The White House’s announcement on February 10, that it would require insurers instead of employers to pay for contraception, sterilization and abortifacients has not changed the very narrow definition of religious employer contained in the U.S. Department of Health and Human Services (HHS) regulations. The rule states that to be a religious employer an organization must "serve primarily persons who share the[ir] religious tenets."
In fact, the effort to remedy the situation announced by President Obama last week not only finalized the HSS rule but left unanswered critical questions, such as how self-insured organizations can comply if the mandate violates their religious beliefs. Many Catholic organizations – dioceses, hospitals and schools – are self-insured to avoid such conflicts with government mandates. Also open: how would HHS determine if an institution is “religious” enough to qualify as a religious employer? What other mandates might be imposed further down the road? How will insurance companies pay for coverage without passing costs on to employers?
The U.S. Conference of Catholic Bishops (USCCB) summarized the continuing difficulties with the regulation in a bulletin insert (available in Spanish and English):
• The original rule that violated our religious liberty has not been changed, but finalized.
• HSS promised additional “accommodations” but only after the election in November.
• Assuming insurers will pay for requirement without passing the costs on to employers is naïve.
The controversial HHS mandate was first proposed last fall and implemented January 20 by HHS Secretary Kathleen Sebelius. A storm of protest followed because the rule forced religious institutions to pay for coverage that violates their beliefs. HHS exempted religious employers but defined them so narrowly that Catholic hospitals, charities, schools and other ministries would no longer qualify. President Obama's announcement leaves the new definition intact which opens the door to other mandates that might be issued by HHS under the new health care law.