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Contraception Coverage Issue Continues To Smolder On Capitol Hill

Jackie Judd and KHN’s Mary Agnes Carey discuss the continuing dispute over the health law provision mandating free-to-consumers contraception coverage, as the focus broadens from Congress to the courts as well.

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Here’s a transcript:

JACKIE JUDD:  Good day, this is Health on the Hill. I’m Jackie Judd. Over the next few years, various aspects of the health overhaul law will go into effect—some big and some small. Recently, there was a significant expansion of women’s health services, including coverage of contraception. That has triggered a new round of controversy involving Capitol Hill and the Catholic Church. Here to fill us in is Mary Agnes Carey of Kaiser Health News.  Welcome, as always. 

Let’s go back to the beginning and remind us what these services include and who for the moment is exempted. 

MARY AGNES CAREY:  This is a package of women’s health preventive services that went into effect Aug. 1.  It applies to plans that are new after that date; it does not apply to grandfathered plans.  But you’re talking about contraceptive services that have been approved by the Food and Drug Administration.  The controversy here is that for the Catholic Church and for some other faiths, they are arguing that requiring them to cover these is a violation of their religious liberty.  There was an exemption for organizations that serve members primarily of their own faith: a church or a synagogue, for example.  They don’t have to abide by this coverage requirement.  But religiously affiliated organizations, a hospital or a university, would have to abide.  They’ve been given a one year exemption from complying, but the fact that they have to comply remains controversial.

JACKIE JUDD:  Soon after it was enacted Aug. 1, the Catholic bishops of the U.S. wrote yet another letter to the U.S. Congress asking them to address this “urgent and fundamental issue.”  Congress has taken a couple stabs at rolling this requirement back; none successful so far.  What was in this letter and what prompted it once again?

MARY AGNES CAREY:  The bishops noted, as you just explained, earlier this year in the Senate, there was a move to expand the exemption to any religious organization — or even a health insurer that found this morally objectionable. That did not succeed in the Senate. In the House there’s an appropriations bill pending that would accomplish the same goals. That’s not expected to become law.

And so the thought is that the bishops have said to Congress: “We know that you’ve tried in other avenues, but — to every member of Congress — you’ve got to work on this and resolve it and expand this exemption before you adjourn for the year.”

JACKIE JUDD:  What is the likelihood that that will happen? As always on Health On The Hill, we note: We’re in the middle of a political year, which changes so much.

MARY AGNES CAREY: John Boehner, who is the speaker of the House, who had said previously on the floor of the House that the House would take action to repeal this. He said at a news conference last week, before the House adjourned for the August break, that he and others that oppose this requirement continue to work with groups that also oppose it, but it wasn’t going to telegraph their strategy.

As we know, when this was debated earlier in the year, Democrats attacked Republicans, saying this was a “war on women.” And that strategy seems to have worked for Democrats. I doubt very much that Republicans would want to vote on this again before the election.

JACKIE JUDD: There are couple of dozen lawsuits that have been filed contesting this requirement. What is the likelihood that the courts would act and act quickly?

MARY AGNES CAREY: Well, it’s interesting. In Denver, about a week ago, a judge gave a reprieve to a Catholic business owner who said: “I don’t want to comply with this requirement. This is morally objectionable. It violates my religious freedom.”  And so he did get a reprieve.

Now whether or not that will play out in other courts is unclear. But it seems at least through the election, perhaps through the end of the year, the courts may be the place where we see more action on this than Congress.

JACKIE JUDD: What’s so interesting, if you step back from this specific issue, is the Supreme Court ruled that the Affordable Care Act is constitutional, and yet that hasn’t stopped these kinds of issues still coming to the fore.

MARY AGNES CAREY: Absolutely, and you may see more of this as the health law is implemented.

JACKIE JUDD: OK. Thank so much, Mary Agnes Carey of Kaiser Health News.


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