Reacting to an election-year firestorm, the White House on Friday shifted course on its health care contraception mandate, announcing that religious employers will not have to cover free birth control for their employees and that the responsibility would instead fall to private insurers.
President Obama announced the compromise designed to accommodate religious organizations, led by the U.S. Catholic Church, infuriated by the new rule that would have required them to provide free contraception and other birth control services to employees at faith-based hospitals, schools and organizations.
"Today we've reached a decision on how to move forward," Mr. Obama told reporters a White House news briefing. "Under the rule, women will still have access to free preventative care that includes contraception no matter where they work, so that core principle remains. But if a women's employer is a charity, or a hospital that has a religious objection to providing contraceptive services as part of their health plan, the insurance company — not the hospital, not the charity — will be required to reach out to offer the woman contraception care free or charge without co-pays and without hassles."
The U.S. Conference of Catholic Bishops, which led the charge against the original rule, adopted a wait-and-see attitude Friday afternoon to the announcement while it studied the implications of Mr. Obama's revised plan.
"While there may be an openness to respond to some of our concerns, we reserve judgment on the details until we have them," said Cardinal-designate Timothy Dolan, president of USCCB, in a statement.
Mr. Obama, with Health and Human Services Secretary Kathleen Sebelius at his side, said the compromise solution allows him to stay true to a deeply held principle that contraception should be affordable to women regardless of their economic status or where they work, while allowing religious groups to remain true to their faith. But the original policy met with a furious reaction from the Catholic Church and joined by all of the leading Republican presidential candidates.
The abrupt reversal on a three-week-old policy was a dramatic public retreat for the president, which could produce political fallout among Catholics and Hispanic voters at the polls in November. In 2008, Mr. Obama won 54 percent of the total Catholic vote, compared to 45 percent for Republican John McCain.
In a pluralistic society, the president said, Americans are going to have honest disagreements, but he said he hoped that the compromise would satisfy all sides of the debate and critics would not continue to use the fight as "another political wedge issue."
"This is an issue where people of good will on both sides of the debate have been sorting through some very complicated questions to find a solution that works for everyone," Mr. Obama said. "With today's announcement, we've done that. Religious liberty will be protected, and a law that requires free preventive care will not discriminate against women."
The president of the Catholic Health Association, a trade group representing Catholic hospitals that had fought against the birth control requirement, said the organization was pleased with the revised rule.
"The framework developed has responded to the issues we identified that needed to be fixed," Sister Carol Keehan said in a statement.
Planned Parenthood also backed the revisions, saying the Obama administration was still committed to ensuring all women have access to birth control coverage, no matter where they work.
"We believe the compliance mechanism does not compromise a woman's ability to access these critical birth control benefits," Cecile Richards, the women's group president, said.
But several groups and officials critical of the original rule said Mr. Obama's revision did not go far enough, and it was far from clear Mr. Obama had succeeded in defusing the controversy.
"Only the most naive or gullible would accept this as a change in policy," Rep. Chris Smith, New Jersey Republican and one of the most vocal pro-life voices in Congress, said in a statement. "The newest iteration of Obama's coercion rule utterly fails because it still forces religious employers and employees who have moral objections to paying for abortion-inducing drugs, sterilization and contraception to pay for these things, because it is still the employers who buy the coverage for their employees."
Senior administration officials said the decision to require contraception coverage for all women was a deeply personal one for the president. The issue prompted an intense debate within the White House before the rule was released publicly Jan. 20, but Mr. Obama believed he had managed to balance concerns of religious organizations by exempting churches and other houses of worship from the requirement. But the mandate would force religiously-affiliated hospitals, universities and charities to provide contraception coverage as preventive care.
The uproar that followed forced Mr. Obama and administration officials back to the drawing board. Originally, Mrs. Sebelius had said she would work with members of these hospitals, universities and religiously-affiliated organizations over the next year to find middle ground before the rule became law, but last week the White House decided it could not wait.
The policy came under attack by Catholic cardinals and bishops across the country and Republicans presidential contenders on the campaign trail who accused Mr. Obama of attacking religious liberty. Earlier this week, House Speaker John Boehner, an Ohio Republican, said he would work to overturn the contraception mandate in Congress, and some influential Catholic Democrats came out against the president.
Under the new policy, religious employers will not have to provide contraceptive coverage or refer women to organizations that provide contraception. If an employer decides to opt out of covering birth control, the employer's insurance company will be required to contact the woman directly and provide the contraception coverage free of charge. The change pertaining to religious-affiliated organization is to take effect in August 2013, while most insurance plans will be required to cover women's preventive services without a co-pay, starting on Aug. 1, 2012.
Those services include mammograms, immunizations, domestic violence screening and contraception, all designed to encourage health care that many women may otherwise find unaffordable.
The White House says covering contraception saves insurance companies money in the long run by keeping women healthy and allowing them control over when and how often they bear children; how the insurance industry will view the mandate is another question.
Already, 28 states had required health insurance plans to cover birth control before the federal regulations were issued. However, they appear to have differing exemptions for religious employers.
The pressure was particularly intense because Mr. Obama risked alienating Catholics many of whom are swing voters in such pivotal political states as Ohio, Pennsylvania, Wisconsin and Michigan.
As the week wore on, the White House increasingly signaled that a change was coming.
Vice President Joe Biden, a Catholic, said in a radio interview Thursday that "there is going to be a significant attempt to work this out, and there is time to do that."
The Associated Press contributed to this report.
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