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President Obama compromises on contraception

Under the new plan, even women who work for religious employers will have access to free birth control.

Kai Ryssdal: It took the White House a week, but today the president announced what he's calling an accommodation on contraception and religious employers.

Barack Obama: These employers will not have to pay for or provide contraceptive services, but women who work at these institutions will have access to free contraceptive services, just like other women.

The health care law says companies do have to pay for preventive health services, including birth control for women. That means no copays. Some religious institutions say they shouldn't have to pay for birth control, so under the compromise today, they won't -- their insurance companies will.

From the Marketplace health desk at WHYY, Gregory Warner breaks down how it's going to work.


Gregory Warner: Your insurance company is like a pool fed by three sources:

1) the premium paid by the employer,
2) the premium paid by the employee, usually comes out of your paycheck, and
3) copays.

The law says that women can’t be charged a copay for contraception. Some religious employers don’t want to pay for it. But there’s one more source left: the employees share of the premium. That’s effectively what the president proposed today.

JB Silvers is a professor of healthcare finance at Case Western Reserve University.

JB Silvers: You’re making the assumption that dollars have labels on them. But in reality, all the dollars go in from the premium from the employee from the employer they all go into the policy.

Some Republicans have called the president’s compromise a “shell game.” But Silvers says divvying up funds is done in all kinds of sticky situations involving money and religion. For instance tax money goes to faith-based charities but can’t be used for religious services.

Silvers: It’s a fine line, obviously.

But it’s a line that faith-based organizations have accepted, even on this very contraception issue, on the state level. Catholic bishops are mulling over the president’s offer. Women are also trying to figure out how it's going to work.

I reached Colleen Vermeulen of Indiana in her car on the way to divinity school where she’s studying to become a Catholic lay minister. She agrees with the bishops that her Catholic University should not be forced to pay for birth control.

Colleen Vermeulen: It’s not about whether I use it. It’s about who’s paying for it.

So what if it were paid out of her share of the premium?

Vermeulen: If the health insurance company itself is shifting the money around, I would have to look and see, you know exactly how they’re using -- like, are they actually earmarking, for contraception? Or is some of that money going into other pools?

She says she’d support it if she could feel comfortable that those pools of money are really separate. And that is, as we’ve heard, a leap of faith.

In Philadelphia, I’m Gregory Warner for Marketplace.

About the author

Gregory Warner is a senior reporter covering the economics and business of healthcare for the entire Marketplace portfolio.

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