women will have access to the health care they need no matter where they work; their access to contraceptive services is guaranteed. "No longer will they have to struggle to pay for it," said the White House official. At the same time, "we are able to respect the beliefs of religious institutions." These are two principals, the official said, "that the White House holds dear."
The rule will be applied to all but the original institutions that were exempted—those for which religious inculcation is their primary purpose—and will not be expanded to include other entities such as hospitals, clinics, or social service organizations.
It most certainly will not, according to White House officials, exempt private employers. The Bishops had made clear earlier this week that their ultimate goal was to get rid of contraceptive coverage in health reform entirely.
The White House said that they plan to publish the final rule as soon as possible, and that it would go into effect on August 1, 2012, the original date, removing the one-year grace period from the original plan.
A White House official described the plan as providing "seamless coverage" to women for contraceptive care and crafted to allay concerns about privacy and confidentiality in accessing such coverage.
White House spokespeople pointed to support from two sides of the debate.
On one hand, Sister Carol Keehan of the Catholic Health Association applauded the policy, although I could not find her statement at this time.
And in a statement, Cecile Richards, president of Planned Parenthood Federation of America said:
“We believe the compliance mechanism does not compromise a woman’s ability to access these critical birth control benefits.
“However we will be vigilant in holding the administration and the institutions accountable for a rigorous, fair and consistent implementation of the policy, which does not compromise the essential principles of access to care.
“The individual rights and liberties of all women and all employees in accessing basic preventive health care is our fundamental concern.
“Planned Parenthood continues to believe that those institutions who serve the broad public, employ the broad public, and receive taxpayer dollars, should be required to follow the same rules as everyone else, including providing birth control coverage and information.
“As a trusted health care provider to one in five women, Planned Parenthood’s priority is increasing access to preventive health care. This birth control coverage benefit does just that.
“The birth control benefit underscores the fact that birth control is basic health care, and is fundamental to improving women’s health and the health of their families.