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Dept. of Justice Responds to Contraceptive Coverage Lawsuit as Debate Continues

Dept. of Justice Responds to Contraceptive Coverage Lawsuit as Debate Continues

February 21, 2012 — The Department of Justice on Friday filed a motion to dismiss Belmont Abbey College's lawsuit against the Obama administration's new contraceptive coverage rules, CNN reports (Mears, CNN, 2/17).

The lawsuit charges that the requirement that the college provide no-cost contraceptive coverage to employees violates its religious teachings as a Catholic institution. The suit contends that the requirement forces the college and "millions of other Americans ... to pay for contraception, sterilization, abortion, and related education and counseling" (Rovner, "Shots," NPR, 2/17). The rules implement a provision in the federal health reform law (PL 111-148) that requires health plans to cover preventive services without copayments or deductibles.

Originally, the administration exempted certain religious employers from covering contraceptive services for their employees, but it did not exempt religiously affiliated organizations with more general missions, such as Catholic hospitals and universities. President Obama recently announced that religiously affiliated employers will not have to offer contraceptive coverage for their employees, but their health insurance companies will be required to provide the coverage directly to women at no charge (Women's Health Policy Report, 2/14).

According to the DOJ's motion to dismiss the case, Belmont Abbey College's health plan would not be affected by either the original or current version of the rules because the plan has not changed substantially since the health reform law was passed, meaning it has "grandfathered" status and is not subject to the requirement. Even if the health plan was not grandfathered, Belmont Abbey -- like all religiously affiliated institutions -- would have one year to comply, DOJ added ("Shots," NPR, 2/17).

In related news, the Becket Fund for Religious Liberty on Tuesday filed a federal lawsuit against the rules on behalf of Ave Maria University, The Hill's "Healthwatch" reports (Baker, "Healthwatch," The Hill, 2/21).

Meanwhile, a group of evangelical pastors on Monday pledged to join Catholic leaders in fighting the contraceptive coverage rules. Family Research Council President Tony Perkins said more than 2,500 pastors and evangelical leaders have signed a letter to Obama asking him to reverse the rules (AP/Washington Post, 2/20).

Birth Control Rule Sparks Election-Year Battle

The fight over the new federal contraceptive coverage rules likely will continue through the 2012 election, with political implications for both sides, the Washington Post reports. The rules have sparked a national debate on access to contraception, which "might seem a bewildering turn of events," given that polls show voters are more concerned about the economy and that the vast majority of U.S. residents use contraception, according to the Post (Gerhart, Washington Post, 2/20). The debate might alienate voters who think the economy should be a higher priority in the election than social issues, according to USA Today (Davis, USA Today, 2/17).

However, Politico suggests that the issue has become so prominent that 2012 could "be the year of the 'birth control moms'" -- the latest version of "soccer moms" or "security moms" from past election years. Jennifer Lawless, director of the Women and Politics Institute at American University, said there could be a backlash against politicians who oppose contraceptive access. "If women feel they are being targeted again, that women's health is on the line -- that's not an argument you want to make in an election year," she said (Kenen, Politico, 2/18).

Republicans have argued that the debate is not about birth control but about religious freedom. Meanwhile, female Democrats in a series of floor speeches on Friday cast the issue as part of a broader "attack on women's health" (Feder, Politico, 2/17).

Santorum's Position on Contraception, Prenatal Testing Attract Scrutiny

Republican presidential candidate Rick Santorum's recent comments on women's health-related issues might help Democrats mobilize female voters against him, according to Politico (Burns/Haberman, Politico, 2/18).

Santorum attempted to clarify his stance on contraception on Friday, telling reporters that although he personally opposes birth control, he thinks it should be available to women (Yadron, "Washington Wire," Wall Street Journal, 2/17). On CBS' "Face the Nation," Santorum also criticized a provision in the health reform law that requires insurers to cover prenatal testing (Barrett, "Washington Wire," Wall Street Journal, 2/19). He claimed that prenatal testing "more often than not" leads to abortion, adding, "People have the right to do it, but to have the government force people to provide it free, to me, is a bit loaded" (Cohen, CNN, 2/19).

Kim Gandy, former president of the National Organization for Women, said Santorum "constantly says things that are offensive to women." She added, "The idea that a man who opposes something as widespread as the use of birth control would even be taken seriously as a candidate, would be shocking to me" (Burns/Haberman, Politico, 2/18).

Obama Campaign Highlights Contraceptive Coverage, Progress on Women's Issues

First lady Michelle Obama will host several events around the country to boost support for her husband among female voters, according to an email sent to supporters on Sunday, Bloomberg reports. The first lady will discuss progress the administration has made for women, including the contraceptive coverage requirement, the Lilly Ledbetter Fair Pay Act and provisions in the health reform law that provide coverage for mammograms and prevent insurers from charging women higher premiums than men (Talev, Bloomberg, 2/21).

Rules Would Reduce Cost Barriers, Experts Say

In related news, women's health advocates hope that by reducing cost barriers to birth control, the contraceptive coverage rules will encourage more women to choose highly effective, long-acting methods, such as intrauterine devices and hormonal implants, the Washington Post reports. Although long-acting methods are the most cost-effective type of contraception, the initial cost can be an impediment for women who have to pay out-of-pocket (Andrews, Washington Post, 2/17).

States' Approaches to Contraceptive Coverage Vary

The Post reports that 28 states already have contraceptive coverage laws similar to the federal rules, and nearly one-third of those states do not offer an exemption for religious institutions or affiliated groups. However, the Post notes that many religious employers have found ways to circumvent the laws, such as by self-insuring or taking advantage of vague language or lax enforcement at the state level (Aizenman/Sun, Washington Post, 2/19).

Meanwhile, Republican lawmakers in a few states are attempting to fight the federal rules through legislation. Legislators in Idaho, Missouri and Arizona recently introduced measures that would allow any health plan or employer to refuse coverage of contraception, abortion or sterilization (Miller, AP/Boston Globe, 2/17).

Reproductive Health Issues Complicate Catholic Hospital Mergers

The escalating tension between Catholic leaders and the Obama administration comes as Catholic-affiliated health systems increasingly are merging with smaller secular hospitals to address growing financial pressures, the New York Times reports. Over the last three years, nearly 20 Catholic hospitals have merged with smaller, secular hospitals. In some cases, the mergers have limited access to contraception, abortion and sterilization, according to the Times (Abelson, New York Times, 2/20).

Meanwhile, the Philadelphia Inquirer reports that tubal ligations -- which are prohibited under Catholic doctrine -- have been performed in Catholic hospitals across the country. For example, a 2011 doctoral dissertation by a student at Baylor University found that more than 20,000 women who gave birth at Catholic hospitals in seven states received tubal ligations from 2007 through 2009 (McCullough, Philadelphia Inquirer, 2/20).

The New York Times reports that there also is variance among parish priests in the rigidity of Catholic teachings on birth control. While some priests preach against contraception and equate some methods with abortion, other priests do not typically discuss the issues with their parishioners (Oppenheimer, New York Times, 2/18).

Interview on 'Sexual Counterevolution'

In related news, Salon recently interviewed Nancy Cohen -- author of the new book "Delirium: How the Sexual Counterrevolution is Polarizing America" -- about the history of the political fight over sexual rights and health. She coined the term "sexual counterrevolution" to describe the "concerted, organized movement to turn back the changes brought about by the sexual revolution: feminism and gay rights" (Wood, Salon, 2/20).