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Obama fixes contraception mandate. (updated)

President Obama has announced a major revision of the mandate requiring employers to provide contraception coverage in employee health plans. Under the new rule, senior administration officials confirmed, no religious institution will have to pay for health-insurance plans that include contraception coverage. Not houses of worship, not parish schools, not universities, not hospitals, not charitable organizations.The outline of the new rule is fairly simple. Nonprofit religious institutions that do not fall within the narrow religious exemption will not have to offer employee health plans that cover contraception. Instead, the employer's insurance company will have to contact employees directly and offer contraception coverage at no cost. (Religious organizations that primarily employ and serve co-religionists, and whose mission is primarily to inculcate its values, will not be covered by this new arrangement.)

Why would insurers agree to provide contraception services for free? Because, actuarially, it seems to make financial sense. The average pregnancy costs roughly $12,000. Enrollees who use contraception are cheaper to cover.

The revised ruling seems to have satisfied both Sr. Carol Keehan, president of the Catholic Health Association, who had criticized the original ruling, and Cecile Richards, president of Planned Parenthood, both of whom made statements praising the revised policy.Given that religious institutions will not have to pay for policies that include contraception, and they there is no requirement that they refer employees for such services, the new policy directly addresses the legitimate objections raised by the U.S. Conference of Catholic Bishops.We'll see. More details as they come throughout the day.

Updates: USCCB press release:

"While there may be an openness to respond to some of our concerns, we reserve judgment on the details until we have them," said Cardinal-designate Timothy Dolan, president of USCCB. "The past three weeks have witnessed a remarkable unity of Americans from all religions or none at all worried about the erosion of religious freedom and governmental intrusion into issues of faith and morals," he said.

"Today's decision to revise how individuals obtain services that are morally objectionable to religious entities and people of faith is a first step in the right direction," Cardinal-designate Dolan said. "We hope to work with the Administration to guarantee that Americans consciences and our religious freedom are not harmed by these regulations."

Statement from Sr. Keehan:

The Catholic Health Association is very pleased with the White House announcement that a resolution has been reached that protects the religious liberty and conscience rights of Catholic institutions. The framework developed has responded to the issues we identified that needed to be fixed.We are pleased and grateful that the religious liberty and conscience protection needs of so many ministries that serve our country were appreciated enough that an early resolution of this issue was accomplished. The unity of Catholic organizations in addressing this concern was a sign of its importance.This difference has at times been uncomfortable but it has helped our country sort through an issue that has been important throughout the history of our great democracy.The Catholic Health Association remains committed to working with the Administration and others to fully implement the Affordable Care Act to extend comprehensive and quality health care to many who suffer today from the lack of it.

President Obama's remarks:

As part of the health care reform law that I signed last year, all insurance plans are required to cover preventive care at no cost. That means free check-ups, free mammograms, immunizations and other basic services. We fought for this because it saves lives and it saves money - for families, for businesses, for government, for everybody. That's because its a lot cheaper to prevent an illness than to treat one.

We also accepted a recommendation from the experts at the Institute of Medicine that when it comes to women, preventive care should include coverage of contraceptive services such as birth control. In addition to family planning, doctors often prescribe contraception as a way to reduce the risks of ovarian and other cancers, and treat a variety of different ailments. And we know that the overall cost of health care is lower when women have access to contraceptive services.

Nearly 99 percent of all women have relied on contraception at some point in their lives - 99 percent. And yet, more than half of all women between the ages of 18 and 34 have struggled to afford it. So for all these reasons, we decided to follow the judgment of the nations leading medical experts and make sure that free preventive care includes access to free contraceptive care.

Whether you're a teacher, or a small businesswoman, or a nurse, or a janitor, no woman's health should depend on who she is or where she works or how much money she makes. Every woman should be in control of the decisions that affect her own health. Period. This basic principle is already the law in 28 states across the country.

Now, as we move to implement this rule, however, we've been mindful that there's another principle at stake here - and thats the principle of religious liberty, an inalienable right that is enshrined in our Constitution. As a citizen and as a Christian, I cherish this right. In fact, my first job in Chicago was working with Catholic parishes in poor neighborhoods, and my salary was funded by a grant from an arm of the Catholic Church. And I saw that local churches often did more good for a community than a government program ever could, so I know how important the work that faith-based organizations do and how much impact they can have in their communities. I also know that some religious institutions - particularly those affiliated with the Catholic Church - have a religious objection to directly providing insurance that covers contraceptive services for their employees. And that's why we originally exempted all churches from this requirement - an exemption, by the way, that eight states didn't already have. And that's why, from the very beginning of this process, I spoke directly to various Catholic officials, and I promised that before finalizing the rule as it applied to them, we would spend the next year working with institutions like Catholic hospitals and Catholic universities to find an equitable solution that protects religious liberty and ensures that every woman has access to the care that she needs.

Now, after the many genuine concerns that have been raised over the last few weeks, as well as, frankly, the more cynical desire on the part of some to make this into a political football, it became clear that spending months hammering out a solution was not going to be an option, that we needed to move this faster. So last week, I directed the Department of Health and Human Services to speed up the process that had already been envisioned. We weren't going to spend a year doing this; we're going to spend a week or two doing this.Today, we've reached a decision on how to move forward. Under the rule, women will still have access to free preventive care that includes contraceptive services - no matter where they work. So that core principle remains. But if a woman's employer is a charity or a hospital that has a religious objection to providing contraceptive services as part of their health plan, the insurance company - not the hospital, not the charity - will be required to reach out and offer the woman contraceptive care free of charge, without co-pays and without hassles.The result will be that religious organizations wont have to pay for these services, and no religious institution will have to provide these services directly. Let me repeat: These employers will not have to pay for, or provide, contraceptive services. But women who work at these institutions will have access to free contraceptive services, just like other women, and they'll no longer have to pay hundreds of dollars a year that could go towards paying the rent or buying groceries.

Now, I've been confident from the start that we could work out a sensible approach here, just as I promised. I understand some folks in Washington may want to treat this as another political wedge issue, but it shouldn't be. I certainly never saw it that way. This is an issue where people of goodwill on both sides of the debate have been sorting through some very complicated questions to find a solution that works for everyone. With today's announcement, we've done that. Religious liberty will be protected, and a law that requires free preventive care will not discriminate against women.We live in a pluralistic society where we're not going to agree on every single issue, or share every belief. That doesn't mean that we have to choose between individual liberty and basic fairness for all Americans. We are unique among nations for having been founded upon both these principles, and our obligation as citizens is to carry them forward. I have complete faith that we can do that. Thank you very much, everybody.

E. J. Dionne reports Catholic Charities USA is pleased with the new ruling:

"Catholic Charities USA welcomes the Administration's attempt to meet the concerns of the religious community and we look forward to reviewing the final language," the group said. "We are hopeful that this is a step in the right direction and are committed to continuing our work to ensure that our religious institutions will continue to be granted the freedom to remain faithful to our beliefs, while also being committed to providing access to quality healthcare for our 70,000 employees and their families across the country."

And Catholics for Choice is none too pleased:

Previous compromises of this nature, such as that in Hawaii, may have made some conservatives happy, but they have also meant that some women have not been able to access coverage in a timely and easy manner. That is unacceptable.Its unfortunate that on this issue, as many others, far too many in the administration and Congress have sacrificed womens health to get something they want more.

I'm not sure they have the slightest idea what the new rule actually requires.



Commenting Guidelines

Um, whatever, but if the theory is that not enough people have this "health" coverage because greedy insurance companies have been missing a money-making opportunity lying right under their noses, then again, you might want to check your calculations.

Shell Game AlertInsurance companies do not provide anything for free; no company does. It is simpl enough for anyone to understand; the premiums paid by the employer pay for the coverage provided by the insurer; nothing more and nothing less.And so in these cases the insurance company will up the premium enough to cover the BC pills (or whatever), and they will pretend to not offer coverage to the Church, and instead will cover the ills free to women on that policy who want them.The insurance company will be lying to the church and the Church will be lying to itself, all so that some women do not have to pay for BC pills.Lie after lie after lie, and everyone is supposed to be happy with that? Will this sort of lying help, does lying in general help anyone? In considering matters this personal and this important, we ought to be more honest with ourselves and with each other.If the government so much wants women to have free BC pills and the like, why does the federal government not just pony up the dinero for this and be done with it? Seems to me the ones paying the bill ought to have a say in the matter.No - This will not work.

Whatever indeed.

What you said in the post implies that you are able to spot a money-making opportunity in the insurance market that insurance companies have somehow missed, despite their greater knowledge and incentive to spot such cost-savings. You obviously have no answer to that point.

Studebaker,Almost all insurance does already provide coverage of contraception. Nobody is saying health insurance that covers contraception is much cheaper than health insurance that does not. It's that adding contraception coverage is revenue-neutralit raises costs in some areas and lowers them in others. I doubt if there is a major insurance company that doesn't offer policies covering contraception. The mandate was not on insurance companies. It was on employers providing insurance to their workers.

It's about compromise, Stuart. It's not the point of the whole health care law. This won't harm the insurance companies in the long run. And it shouldn't cost enrollees extra.I can see you have found something to obsess over. Have at it. I'm not interested in dancing to another of your obnoxious tunes.

Faith-based (aka Voodoo) economics makes a comeback. Washington thrives when the credulous believe in the latest version of a free lunch.

And the lying goes on . . . .

I've never found argument revolving around the fungibility of money, or that Catholics must contribute to this pool of money, which under certain circumstances, could be used to pay for X, terribly compelling. We all pay taxes; the government does things almost everybody doesn't like. We learn to live with it. We still need to oppose things that are wrong, but if our cooperation is limited to adding money to a pool of money that helps pay for something else, that's life.What was most important to me was that Catholic employers would not have to say to its employees, "here's your contraceptive benefit" in some way. It seems to me this agreement means they don't have to do that, which is why I'm OK with it.I would prefer if *nobody* had to supply such a benefit, but converting that into policy will require convincing more people of basic teachings, and that will require more than howls of outrage.

Megan McArdle ( non-Catholic, if I'm not mistaken) at the Atlantic doesn't see this as much of a compromise since the "no cost" arrangement means the insurance companies will pass the bill on to the Church."Update: Commenters point out that I've misread it--the insurers have to provide it "at no cost". Which of course means the Church will still be paying for it. So the question is, how do the Catholics take it? Not well, from what I can see."

Couple of responses to questions above:- note that Dolan is in Rome right now so convening and gathering bishops via Dolan is probably difficult and time consuming- Wonder if the next step on the catholic side is to again see the division between Sr. Carol and the CHA and the USCCB and more vocal bishops. Remember, USCCB never did approve the PPACA which Sr. Carol blessed. But, as Grant says above, the bishops will only weaken their current position if they press back harder and with more questionable grounds.Here is an interesting added piece that talks about the fact that the structure of this decision has actually been in place and repeatedly upheld by the courts since 2000: really does show that none of the current Rep. candidates; many talking heads; or even the USCCB lawyers know a whole lot.

Mr. Karlson and some others here seem to enjoy the straw man. Opponents of the President's illegal mandate have said from the beginning, that constitutional and federal law require universal exemptions for any kind of religious objector from any kind of objectionable activity. Karlson responds, so you only object to charities directly paying--well the President just called his plan "charities not directly paying"--now you're moving the target. No, you're arbitrarily redefining the target that was universally stated all along as necessary for compliance with the federal RFRA statute (and other laws). You can't omit religious individuals or religious people running businesses. You can't force self-insured religious organizations to cover this stuff. You can't claim that the employer's provision of a plan that lets the employee access objectionable items from the insurer is not an objectionable participation. And you can't change the subject to Bush or whatever, or claim that religious freedom advocates didn't ask for a universal conscience protection from the get-go. The bills pending to provide a universal fix for this have been introduced for two congresses in a row now.

"Which really does show that none of the current Rep. candidates; many talking heads; or even the USCCB lawyers know a whole lot."Wow - Commonweal, America, NCR (for God's sake), Jonathan Chait, EJ Dionne - none of these people know a whole lot.

Certain posters at dotC will not be happy until the President and his supporters are drawn, quartered and relegated to the dung pile of history.It ain't gonna happen. If anything, those who feel that have been done in by "the church" will find ways to fight back.If "the church" doesn't treat this compromise with good grace, the negative feedback will be as bad as they have gotten on their obfuscation on the sexual abuse mess - possibly even worse.I'll remind people here that a regular contributor, JAK, has taught us more than once that "the church" is much more than the bishops and their lackeys. The 99% is more powerful than the 1% when given the right incentive.Bishops, be careful. Be very, very careful! The loyal and those of us in the disloyal opposition are not finished by a long shot.

The initial HHS mandate would, more than likely, have be found unconstitutional so how can a compromise be reached on a mandate that was illegal in the first place. This is typical of a command and control regime, two steps forward, one step back again and again. The Bishops would be fools to agree to this 'compromise" and follow the old saying "fool me once, shame on on you, fool me twice, shame on me." This whole charade has nothing to do with condoms or contraceptives, it has everything to do with forcing religious and non-governmental charities to submit to the Federal government rules, regulations and mandates or be forced out of providing charitable services.

All this back and forth seems to take some aspects of this issue as resolved that don't seem to be so in my judgment.Freedom from the institution of state religion doesn't not speak to freedom of conscience any more than an all volunteer military intentionally selects out who will die in time of conflict.The prudence of birth control, in an age of declining middle class prosperity and increases in the cost of health care that annually outpaces inflation by 5-6:1, is not an issue that most American's are willing to concede should be tossed on a fire of retrograde ideological indignation. It is embarrassing to read all this talk about fine points of for-profit insurance when we as a nation of church-going people are routinely willing to toss off millions of person years of life expectancy among those born - as a premium for denying universal health care that virtually every modern nation has long taken as some we all deserve much as we deserve clean water.

Anitra Williams "Mr. Karlson and some others here seem to enjoy the straw man. Opponents of the Presidents illegal mandate have said from the beginning, that constitutional and federal law require universal exemptions for any kind of religious objector from any kind of objectionable activity"Tell that to the soldiers who have been working for selective conscience objection in the military. In other words, you are wrong. Try again.

Ken, As I understand the deal, if Catholic Healthcare West (now Dignity) buys health insurance without contraceptive coverage for its 55,000 employees, it will pay some insurance company about $500 million a year for that insurance.There will be a certain number of pregnancies each year depending on how many of the employees buy contraceptives at their own expense. Each of those pregnancies costs the insurance company a lot of money. If the insurance company gives free contraceptives to the employees, that will reduce the number of pregnancies and the insurance company will spend less money than if it paid for those pregnancies. It's in its financial interest to drive down the number of pregnancies by spending its own money to provide the free contraceptives - wihout receiving any additional payment from the company beyond the original $500 million. Therefore, the employer isn't paying for the contraceptives. That's the theory, anyway. I have no knowledge of what the actual numbers are.

Increased availability of contraception most likely will decrease the incidence of abortion.Isn't that a goal that Catholics want?If you think that no available contraception will somehow be a good thing, think again.

When you repeatedly make comments about this mandate, like saying opponents have moved the ball, and then refuse to defend those but instead respond to questions by talking only and exclusively about the military or Bush or immigration, it just shows that your only comments about this mandate are not defensible.

My view is that this is good news and we should be pleased with the development.Under the now-obsolete plan, Catholic institutions would have had to sign contracts with 3rd party providers, one of whose line items would have been to subsidize contraception. This is no longer the case. It's a tiny contract change, but morally it makes a difference.Under the now-obsolete plan, the government was mandating that Catholic institutions subsidize contraception against their will. This is no longer the case.Those are two very good developments.It is not a given that the insurers will somehow pass the cost along to the Catholic institutions. Pricing can be creative and even morally ambiguous. Suppose, for the sake of discussion, that an insurance company charges a Catholic institution a flat fee per employee covered. We know the pricing will change at the beginning of the new enrollment period - perhaps in part because of this new regulation, and perhaps for a hundred other reasons as well. I think the cooperation is pretty remote.The whole point of religious freedom, istm, is that we are free to proclaim the Good News to our fellow citizens, without any government interference. Because of this change, Catholic institutions can stand up in the public square and say, "See? We're witnessing to our faith - we're not subsidizing what we think is evil." That's a very good thing. And Catholic institutions and indivuals are free to make our case - to try to make persuasive arguments about marriage, family, the worth of children - all of the values that swirl around contraception.

"And you cant change the subject to Bush or whatever, or claim that religious freedom advocates didnt ask for a universal conscience protection from the get-go."Right, one can't point they made one demand and then changed it when they saw they were getting that demand. It's not fallacious to point out the shifting demands because it points to dishonesty in the process of dialogue. "We didn't really mean that, now this." And then what? "Sorry, that's not good enough, now this." And then there are other questions such as differing religious traditions with different moral claims. What if one's personal religious belief is that everyone should pay for insurance with contraception - does the lack of that requirement mean their religious liberty has been violated? That is a part of the process which is being neglected -- there are, at times, religious beliefs which makes demands opposite other religious traditions; one side is going to find their freedom limited. What then? Yes, we know, some people change their demands for one reason: so they can continue to demonize their opposition. In doing this, they show they have no real standard, they are nihilistic to the core -- if they held to a consistent demand, one could see principle, when they demand something then act like those giving in to the demands are evil for their compromise, one get sense that one is dealing with a would be tyrant or bandit.

AnitraWhen your concern is only about Obama, the mandate, and not consistency, one can see that your objection is not based upon religious liberty but on the man who you detest. That is the problem. Complaining that I point out to the full extent of the religious liberty concern shows you are not concerned with the problem. You say one should be free to object for anything; but then when shown that is not allowed, nor has been allowed, you say 'how dare you point out that fact.' Seriously?

Anitra: I have another declaration for you: You are wrong.Jim P., well said. It's quite touching to see conservative critics of the revised mandate so deeply concerned about the finances of insurance companies, when they are earning record profits. The health-care reform law will provide them with plenty more in 2014. While the long-term costs are neutral at worst (from the point of view of the insurer), the short-term costs can be eaten as a concession to the government that handed them all these new customers.Soon enough I'll have a response to critics who think this is nothing more than an accounting gimmick. The "accounting gimmicks" in the new HHS ruling are way less gimmicky than the ones required by the Hyde Amendment. which requires states to segregate federal dollars from state Medicaid funds that go toward elective abortions.

"Under the now-obsolete plan, Catholic institutions would have had to sign contracts with 3rd party providers, one of whose line items would have been to subsidize contraception. This is no longer the case. Its a tiny contract change, but morally it makes a difference."So simply removing a line-item on the bill labelled "contraceptive services" and lumping into some generic category (but still charging the employer for the coverage) makes that much of a difference morally? I fail to see that logic or moral significance of an accounting gimmick.

Isn't it a little weird that this one particular type of drug is being singled out as a no copay, mandatory component of everyone's insurance coverage?

I hope he is wrong. The bishops are at risk of destroying their credibility."a source at the U.S.C.C.B., worried that there could be some [bishops] who still want to snatch defeat out of the jaws of victory, said, Theyve framed this as a fight over religious liberty; they cant pivot over to contraception.

"So simply removing a line-item on the bill labelled contraceptive services and lumping into some generic category (but still charging the employer for the coverage) makes that much of a difference morally? "Jeff, I know you're an attorney, so I'm approaching this with suitable trepidation :-), but istm that charging the Catholic employer for the contraception, whether it's broken out into a separate line item or buried in some generic category, is in violation of federal law (or will be when the new regulations take effect). As presented here, the insurance company is supposed to be providing the subsidy. Charging the Catholic institution through some bald "special services" line item would seem to mean that the Catholic institution is subsidizing it. That doesn't mean that insurance companies won't do it, but *morally*, they'll be in the position of flim-flamming the Little Sisters of the Poor. I'd like to think that God has special punishments saved up for people like that.

It has occurred to me that most likely the reason the last several 24-hour news cycles have been obsessing on this confrontation over contraception is that the economy is improving and the righties would be deprived of any readily available cudgel to pound on the President."We have no serious policy proposals to present to the electorate ... No driving ideas to capture peoples' imagination ... We're just an intellectually spent force." Bill Crystal is pulling what's left of his hair out.So I guess, for the Republicans it is back to the culture wars, all the way back to arguments about contraception that were decided nearly 50 years ago. The next things in the pipeline most likely will be gay-bashing and guns. Then there is always birtherism and immigrants.[The recent Ninth Circuit decision, decided as "sui generis" to California alone, striking down Proposition 8/same-sex marriage offers the SCOTUS the opportunity to pass on even taking the case. At a discussion at Bolt Hall School of Law (UCB) this week there seemed to be a majority opinion that Justice Kennedy would like to avoid if at all possible to dis-sing his fellow Republicans on the court again. We'll see, but it would deprive the right of another wedge issue.]Never have been able to understand the Republican mind, but I would presume that this whole anti-contraception frenzy is designed and timed to help Santorum gain traction - the hierarchs' dream Opus Dei presidential candidate. Could you imagine the police state we would become under a "Santorum Administration?" Kiss the Bill of Rights goodbye.I know, that is hyperbolic. But in the bizarro-world of rightwing politics, we may be seeing the shotgun marriage of Mitt and Santorum at either end of the top of the Republican ticket? [I'm only speaking metaphorically...I'm not suggesting any same-sex unions for the Republican candidates - although there is a certain deliciousness to the thought.]

With regard to the comment about Catholic institutions that self-insure, many of those self-insured in order to escape state laws that required commercial insurance policies to include contraceptive coverage. By self-insuring they bought themselves under federal law (ERISA) and could ignore the state requirements. As Bishop Morlino found in Madison, self-insuring may be more expensive and riskier than buying commercial insurance. This will be an opportunity for Catholic institutions that self-insured only to avoid providing contraception coverage to go back to commercial insurance. For the few Catholic institutions that are so large that self-insuring might actually be cheaper, they will have to weigh the savings against the greater distancing from contraception that commercial insurance can provide.

If I had an ongoing, expensive health issue (other than endometriosis) I would be feeling pretty upset right now about my copay.

In my 5:26 comment: "a source at the U.S.C.C.B., worried that there could be some [bishops] who still want to snatch defeat out of the jaws of victory, said, Theyve framed this as a fight over religious liberty; they cant pivot over to contraception.I guess Bishop Slattery is one of them. He's posted his response to today's announcement:"the Constitution of the United States does not merely guarantee the freedom of religion to institutions, but to every American.This includes every businessman or woman who willingly provides health insurance to his or her employees. It includes every single mother, every married couple, and every individual who does not wish to cooperate in this sin. No one should be required to betray their religious and moral beliefs or violate their conscience.I want to encourage people not to be afraid of the sacrifices which are required to love one another with a genuine, faithful and life-giving love. Through these we are made holy and are formed more fully into what God wants us to be. Thank you.

If the insurance company gives free contraceptives to the employees, that will reduce the number of pregnancies and the insurance company will spend less money than if it paid for those pregnancies. Its in its financial interest to drive down the number of pregnancies by spending its own money to provide the free contraceptives wihout receiving any additional payment from the company beyond the original $500 million.John Hayes -- Grant is irritated at being asked this while having no answer, but perhaps you'll think of something: If what you say about costs is true, why aren't insurance companies already clamoring not just to offer free contraception, but to pay people to take it? Why aren't employers doing the same?

"why arent insurance companies already clamoring not just to offer free contraception, but to pay people to take it?"Because they know we'll all pay them to cover it and they like to take our money?

Bishop Slattery's comments on video: Wuerl's comments (before the White House press conference):

This theory that insurance companies (and hence employers) need to be forced to do something that would save them all money is very interesting. I await the equally brilliant explanations as to why we should have federal mandates that: 1) children eat ice cream when offered to them; 2) individuals agree when offered 10% yearly raises for doing the same job; 3) lottery winners accept their lottery payments; and 4) everyone accept a free work holiday on their birthday each year. After all, without a federal mandate, how would anyone remember to make decisions that benefit themselves?

John Hayes - pretty sure that Morlino opted to buy an "off the shelf" insurance plan (95% of these include contraceptives). To go self-insured and build his own diocesan benefit plan without contraceptive coverage, would have cost the diocese more money. Standard large insurance company plans usually compete in the marketplace for market share and their pricing is lower.Self-insured is usually the route used by the Fortune 500 who can and want to design their own benefit plans in order to meet the needs of an older but more experienced workforce; want to maintain the benefits they have usually been offering over time so they can keep experienced workers and attract highly desired recruits. Many small and mid-market companies opt for the standard plans because of cost, because it takes an internal staff to administer your own benefit plan; pay for claims, etc.Bishop Slattery - like his tendency to celebrate the TLM in Cappa Magna; not sure I would view him as a moral authority much less an authority about the complex world of contraception, etc.

Studebaker - you ignore reams of studies that have proven that health and wellness do require some type of requirements; incentives, and explanations - folks are notorious to freely choose poor health but it costs the US billions. Compare the past five years of studies done by the WHO in terms of best care; longest lifes; most accessible and cheapest medical care; death rates; infant mortality rates. The US spends the highest amount of medical dollars and yet we rank lower than 10-15 on each of these health markers.You cite a few examples - so, let's cite a few more: smoking; weight issues resulting in heart problems, diabetes, disability. This impacts the US economy to the tunes of billions every year in lost productivity; increased costs of care; etc. We know the US has a diabetes epidemic - caused by our poor diets; processed foods; eating out to much; alcohol consumption. And yes, over time the states and the federal government has intervened and used incentives (taxes; outlawing smoking in restraurants, smoke free buidlings/aircraft/trains/buses; changes to school lunch menus; FDA regulation of what food companies can say and market; etc.)That is the whole point of the PPACA - US medical care needs to move from reactive treatment to prevention and wellness. Your argument defends a proven failed medical paradigm. And yes, without those state/federal interventions, folks would not make decision to benefit themselves.Your argument is silly.

Your argument is not only silly but completely unresponsive.You're right, of course, that individuals in their own private lives often make decisions based more on short-term pleasure (smoking, eating the wrong foods, getting drunk and driving) than on long-term consequences. That is completely irrelevant to what is being claimed here: that insurance companies and employers with dollars at stake are passing up a great chance to save or make money, and even when told about it, they will refuse to act in their own self-interest. Hence, they need to be forced to do it. What's the cognitive bias or short-term pleasure (akin to smoking, etc.) that you think is driving insurance companies and.or employers to willfully turn down more money?

That is completely irrelevant to what is being claimed here: that insurance companies and employers with dollars at stake are passing up a great chance to save or make money, and even when told about it, they will refuse to act in their own self-interest. Hence, they need to be forced to do it.Studebaker,Actually, what is being claimed is that adding contraceptive coverage is revenue neutral, not that it is a big money-saver. Also, most employer-provided insurance already covers contraception. Finally, we know you are opposed to the mandate, but what's under discussion here is whether there is still a significant issue of religious freedom. It doesn't appear to me that there is. You are still making the same arguments you made before today's announcement. You would still be making the same arguments if Obama had broadened the exemption to include all groups that could even remotely be considered religious.

The bishops argued "we won't pay for such coverage on grounds of religious liberty." Obama said, "Great. You don't have to pay for it." Insurance companies get lots of new clients under the ACA, and, if contraceptive coverage actually saves them money, they'll be laughing all the way to the bank. A change in tune by the bishops now to reject this compromise will look like (and, I'd say, will be seen for what it is,) crass politicking with women's health care the battleground. (See It would do my heart good if several bishops would stand up and say "The administration has met my concerns about religious liberty in a way appropriate in a pluralist society." My fear is that many will think this, but only the opponents will continue to speak. The compromise puts the bishops in "remote, remote, remote" material cooperation, no closer than they are in any number of objectionable public policies about which they raise nary a peep. If they object to this, they are objecting to participating in a pluralist democratic republic. In other words, they will be declaring themselves a sect. A smaller, purer sect, perhaps, but a sect regardless.

Why would anybody think that insurance complanies have not tried to make money by offering contraception? Someone has said 95% of plans offer coverage. By charging less for plans that cover contraception, insurers are in effect paying people to take it. If they charge the same, they are taking profits from it. If they are charging more -- well it appears there are people out there who think more coverage should cost more rather than less. (see comments by Bender, Studebaker and others above.) Any of these rates could probably be justified by actuarial tables. (I suspect that another factor is that planned pregnancies have fewer complications than unplanned, though I do not know.)The Affardable Care Act has as a principal purpose lowering health care costs. It was envisioned that this would be done by promoting preventive care, which is why a range of preventive services like contraception are covered. There is a government mandate for preventive care because free marketa have relentlessly driven up costs and that rise in prices threatens our society.

A fabulous victory for Cardinal Timothy Dolan! He should be grateful to Commonweal for their support. While Obama caves, the Cardinal speaks like a true leader: "While there may be an openness to respond to some of our concerns, we reserve judgment on the details until we have them," said Cardinal-designate Timothy Dolan, president of the United States Conference of Catholic Bishops.

Within hours of Obama's announcement, the political and cultural fissures within the American Catholic community were again visible. Over the past 10 days, it was shocking to read almost identical editorials in Commonweal and The National Catholic Register! That won't last for long!Today President Garvey of Catholic U. joined Prof. Robert George, et. al, in denouncing the "Obama compromise." When will we hear from President Jenkins of Notre Dame? It will not be surprising if the leadership of Catholic universities/colleges will be less willing than the leadership of Catholic health care systems and Catholic social service organizations to take public positions that differ from the local bishop. Normalcy has returned!Joe F.

Garbey's public statement (coming from a professional academic) is frightening in its ignorance of legal precedence concerning religious liberty; history of catholic moral principles, and the history and current practice of medical coverage in the US.Does this suggest why he was the "lay" choice for CUA? Any reasonable masters student can see through his statement and the gaps in that statement.

The bishops have already declared themselves a sect by their behavior in this case. Contraception was included because it was recognized as something that should be included in all health insurance. This reflects a consensus expressed through the election of the President.If the bishops were capable of persuading the people in their pews on contraception, this consensus would not exist, and the mandate might not be included as a neccesary part of health insurance. By failing to persuade, and then demanding religious liberty to opt out, they declare themselves a minority on the fringes of society.

The USCCB has issued a followup press release: headline: "Bishops Renew Call to Legislative Action on Religious Liberty"Excerpt:"These changes require careful moral analysis, and moreover, appear subject to some measure of change. But we note at the outset that the lack of clear protection for key stakeholdersfor self-insured religious employers; for religious and secular for-profit employers; for secular non-profit employers; for religious insurers; and for individualsis unacceptable and must be corrected. And in the case where the employee and insurer agree to add the objectionable coverage, that coverage is still provided as a part of the objecting employer's plan, financed in the same way as the rest of the coverage offered by the objecting employer. This, too, raises serious moral concerns."Final paragraph:"We will therefore continuewith no less vigor, no less sense of urgencyour efforts to correct this problem through the other two branches of government. For example, we renew our call on Congress to pass, and the Administration to sign, the Respect for Rights of Conscience Act. And we renew our call to the Catholic faithful, and to all our fellow Americans, to join together in this effort to protect religious liberty and freedom of conscience for all."

Kathy, here is a listed of mandated covered services, and ones that have no copay are asterisked: to say, they are many and varied.

Fr. O'Leary,The really impressive moment came at the end of the press conference, when all the reporters asked the departing president whether he had spoken to Archbishop Dolan.

The righties are saying /implying that Dolan had a promise from the president of no mandate at their Nov. meeting. Watching the weasel wording I have concluded that the president did NOT give Dolan a promise of NO mandate. why did they tear out Nixon's tape recorder? ... maybe it's been reinstalled..