Benefits and Compensation

A More Flexible Contraceptive Mandate? Carve-outs for Religious Organizations Look Likely

After increasing hammering from conservatives, the White House looks like it is ready to compromise on health reform’s contraception mandate. The administration had included contraceptives and sterilization in its list of preventive services all (except the few grandfathered) plans must cover starting plan years in August 2012. It had offered a year-long delay to religious employers, but the  message was after August 2013 it would apply to them too, regardless of their objections. Growing controversy, we all know, ensued.

In his daily briefing on Feb. 7, White House Press Secretary Jay Carney said the process of “working with those organizations and individuals who have concerns about the implementation of this rule … will continue,” and the President is very interested in finding the appropriate balance between religious beliefs and convictions and … making sure that women of all faiths have access to these important health care preventive services.”

David Axelrod, a senior strategist for President Obama said Feb. 7. “We certainly don’t want to abridge anyone’s religious freedom,” he said.

The administration seems headed to a policy under which plans that object to paying contraceptives would be allowed not to, those plans would have to attest that status, but the feds would ensure that all women in such plans could get free contraceptives elsewhere.

Religious groups objected to the rule, calling it an attack on religious freedom because (for example) it would require Catholic charities, schools, and hospitals to provide contraception and sterilization.

House Speaker John Boehner (R-Ohio) recently pledged that if the president does not reverse the requirement, then the U.S. House of Representatives will draft legislation to reverse it. The contraceptive rule “must not stand and will not stand,” Boehner said.

On Jan. 20, 2012, HHS announced that faith-based employers (such as universities and hospitals) could delay compliance with the contraceptive mandate until Aug. 1, 2013, a one year delay.

On Aug. 1, 2011, HHS issued preventive care guidelines that included contraception for women to be provided starting with plan years that begin or after Aug. 1, 2012.

Here’s a current press digest on recent developments.

Limiting employers’ ability to tailor plans

Employers have long been able to tailor health benefits to their demographics and their population size. That means they may choose to exclude certain services, like acupuncture or chiropractic manipulations under anesthesia, because they’re expensive, prone to abuse or just not essential to the company’s workforce.

The most important advantage to self-funded plans is the ability to create their own benefit design, many proponents of self-insuring health benefits say.

Health reform’s preventive care mandate and essential benefit rules will further limit companies’ ability to offer slimmed-down benefit packages. In response to negative reactions about mandates’ effect on plan design, the government strategy seems to be to back down and add some flexibility. For example, it recently surprised the public by announcing that it would allow states to define health reform’s essential health benefits (EHB) package by referring to prevalent plan or plans in their territories.

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