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Catholic Contraception Controversy: The State Of Pay

Two Democratic governors — Gov. Dannel Malloy of Connecticut and Gov. Martin O’Malley of Maryland — tried to tamp down the controversy over contraception coverage at Catholic institutions this week by quoting the same number:  28 states already require insurance coverage of contraception.

That’s true and it’s mentioned in a state policy brief by the reproductive health think tank, the Guttmacher Institute. But it’s not the whole story.

The same report shows that 20 of those 28 states have exemptions from the coverage policy for religious employers and insurers. Guttmacher categorizes eight of those exemptions as “expansive” – and both Connecticut and Maryland are in that category.

For Maryland, that means that most Catholic schools, universities and hospitals are not required to cover contraception for their employees. In Connecticut, religious insurers are required to offer contraceptive coverage through a subcontract, according to the report.

Eight states have no exemption – so Catholic employers in Colorado, Georgia, Iowa, Montana, New Hampshire, Texas, Vermont, Virginia and Wisconsin must provide contraception coverage under state laws.

Four more states have a limited exemption that cleaves closely to the new federal rule. That rule applies narrowly to churches that employ mainly members of their own faith. The four states with narrow exemptions from the contraception coverage mandate are Arizona, California, New York and Rhode Island.

Massachusetts is on the roster of states with an exemption to the coverage mandate that Guttmacher labels as “broader” — meaning that most churches and  schools don’t have to provide birth control coverage but universities and hospitals do.

Elizabeth Nash is the state issues manager for Guttmacher; she put together the policy brief. Nash says there’s wide variation state to state, and that the coverage laws have evolved over time. “The first law was adopted in 1998 in Maryland, and it had a very broad exemption, ‘Religious organizations may opt out.’ There was no definition of what a religious organization is,” Nash said.

It is unclear how many Catholic institutions would be affected if the new federal rule goes into effect, which is increasingly in doubt as political pressure from within Democratic circles heats up. A spokeswoman for the Association of Catholic Colleges and Universities said her organization doesn’t track which of its member institutions are required to offer contraception coverage under state laws.

Calls to the Catholic Health Association, representing Catholic hospitals, and the United States Conference of Catholic Bishops were not returned by press time.

Jeff Cohen of WNPR in Connecticut contributed to this report. This is part of a reporting partnership that includes NPR, member stations and Kaiser Health News.