By Katrice L. Mines
In August, the Obama Administration took several steps to facilitate women receiving coverage for recommended contraceptive services at no additional cost, as they should be entitled to under the Affordable Care Act. The rules, which are in response to recent court decisions, balance the Administration’s commitment to helping ensure women have continued access to coverage for preventive services important to their health, with its goal of respecting religious beliefs. The first Administration action announced maintains the existing accommodation for certain religious non profits, but also creates an additional pathway for eligible organizations to provide notice of their objection to covering contraceptive services. In addition, officials are soliciting comment on how it might extend to certain closely held for-profit companies the same accommodation that is available to non-profit religious organizations, while continuing to urge Congress to take action to ensure women’s access to contraception services.
“Women across the country deserve access to recommended preventive services that are important to their health, no matter where they work,” said Health and Human Services Secretary Sylvia Burwell. “[This] announcement reinforces our commitment to providing women with access to coverage for contraception, while respecting religious considerations raised by non-profit organizations and closely held for-profit companies.”
In July 2013, the Administration published final rules providing women with coverage for recommended preventive care, including all Food and Drug Administration-approved contraceptive services prescribed by a health care provider, without cost-sharing, while providing an accommodation for certain non-profit religious employers that object to contraceptive coverage on religious grounds so that they do not have to contract, arrange, pay, or refer for such coverage for their employees or students.
According to a 2013 survey by Belden and Russonello Strategists LLC, eight in 10 African-American adults surveyed had beliefs that fell in line with the ruling. Findings showed participants believe contraception, such as birth control pills, diaphragms, IUDs, and Depo-Provera shots should be a part of basic health care for women. The survey was sponsored by a reproductive justice communications strategies group that includes Black Women for Wellness, Black Women’s Health Imperative, New Voices Pittsburgh, SisterLove Inc., SPARK Reproductive Justice and individual reproductive justice activists, in partnership with Communications Consortium Media Center. More than nine of the 10 surveyed said publicly funded contraception should be available, and was consistent across demographics and backgrounds, 91 percent of self-identified conservatives and 92 percent of those who attend religious services weekly or more.
“Black women’s perspective on birth control — recognizing its potential for both liberation and oppression — makes an important contribution toward development of a more just vision of reproductive freedom, says Dorothy Roberts in “Black Women and the Pill.”
In a nutshell
Interim Final Rule for Non profits: A second pathway
The interim final regulations lay out an additional way for organizations eligible for an accommodation to provide notice of their religious objection to providing coverage for contraceptive services. The rule allows these eligible organizations to notify the Department of Health and Human Services in writing of their religious objection to providing contraception coverage. The Department of Labor and HHS will then notify insurers and third party administrators so that enrollees in plans of such organizations receive separate coverage for contraceptive services, with no additional cost to the enrollee or the employer.
Closely Held For-Profit Entities
The Administration also issued a proposed rule soliciting comments on how it might extend to certain closely held for-profit entities, like Hobby Lobby, the same accommodation that is available to non-profit religious organizations. Under the proposal, these companies would not have to contract, arrange, pay or refer for contraceptive coverage to which they object on religious grounds. The proposal seeks comment on how to define a closely held for-profit company and whether other steps might be appropriate to implement this policy.
Meanwhile, officials continue to encourage Congress to act to ensure that women affected by the Supreme Court’s Hobby Lobby decision have access to the same coverage options offered to others, while it begins the process of soliciting feedback to determine how, through rulemaking, it can ensure that the religious concerns of organizations are respected and women are able to get coverage of recommended preventive services without cost sharing, as intended under the health care law. AT