Tulsa's Catholic hospitals had little response Friday to proposed federal rules that would loosen contraception insurance requirements for church-related nonprofit organizations, but an attorney for an Oklahoma City company challenging the mandate in court said the change would do nothing to protect the religious liberty of millions of Americans.
"We are extremely disappointed with today's announcement," said Kyle Duncan, one of the attorneys representing Hobby Lobby in its federal court challenge of Affordable Care Act requirements. "We remain committed to protecting religious liberty until the administration recognizes the conscience rights of all Americans."
The federal health law -- "Obama- care" -- requires inclusion of contraception with no co-pays or deductibles for women in all employer-provided health coverage.
Churches were already exempted from the requirements, but the rules proposed Friday offer to wire around them for church-related nonprofits such as schools and hospitals.
The nonprofit organizations wouldn't have to buy contraception-funding insurance, but their insurance companies would have to provide separate coverage to insured women at no cost under the proposed rules. A complex scheme of reimbursement to third-party administrators would result in essentially the same result for self-insured nonprofits.
St. John Medical Center and Saint Francis Health System -- both of which appear to be potentially covered by Friday's exception -- referred requests for comments to a statement from the Catholic Health Association, which said only that it looked forward to studying the proposal.
A statement from Saint Francis added that it would be speculative to comment on the proposal's outcome until the rule-making process ends.
But Duncan said the proposed rules fall far short of what is needed to protect the religious liberty of for-profit employers.
"Today's proposed rule does nothing to protect the religious freedom of millions of Americans. For instance, it does nothing to protect the rights of family businesses like Hobby Lobby," he said.
"The administration obviously realizes that the ... mandate puts constitutional rights at risk," Duncan said. "There would have been an easy way to resolve this -- expanding the exemption -- but the proposed rule expressly rejects that option."
While its owners don't object to many forms of contraception, Hobby Lobby has argued in court that some of the methods included under the mandate would amount to chemical abortions in violation of the religious beliefs of company founders.
Federal courts, including the U.S. Supreme Court, have turned away the arts and crafts store chain's requests for an injunction to block the mandate.
The company's legal challenge to the mandate is pending at the 10th U.S. Circuit Court of Appeals. In January, the company announced that it would shift the timing of its employee health plan to stave off fines of up to $1.3 million a day for failing to obey the federal requirements.
A U.S. Department of Health and Human Services official said the proposed rules protect women and religiously affiliated groups.
"The administration is committed to working with all employers to give them the flexibility and resources they need to implement the health-care law in a way that both protects women's health and makes common-sense accommodations for religious belief," Chiquita Brooks-LaSure, deputy director of the federal Center for Consumer Information and Insurance Oversight, said in a teleconference from Washington on Friday.
The law requires employer-provided health-care plans to include a long list of preventive health-care measures for women without any out-of-pocket costs. Most of the services -- things such as well-woman visits and domestic violence counseling -- were relatively uncontroversial.
But the mandate's contraception requirement has brought 44 lawsuits, including the Hobby Lobby case.
The proposed rules would still provide women who work for religion-affiliated nonprofits with no-expense contraception but would build a wall of separation between the employer and the coverage.
If a nonprofit provides its employees with coverage through an insurance company, the insurance company is required to provide a free policy to the nonprofit's women to cover contraceptives. Arguing that contraceptives have health benefits that lower the total cost of covering women, the Obama administration expects insurance companies to absorb the cost of the contraceptive coverage.
"Independent scientists and experts at the Institute of Medicine, who first recommended covering contraception free of charge, know that there are tremendous health benefits for women that come from using contraception," Brooks-LaSure said.
If the nonprofit is self- insured, the plan's third-party administrator is required to purchase contraceptive insurance coverage at no cost to the woman or the nonprofit. The third-party providers will be reimbursed the costs of the insurance through lowered fees to participate in health insurance exchanges in states where those exchanges are run by the federal government. In places with state-run exchanges, the costs can be shifted to affiliated third-party providers in other states.
Again, under the assumption that contraceptives lower the cost of health care, the administration maintains that taxpayers will not end up with any higher costs because of the coverage.
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