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Contraceptive coverage delayed for religious groups

Employers granted extra year to comply with mandate

Contraceptive coverage delayed for religious groups

WASHINGTON—Federal regulators may have given employers affiliated with religious organizations an extra year to ensure that their health plans fully cover prescription contraceptive services, but those employers should not regard the move as anything more than a delay.

While employers affiliated with religious organizations and some lawmakers oppose the health care reform law-related mandate, there likely is not sufficient support in Congress to overturn the rule, experts say.

The rule, announced this month by Department of Health and Human Services Secretary Kathleen Sebelius, will go into effect in two stages.

For most employers, the requirement, like a previous proposal, will apply to plan years that start on or after Aug. 1, 2012. As most employers offer calendar-year plans, the requirement will apply to the majority of plans on Jan. 1, 2013.

The shrinking percentage of employers with health plans that have grandfathered status under the reform law, are exempt from the contraceptive mandate. But to maintain grandfathered status, plans cannot ever increase coinsurance requirements and are sharply limited in how much they can increase employee copayments or premium contributions, among other things.

Religious-affiliated organizations, such as Catholic health care systems and universities, would have an additional year before they would have to comply. For such organizations, the mandate would apply for plan years starting on or after Aug. 1, 2013.

“This additional year will allow these organizations more time and flexibility to adapt to this new rule,” Ms. Sebelius said.

Besides grandfathered plans, the only organizations automatically exempt from the mandate are certain religious employers, such as a church whose purpose is the “inculcation” of religious tenets, primarily employs those who share its religious tenets, and primarily serves those who share its religious tenets.

It isn't known how many employers will have to upgrade or expand their prescription drug plans to comply with the new requirement.

Such coverage is “widespread but by no means universal,” said Michael Thompson, a principal with PricewaterhouseCoopers L.L.P. in New York.

Aside from employers with religious objections, some may not offer prescription contraceptive coverage because they limit prescription drug coverage to treatment of diseases or other medical problems, consultants say.

“This does not fit that category,” Mr. Thompson said.

On the other hand, many employers view this as a “family-friendly, visible and widely appreciated benefit,” he said.

And some employers view coverage of contraceptives as the same as any other prescription.

“Whether it's for regulation/ control of a woman's period, long-term contraception, or short-term family planning, I think plans should cover these prescriptions, just like any other medication,” said Joseph P. Molloy, vp-benefits/employee services at North Shore-LIJ Health System in Lake Success, N.Y.

For those employers that will have to add the coverage, the additional cost will be modest, certainly less than 1% of total health care plan costs, said Rich Stover, a principal with Buck Consultants L.L.C. in Secaucus, N.J.

Some members of Congress, however, strongly oppose the requirement. Bills have been introduced in the House and Senate that would exempt any organization from the mandate if offering the coverage is contrary to its affiliated religious beliefs.

But experts say it is unlikely that those measures could win congressional approval this year. “There may be some interest” in Congress in preventing enforcement of the requirement, but it is not widespread, said J.D. Piro, a principal in the Norwalk, Conn., office of Aon Hewitt.

Certain religious organizations, though, are strongly opposed.

“Never before has the federal government forced individuals and organizations to go out into the marketplace and buy a product that violates their conscience. This shouldn't happen in a land where free exercise of religion ranks first in the Bill of Rights,” Cardinal-Designate Timothy Dolan of New York and president of the U.S. Conference of Catholic Bishops, said in a statement.

He urged Catholics and others to contact federal lawmakers to get the rule withdrawn.

“Let your elected leaders know that you want religious liberty and rights of conscience restored and that you want the administration's contraceptive mandate rescinded,” he said.

“The challenge that these regulations posed for many groups remains unresolved. This indicates the need for an effective national conversation on the appropriate conscience protections in our pluralistic country, which has always respected the role of religions,” Sister Carol Keehan, president and CEO of the Catholic Health Assn. of the United States in Washington, said in a statement.