The Catholic Health Association (CHA), which represents 620 Catholic hospitals and 1,400 nursing homes, is backing the Obama administration’s final rule on the contraception mandate in the health care reform law. The Affordable Care Act (ACA) requires that health plans offered by insurers or employers must include contraception coverage without any out-of-pocket expense to enrollees as part of required preventive health services for women. It applies to all FDA-approved contraceptive medicines and devices, including oral contraceptives, patches, rings, intrauterine devices (IUDs), and emergency contraception.
When it was introduced a year and a half ago, the mandate sparked a backlash from religious groups and employers. CHA and the U.S. Conference of Catholic Bishops (USCCB) joined forces in condemning the government for undermining religious freedom, given that there were no exceptions for religious employers.
However, the Catholic hospitals and the bishops approached the issue very differently. Sister Carol Keehan, head of the hospital association, has publicly supported the health care reform law since 2010, while the bishops have consistently opposed it out of concern that it would use federal funds to provide abortions. Although high-ranking Vatican officials who view the law as pro-abortion have criticized Sister Carol, she has continually argued that health care is an essential human right and that the law must be preserved. As a result, CHA willingly negotiated with the administration to achieve a workable resolution while the bishops remained unyielding, soon joined by additional evangelical and conservative groups.
The final rule, released on June 28 and accepted by CHA, exempts churches and houses of worship from the mandate. Other nonprofit religious employers like hospitals and schools must provide the contraception benefit or, if they object on moral grounds, they can notify insurers or third-party administrators to provide separate no-cost contraceptive coverage to enrollees who request it without the employer taking any specific action.
Private businesses owned by religious employers must comply with the federal contraception coverage mandate, which the bishops object to. Most notably, the evangelical Christian owners of Hobby Lobby, a nationwide chain of craft store, filed suit against the government in May. The owners say they refuse to provide coverage for what they consider to be abortion-inducing drugs, Plan B and Ella. However, experts say those drugs do not cause abortion but instead prevent the completion of conception.
After extended review and dialogue within the Catholic health community, the Catholic hospitals concluded that the Obama administration accommodations are acceptable. The final rule satisfies the CHA given that member hospitals will not have to organize, contract or pay for contraception coverage. The bishops continue to object to the mandate because it lacks conscience exemptions, and they are apparently continuing their legal challenge.
■ Anya Clifford