This post is part of a weekly “Did You Know” blog series that highlights important, but not well known features of the health reform law about prevention, wellness, and personal responsibility for our health.
If you’ve been tuning in to our weekly “Did You Know” blog series on preventive health and the Affordable Care Act, you might remember that last summer the U.S. Department of Health and Human Services (HHS) required health insurance companies to cover a set of women’s preventive health services without charging a co-payment (effective August 2012). The comprehensive set of free women’s preventive health services recommended by the Institute of Medicine includes, among many other necessary services, Food and Drug Administration-approved contraceptives, or birth control. This issue affects millions of Americans. There are approximately 43 million sexually active women who do not want to become pregnant in the United States; 89% of them use contraception.
Last summer’s interim rule allowed certain nonprofit religious employers offering health insurance to their employees to qualify for a religious exemption and therefore be able to decide for themselves whether or not to cover contraceptive services in their employer-sponsored coverage. This religious exemption was narrowly defined, pertaining only to those religious institutions that employ and serve people of the same religious beliefs, like churches or synagogues. The exemption did not include religiously affiliated institutions, like hospitals and schools. When HHS asked for public comment on this part of the rule, it received an outpouring of input from groups supporting the narrow exception and groups wanting it expanded.
On Friday of last week, HHS announced its final ruling on this issue, concluding that the narrow definition of the religious exemption will stand. Religious places of worship like churches will be exempt from the rule, but institutions with religious affiliations like hospitals and schools will not. This means, for example, that churches will not have to cover contraceptive health for their employees, but religiously affiliated hospitals will have to offer that coverage to their doctors, nurses, and other employees. The only change to the rule from last August is the decision to give employers who don’t currently offer contraceptives in their employer-sponsored health coverage because of a religious belief an extra year (until 2013) to comply with the mandate. The Secretary of HHS, Kathleen Sebelius, said that she believes this proposal “strikes the appropriate balance between respecting religious freedom and increasing access to important preventive services.”
This blog post was coauthored by Rachel Gielau.