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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@conmigo, you can respond with "Please with the war on women crap." and other feeble, knee-jerk retorts, but that doesn't make the facts any less real.

It is obvious for all to see, that the House Repubs and teapots have spent the entirety of their 2 seesions focused on womens uterii and not on Jobs.

The bottomline of this issue is still a "Made-for-Election-2012" wedge confusion issue concocted by extremists.

How is anything I've said feeble??? It would seem more extreme, when the minimum wage in this country averages out to about $9 an hour, that overpaid government and subsidized by the government workers such as teachers, police officers, corrections officers, firefighters, nurses, doctors, and most trade workers working on senseless unpaid for government projects won't take pay or wage cuts to help actually stimulate the economy and lower prices for everybody. I would rather let someone who actually worked a job collect unemployment benefits for years than subsidize people who were married to someone for 10 years live comfortably for 20 plus years having almost no work history and little if any education. Look around you. This isn't a war against women. It's a war between those who want to recieve something for basically nothing and those that have worked there asses off for nothing in return. And as for it's obvious for all to see, the Republicans have not had significant control of the government since 2006...Just about the time everything started to go off the cliff. How many jobs bills has the House of Representatives passed that got approval by the Senate and a signature from the president: Zero. Just because somebody wishes something does not make it true. Everyone might want higher wages and benefits; but only giving them to the least productive is insanity. And as for the hypocritical quasi-socialists, I laugh. C'mon, if someone knocked on their door and said: "I've got a paying job for you right now that you can do to help everyone," would they really do it or would they rather find some better "scam" to keep whatever gravy train there working rolling. Full disclosure: My father is a retired State Worker who, after 30 years of making over $80,000 a year with just a Bachelors in Civil Engineering, at age 53 began pulling a $3000 a month pension. He drank and did drugs from his teens all the way until his retirement...now 10 years later he sits in his million dollar house still drinking and smoking up his pension money every month with money left over. There are far too many people like my father really draining the system to the point of never actually making any contributions themselves...its sickening. Let us really all start to pay our "fair share," whatever that's supposed to be.

Please with the war on women crap. This is another stupid expense that employers should not be forced to pick up. People always make these general "if this doesn't happen, this will happen" scare arguments which really detract from the real issues. Look for female employment to go down as a result. Just look at the tactics companies use to get out of paying higher unemployment insurance and other penny-pinching methods as an example of "cost-cutting." I honestly believe that an incompetant women is less likely to be fired than an incompetant man, in any profession, due to employer fears of bogus discrimination or harassment litigation. Watch women not get hired because of this provision; and than sue for paydays like they always seem to. Women with feeble work experience and questionable resumes are the recipients of more cash settlements than any other group. I can see the lawsuit now: Class-action against a major "corporation" to the tune of 10 million per litigant for discrimination for not hiring because their women and would cost more to do so.

This was never a real issue. The guidelines as promulgated by HHS conformed to those health insurance requirements of 28 States, including the RomneyCare Health Care initiative in Mass. This was a "made-for-2012-Election" political issue deliberately created by a very few far-out politicos, Zealots and a grandstanding bishop or 2.

90 odd% of Roman Catholics and 100% of X Catholics disagree with the bishops.

Viagra and Cialis are covered.

However, Journalists have forgotten what journalism is about. Way too many spooked like a herd of cattle after a lightning flash. Unfortunately, We the Normal People do not have a gang of cowboys to ride out to rein in the stampeding herd.

I have to ask Gregory Warner how in the World he found the contact information for the 1 (One) "Catholic" woman in America who agrees with the bishops?? In the interests of "fair and balanced" shouldn't you have talked to Catholics supporting the regs including Irish-Catholic head of N.O.W., Terry O'Neill (of the High O'Neills)?

And WHY are Republicans and bishops waging war against women? Why are RepubliPots spending all year trying to regulate the use of women's uterii instead of creating JOBS - as promised?

@hivdoc, good points, esp, how this conversation would have gone, if over a Muslim issue. And, now, these same self-proclaimed "protectors of Religious Freedom" have created a precedent and moved towards "respecting an establishment of religion", and of prohibiting any "prohibiting the free exercise thereof".
Unintended consequences, eh?

@dmuliiga, good point. About your question about "claim is that contraceptives are preventative care", 'tho, I think "contraceptives" are pretty universally accepted as "preventative care".

love your show, but this report (and almost everyone else's coverage) misses the point, really. Healthcare is not a gift from your employer, it is a contractural benefit- (usually calculated as a percentage of your wages) that you earn every hour you work. Once I earn my benefit, just like my wages, my employer has no business telling me how to spend it. Now the church can tell me that I shouldn't spend my paycheck on booze, strippers and gambling, but it can't prevent me from spending my paycheck on booze strippers and gambling. Why should it have a voice in how we spend our health care? My employer is not buying my medicine, my x ray or my surgery. I am.

The president’s compromise is an entirely reasonable one, even if it is a fine line (even if it’s a shell game, or smoke and mirrors); it at least recognizes the ethical dilemma (which I suspect is the best for which anyone can hope).

But, there is still something that is disturbing about the reasoning that started this whole debate: The claim is that contraceptives are preventative care; which makes no sense at all since pregnancy is not a disease. Further this co-pay exemption is only for women; which is clearly sexual discrimination.

None the less, it is no longer an issue of ethics; it is now an issue of fairness (and life is never fair).

...also as Noah Millman of the American Conservative point out, how different would this discussion be if it were a muslem or scientologist employer trying to limit healthcare options of a christian employee?

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