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Insurers must pay for birth control

Obama rejects exemption for religious groups

WASHINGTON — The Obama administration said yesterday that most health insurance plans must cover contraceptives for women free of charge, and it rejected a broad exemption sought by the Roman Catholic Church for insurance provided to employees of Catholic hospitals, colleges, and charities.

Most employers and insurers must comply by Aug. 1, but church-affiliated organizations will get one additional year — until Aug. 1, 2013 — to comply with the requirement.

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Leaders of the Catholic Church had appealed to President Obama to grant the broad exemption. He made the final decision after hearing from them, as well as from family planning advocates, scientific specialists, and members of Congress, administration officials said.

The rule takes a big step to remove cost as a barrier to birth control, a longtime goal of advocates for women’s rights and specialists on women’s health.

Catholic bishops issued a statement saying they would fight the issue.

‘‘In effect, the president is saying we have a year to figure out how to violate our consciences,’’ said Archbishop Timothy M. Dolan of New York, president of the US Conference of Catholic Bishops.

Cardinal Sean P. O’Malley of the Archdiocese of Boston spoke out against the announcement on his blog last night and expressed his ‘‘deep disappointment at this unprecedented infringement on religious liberty in our country.’’

‘‘Catholic health plans do not allow for any of those services the Obama administration is trying to force us to do,’’ said Terrence Donilon, a spokesman for the Boston Archdiocese. ‘‘Our employees know that when they come to work here.’’

Donilon said O’Malley and Cardinal-elect Timothy Dola of New York believe the requirement is an attack on religion.

‘‘We’re not going to let this one go,’’ Donilon said. ‘‘The fight is not over.’’

Other opponents of the rule said they would seek legislation to block it and might challenge it in court as well.

The rule includes an exemption for some ‘‘religious employers,’’ including houses of worship. But church groups said the exemption was so narrow that it was almost meaningless.

The 2010 health care law says insurers must cover ‘‘preventive health services’’ and cannot charge for them.

The new rule interprets this mandate. It requires coverage of the full range of contraceptive methods approved by the Food and Drug Administration. Among the drugs and devices that must be covered are emergency contraceptives including pills known as ella and Plan B. The rule also requires coverage of sterilization procedures for women without co-payments or deductibles.

The issue forced Obama to weigh competing claims of Catholic leaders and advocates for women’s rights.

The administration said in August it intended to require coverage of contraceptives, as recommended by a National Academy of Sciences panel. But the White House reconsidered the issue after hearing protests from the Catholic Church and many Republicans in Congress.

The protests prompted debate within the administration. Kathleen Sebelius, the secretary of health and human services, and the president’s health policy team strongly supported the new rule. But Democratic members of Congress said they believed that Obama’s chief of staff, William M. Daley, and his special assistant for religious affairs, Joshua DuBois, favored a broader exemption.

Senator Richard Blumenthal, Democrat of Connecticut, described the final rule as a huge victory for women’s health. It will, he said, ‘‘ensure that women have access to full health care services, regardless of their employer, so they can make the best health choices.’’

Representative Lois Capps, Democrat of California, said, ‘‘The administration deserves credit for standing its ground and following the science.’’

Cecile Richards, president of the Planned Parenthood Federation of America, said the decision ‘‘means that millions of women, who would otherwise pay $15 to $50 a month, will have access to affordable birth control, helping them save hundreds of dollars each year.’’

Dolan discussed the issue with Obama in November and came away reassured that the president understood the Catholic Church’s position.

Now, he said in the interview, ‘‘The sentiments of hope that stemmed from reassurances that I thought I received in November were apparently misplaced.’’

The archbishop said he had heard from evangelical, Greek Orthodox, and Orthodox Jewish leaders who are also concerned about the rule.

Under the government’s narrow criteria, the bishops said, ‘‘even the ministry of Jesus and the early Christian Church would not qualify as ‘religious,’ because they did not confine their ministry to their co-religionists,’’ but urged compassion for the sick and the poor, regardless of faith or creed.

Globe correspondent Amanda Cedrone contributed to this report.
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