President Obama has announced a major revision of the mandate requiring employers to provide contraception coverage in employee health plans. Under the new rule, senior administration officials confirmed, no religious institution will have to pay for health-insurance plans that include contraception coverage. Not houses of worship, not parish schools, not universities, not hospitals, not charitable organizations.The outline of the new rule is fairly simple. Nonprofit religious institutions that do not fall within the narrow religious exemption will not have to offer employee health plans that cover contraception. Instead, the employer's insurance company will have to contact employees directly and offer contraception coverage at no cost. (Religious organizations that primarily employ and serve co-religionists, and whose mission is primarily to inculcate its values, will not be covered by this new arrangement.)

Why would insurers agree to provide contraception services for free? Because, actuarially, it seems to make financial sense. The average pregnancy costs roughly $12,000. Enrollees who use contraception are cheaper to cover.

The revised ruling seems to have satisfied both Sr. Carol Keehan, president of the Catholic Health Association, who had criticized the original ruling, and Cecile Richards, president of Planned Parenthood, both of whom made statements praising the revised policy.Given that religious institutions will not have to pay for policies that include contraception, and they there is no requirement that they refer employees for such services, the new policy directly addresses the legitimate objections raised by the U.S. Conference of Catholic Bishops.We'll see. More details as they come throughout the day.

Updates: USCCB press release:

"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. "The past three weeks have witnessed a remarkable unity of Americans from all religions or none at all worried about the erosion of religious freedom and governmental intrusion into issues of faith and morals," he said.

"Today's decision to revise how individuals obtain services that are morally objectionable to religious entities and people of faith is a first step in the right direction," Cardinal-designate Dolan said. "We hope to work with the Administration to guarantee that Americans consciences and our religious freedom are not harmed by these regulations."
 

Statement from Sr. Keehan:

The Catholic Health Association is very pleased with the White House announcement that a resolution has been reached that protects the religious liberty and conscience rights of Catholic institutions. The framework developed has responded to the issues we identified that needed to be fixed.We are pleased and grateful that the religious liberty and conscience protection needs of so many ministries that serve our country were appreciated enough that an early resolution of this issue was accomplished. The unity of Catholic organizations in addressing this concern was a sign of its importance.This difference has at times been uncomfortable but it has helped our country sort through an issue that has been important throughout the history of our great democracy.The Catholic Health Association remains committed to working with the Administration and others to fully implement the Affordable Care Act to extend comprehensive and quality health care to many who suffer today from the lack of it.

President Obama's remarks:

As part of the health care reform law that I signed last year, all insurance plans are required to cover preventive care at no cost. That means free check-ups, free mammograms, immunizations and other basic services. We fought for this because it saves lives and it saves money - for families, for businesses, for government, for everybody. That's because its a lot cheaper to prevent an illness than to treat one.

We also accepted a recommendation from the experts at the Institute of Medicine that when it comes to women, preventive care should include coverage of contraceptive services such as birth control. In addition to family planning, doctors often prescribe contraception as a way to reduce the risks of ovarian and other cancers, and treat a variety of different ailments. And we know that the overall cost of health care is lower when women have access to contraceptive services.

Nearly 99 percent of all women have relied on contraception at some point in their lives - 99 percent. And yet, more than half of all women between the ages of 18 and 34 have struggled to afford it. So for all these reasons, we decided to follow the judgment of the nations leading medical experts and make sure that free preventive care includes access to free contraceptive care.

Whether you're a teacher, or a small businesswoman, or a nurse, or a janitor, no woman's health should depend on who she is or where she works or how much money she makes. Every woman should be in control of the decisions that affect her own health. Period. This basic principle is already the law in 28 states across the country.

Now, as we move to implement this rule, however, we've been mindful that there's another principle at stake here - and thats the principle of religious liberty, an inalienable right that is enshrined in our Constitution. As a citizen and as a Christian, I cherish this right. In fact, my first job in Chicago was working with Catholic parishes in poor neighborhoods, and my salary was funded by a grant from an arm of the Catholic Church. And I saw that local churches often did more good for a community than a government program ever could, so I know how important the work that faith-based organizations do and how much impact they can have in their communities. I also know that some religious institutions - particularly those affiliated with the Catholic Church - have a religious objection to directly providing insurance that covers contraceptive services for their employees. And that's why we originally exempted all churches from this requirement - an exemption, by the way, that eight states didn't already have. And that's why, from the very beginning of this process, I spoke directly to various Catholic officials, and I promised that before finalizing the rule as it applied to them, we would spend the next year working with institutions like Catholic hospitals and Catholic universities to find an equitable solution that protects religious liberty and ensures that every woman has access to the care that she needs.

Now, after the many genuine concerns that have been raised over the last few weeks, as well as, frankly, the more cynical desire on the part of some to make this into a political football, it became clear that spending months hammering out a solution was not going to be an option, that we needed to move this faster. So last week, I directed the Department of Health and Human Services to speed up the process that had already been envisioned. We weren't going to spend a year doing this; we're going to spend a week or two doing this.Today, we've reached a decision on how to move forward. Under the rule, women will still have access to free preventive care that includes contraceptive services - no matter where they work. So that core principle remains. But if a woman'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 and offer the woman contraceptive care free of charge, without co-pays and without hassles.The result will be that religious organizations wont have to pay for these services, and no religious institution will have to provide these services directly. Let me repeat: 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, and they'll no longer have to pay hundreds of dollars a year that could go towards paying the rent or buying groceries.

Now, I've been confident from the start that we could work out a sensible approach here, just as I promised. I understand some folks in Washington may want to treat this as another political wedge issue, but it shouldn't be. I certainly never saw it that way. This is an issue where people of goodwill on both sides of the debate have been sorting through some very complicated questions to find a solution that works for everyone. 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.We live in a pluralistic society where we're not going to agree on every single issue, or share every belief. That doesn't mean that we have to choose between individual liberty and basic fairness for all Americans. We are unique among nations for having been founded upon both these principles, and our obligation as citizens is to carry them forward. I have complete faith that we can do that. Thank you very much, everybody.

E. J. Dionne reports Catholic Charities USA is pleased with the new ruling:

"Catholic Charities USA welcomes the Administration's attempt to meet the concerns of the religious community and we look forward to reviewing the final language," the group said. "We are hopeful that this is a step in the right direction and are committed to continuing our work to ensure that our religious institutions will continue to be granted the freedom to remain faithful to our beliefs, while also being committed to providing access to quality healthcare for our 70,000 employees and their families across the country."

And Catholics for Choice is none too pleased:

Previous compromises of this nature, such as that in Hawaii, may have made some conservatives happy, but they have also meant that some women have not been able to access coverage in a timely and easy manner. That is unacceptable.Its unfortunate that on this issue, as many others, far too many in the administration and Congress have sacrificed womens health to get something they want more.

I'm not sure they have the slightest idea what the new rule actually requires.