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MICHELE NORRIS, host: This is ALL THINGS CONSIDERED from NPR News. I'm Michele Norris.

MELISSA BLOCK, host: And I'm Melissa Block.

Starting next year, most health-insurance plans will have to offer women an expanded list of preventive services, including prescription contraceptives at no up-front cost. As NPR's Julie Rovner reports, that decision was expected. But it included one, small surprise.

JULIE ROVNER: The Institute of Medicine, two weeks ago, actually recommended that insurers offer eight new women's health services without charging deductibles or co-pays. But the one that's gotten all the attention has been birth control. And that's not surprising, Health and Human Services Secretary Kathleen Sebelius told reporters.

Secretary KATHLEEN SEBELIUS: Since birth control is the most common drug prescribed to women ages 18 to 44, insurance plans should cover it. Not doing it would be like not covering flu shots.

ROVNER: But the rules issued today allow religious groups that offer insurance to opt out of providing prescription contraception. Currently, 28 states require insurers to offer birth control. Eighteen of them have some sort of religious exemption. Federal officials said they based their opt-out on the one most states use.

But the policy has managed to anger those on both sides of the birth control coverage fight. Jeannie Monahan, of the Family Research Council, says the exemption doesn't go far enough.

JEANNE MONAHAN: Groups are very narrowly defined. For example, Catholic hospitals won't be included

ROVNER: While others, like Jon O'Brien of the group Catholics for Choice, think any exemption hurts women who need the coverage.

JON O'BRIEN: If your religious employer thinks you should become pregnant each and every time you have sex, he can deny you the ability to get contraceptive services for free. That's plain wrong.

ROVNER: The rules are set to take effect a year from today. Julie Rovner, NPR News, Washington.

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