Barack Obama signs the Affordable Care Act into law in 2010. (AP Photo/J. Scott Applewhite, File.)
A key project of Obama’s second term will be implementing the major legislative accomplishment of his first term: the Affordable Care Act. Friday ended up being an unusually eventful day on this front.
First, the Department of Health and Human Services announced a slight compromise on the issue of contraception coverage under the new health laws—the issue that thrust Sandra Fluke into the spotlight last year. Under the compromise announced back in February, churches would be able to opt out of the contraception coverage requirement entirely, and nonprofit religious-affiliated institutions would not have to cover employees, but their insurers would.
That principle remained largely intact, with two minor tweaks. First, a slightly larger group of non-profit religious-affiliated employers can opt out of paying for contraception coverage. Until now, there were four basic litmus tests for which organizations could opt out, and have their insurer pay the contraception coverage costs instead:
the inculcation of religious values is the purpose of the organization
the organization is a nonprofit organization
the organization employs persons who share the religious tenets of the organization
the organization employs and serves primarily persons who share its religious tenets
The new qualifications are that the organization
holds itself out as a religious organization
is organized and operates as a nonprofit entity
opposes providing coverage for some or all of any contraceptive services required on account of religious objections
self-certifies that it meets these criteria and specifies the contraceptive services for which it objects to providing coverage
Importantly, the administration has refused to let for-profits opt out of contraception coverage, which some big chains like “Hobby Lobby” sought.
The other changes are still significant, however. Instead of needing to be an organization with primarily religious employees and patrons, objecting organizations must only have some sort of religious objection and “hold itself out as a religious organization”—a rather loose criterion, and one the organization is allowed to self-certify.
That said, even if a nonprofit opts out, employees are still guaranteed contraception coverage under the new rules—though HHS did tweak requirements about who pays for it. Instead of the objecting organization’s insurer picking up the tab, which religious nonprofits objected to on the grounds their premium payments would still be used for contraception, the insurance company must set up a third-party payer.