Birth control rule revised by President

WASHINGTON -- Under election-year fire, President Obama on Friday abandoned his stand that religious organizations must pay for birth control for workers, scrambling to end a furor raging from the Catholic Church to Congress to election foes.

The President demanded instead that insurance companies provide the coverage.

Mr. Obama's compromise means that women still would get birth control without having to pay for it, no matter where they work.

The President insisted he had stuck by that principle even in switching his approach, and the White House rejected any characterization that Mr. Obama had retreated under pressure.

During an appearance in the White House briefing room Friday, he amended a rule announced in August that was to take effect this summer requiring employers to provide contraceptive coverage with no out-of-pocket costs as part of their health plans for workers.

Churches have always been exempt from the mandate.

But Catholic and other religious leaders had complained that the rule would force church-affiliated institutions such as schools, charities, hospitals, and universities to pay for services that violated their beliefs.

Under the new arrangement, details of which have yet to be made final, women who work for such organizations still would be guaranteed contraceptive coverage. But they will obtain it directly from their insurance companies, which must provide the coverage without charging an additional premium.

"I've been confident from the start we could work out a sensible approach here," Mr. Obama said. "Some folks in Washington may want to treat this as another political wedge issue, but it shouldn't be. I never saw it that way."

His involvement in what amounts to a technical regulatory matter underscored the political stakes for a President in a re-election campaign.

As the White House struggled to resolve the contraception controversy, a few blocks away, potential GOP challengers Mitt Romney and Rick Santorum cited the birth control rule Friday in attacks on Mr. Obama during speeches to conservative activists.

By contrast, several Catholic leaders, who pressed the administration for a broader religious exemption to the rule, seemed at least open to the newly revised plan.

Cardinal-designate Timothy Michael Dolan of New York, president of the U.S. Conference of Catholic Bishops, who has led a national campaign on the issue, described Mr. Obama's decision as "a first step in the right direction." He reserved judgment on the details.

Sister Carol Keehan, who heads the U.S. Catholic Health Association, went further, pronouncing herself "very pleased."

The Rev. Larry Snyder, president and chief executive of Catholic Charities USA, said his organization was "deeply appreciative."

But Friday's announcement raised new policy questions.

The Obama Administration has not decided how the arrangement will apply to religiously affiliated employers that self-insure, meaning that instead of purchasing a group policy on behalf of their workers, they collect premiums from workers directly, add their contributions to a pool, and use the funds to pay for workers' health-care costs.

Self-insurance is popular among large employers, who often hire an insurance company to administer the fund.

A significant number of religiously affiliated hospitals and universities are likely to fall into this category.

"We don't really see how this new accommodation would satisfy our concerns," said Michael Warsaw, president and chief executive of EWTN, a nonprofit network of Catholic television and radio stations that self-insures its roughly 350 employees.

The organization has filed a lawsuit challenging the birth control rule.

An Obama Administration official who requested anonymity said the White House will be looking at how to address such cases.

"This policy will be developed collaboratively," the official said.

Other organizations expressed concern that for-profit employers with moral objections to contraception will not be eligible for the accommodation.

Meanwhile, female staff members at churches, which are completely exempt from the rule, will not be able to obtain the additional coverage from their insurer.

Although administration officials cited studies indicating that the impact of the accommodation on insurers would be cost-neutral, industry representatives expressed concern at the precedent set by the administration, which requires them to provide a service without adjusting their premiums.

In addition to escalating attacks from Republicans, the White House over the past week has faced intensifying pressure from friends on both sides of the issue.

Representatives of women's groups and key Democratic members of Congress, who were worried that the White House would go wobbly and repeal the rule, repeatedly called key Obama advisers to press their case.

Several leading Catholic Democrats and outside religious leaders who are otherwise supportive of the administration offered a competing perspective.

They argued that the White House had needlessly put at risk the good will that Mr. Obama had built over years of courting religious leaders and voters.