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Health On The Hill Transcript: Backlash Grows Over Contraception Rule In Health Law

KHN’s Mary Agnes Carey talks with Jackie Judd about an Obama administration rule that would require many religious-affiliated groups to cover birth control in their insurance plans. House Speaker John Boehner has suggested Congress could take legislative action to stop the rule.

>> Watch the video or listen to audio of the interview.

JACKIE JUDD: Good day, this is Health on the Hill. I’m Jackie Judd.

Religion, politics and health care. It’s a potent combination as the political fight between the White House and Capitol Hill shows: A fight triggered by the administration’s decision to require most religious-affiliated institutions—such as Catholic hospitals—to include free contraceptive care as part of their health insurance coverage beginning in 2013. A clear sign of the growing anger over the issue was Speaker John Boehner’s unexpected appearance today on the House floor.

SPEAKER JOHN BOEHNER, R-OHIO (video clip): “In imposing this requirement, the federal government has drifted dangerously beyond its constitutional boundaries, encroaching on religious freedom in a manner that affects millions of Americans and harms some of our nation’s most vital institutions.”

JACKIE JUDD: Kaiser Health News correspondent Mary Agnes Carey is following this and joins us now. Welcome, Mary Agnes.


JACKIE JUDD: Walk us back a couple of steps. This is part of the ACA – the health reform law. What does it require, and what has the administration done about it in the past couple of weeks?

MARY AGNES CAREY: What the health law requires is that preventive services be offered free – no copays, no deductibles. The Institute of Medicine advised the Department of Health and Human Services to include contraception as part of these required services. So when that announcement was made on Jan. 20, churches themselves, synagogues and so on, were exempted. But as you noted, not the religious-affiliated institutions, not the hospitals, not the universities.  They’ve said those institutions will have a year to comply with the requirement that goes into effect for everyone else in August.

JACKIE JUDD:  David Axelrod, one of the president’s top advisors in his presidential campaign, suggested last night there might be a compromise in the works.  What did the White House say about that today?

MARY AGNES CAREY:  The White House has reiterated repeatedly that they’re open to talking to all parties.  As Speaker Boehner mentioned, there are religious institutions – Catholic institutions, some evangelical institutions – that find this requirement offensive to them, and they feel it is an intrusion into their religious freedom.  And so what the White House has said is: We want to talk to people that have concerns. We’ve given them additional time to implement this requirement, and we hope to find a compromise.  But they’ve made it clear that they’re not backing down from this guarantee of contraceptive coverage for all women no matter where they work. 

JACKIE JUDD:  Political tightrope for the White House.

MARY AGNES CAREY:  I think it is a political tightrope, but it kind of cuts both ways.  This was very critical for the Democratic base.  Very important for women’s rights groups, women’s health groups – they feel very strongly about this.  The administration feels strongly.  They’re hoping that signaling that they want to be flexible in giving an additional year to comply will possibly buy them some time.  They might find some compromise.  But opponents of this say it doesn’t matter that they have an extra year.  They have another year to “violate their conscience,” which just doesn’t appeal to them.

JACKIE JUDD:  And in the House floor speech today that John Boehner delivered, he suggested that there may be some kind of legislative action that he will try to move through the House?

MARY AGNES CAREY:  The Energy & Commerce Committee has already had a hearing on this previously.  I’m sure they’ll have more hearings there.  You can see legislation coming out of that committee, going to the House floor.  In the Senate, Mitch McConnell, who is the Republican leader, has suggested they’ll also have a legislative response.  But in the Senate, Democrats control the floor.  So you might not see something like that get to the floor for action.

JACKIE JUDD:  But on Capitol Hill this fight is not breaking cleanly between Democrats and Republicans.  For some Democrats for example, who are Catholic, they’re not very happy.

MARY AGNES CAREY:  John Larson, who is the fourth ranking Democrat in the House has suggested the administration work with opponents, including Catholic churches, to find a compromise on this.  Dan Lipinski, who is another Democrat in the House, is concerned about it.  In the Senate, Bob Casey, who is a senator from Pennsylvania, is very concerned.  Joe Manchin of West Virginia is concerned.

So while the majority of Democrats do support the president, there are absolutely those who do not.

JACKIE JUDD:  And in 2012, we cannot have a conversation like this without making the obvious point that there is presidential campaign going on.  So how much of this dispute is a proxy, if you will, for the larger disagreements that many Republicans have with the reform law at large?

MARY AGNES CAREY:  I think that it is simply another opportunity for Republicans to talk about what they hate about the law.  They’ve made the argument for a long time:  It’s an overreach of the federal government.  Here’s another example: “if, by the way, we run the place, we’ll get rid of it.”  So they’re definitely using this.

But Democrats, as well, are using this to build support for the health law, to say that this guarantee for women is a critical pillar of the health law, and they plan to maintain it.

JACKIE JUDD:  OK, more later I’m sure.

MARY AGNES CAREY:  Absolutely.

JACKIE JUDD:  Mary Agnes Carey of Kaiser Health News, thank you.


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