Federal Government Offers Rulemaking For Compromise On Birth Control Coverage

WASHINGTON, D.C. - (Mealey's) The U.S. Department of Health and Human Services on Feb. 1 issued a notice of proposed rulemaking on recommended changes to the preventive services policy contained in the Patient Protection and Affordable Care Act (PPACA).

(Proposed rules available. Document #31-130206-022X.)

Proposed Rules

Regulations contained in the PPACA require that employee health insurance plans include no-cost sharing coverage for contraception and sterilization procedures. The regulations contained in the PPACA require that coverage must include all Food and Drug Administration-approved contraceptive methods and sterilization procedures. This includes oral contraceptives with abortifacient effect.

The Obama administration has faced a flood of lawsuits by groups objecting to covering birth control in their employee health plans based on religious beliefs. In response to the complaints about the mandate, the government said it would issue new regulations to address the concerns and clarify the regulations.

The proposed rules provide women with coverage for preventive care that includes contraceptive services with no co-pays, while addressing concerns expressed by religious organizations.

The proposed rules are open for public comment through April 8.

Religious Employers

The proposed rules simplify and clarify the definition of "religious employer" for purposes of the exemption from the contraceptive coverage requirement. These religious employers, primarily houses of worship and their affiliated organizations, can exclude contraception coverage from their health plans.

The proposed rules eliminate criteria that a religious employer has the inculcation of religious values as its purpose, primarily employs persons who share its religious tenets and primarily serves persons who share its religious tenets.

The proposed rules are intended to clarify that a house of worship would not be excluded from the exemption because, for example, it provides charitable social services to persons of different religious faiths or employs persons of different religious faiths.

Religious Organizations

The proposed rules lay out how nonprofit religious organizations, such as nonprofit religious hospitals or institutions of higher education, that object to contraception on religious grounds can receive accommodations that provide their enrollees separate contraceptive coverage, with no co-pays and no cost to the religious organizations, the government said in a news release.

An eligible organization would be defined as an organization that opposes providing coverage for some or all of any contraceptive services required to be covered under Section 2713 of the Public Health Service Act on account of religious objections, that is organized and operates as a nonprofit entity, that holds itself out as a religious organizations and self-certifies that it meets these criteria and specifies the contraceptive services for which it objects to providing coverage.

These eligible organizations would not have to contract, arrange, pay or refer for any contraceptive coverage to which they object on religious grounds. However, plan participants would receive contraceptive coverage through separate individual health insurance policies without cost sharing or additional premiums.

For insured plans, religious organizations, including student health plans, would have to provide notice to their insurer and the insurer would then notify enrollees that it is providing them with no-cost contraceptive coverage through separate individual health insurance policies.

For self-insured plans, including student health plans, the religious organizations would provide notice to their third party administrator, which would work with an insurer to arrange no-cost contraceptive coverage through separate individual health insurance policies.

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