This is ALL THINGS CONSIDERED, from NPR News. I'm Melissa Block.


And I'm Audie Cornish. Today, the Obama administration waded back into the fray over the Affordable Care Act and birth control. The law calls for women to receive birth control at no cost, and many women are already getting that benefit. It took effect for most insurance plans last August. But the fight continues with religious employers, who say providing the benefit violates their beliefs.

NPR's Julie Rovner is here to explain what the administration had to say about that today. Hey there, Julie.


CORNISH: So we're talking about a new set of regulations. What are they?

ROVNER: Well, this is part of a so far, not completely successful effort to find a way to ensure that women don't face financial barriers to getting contraception while at the same time, ensuring religious employers freedom of religion. Here's how Health and Human Services official Chiquita Brooks-LaSure put it, this afternoon.

CHIQUITA BROOKS-LASURE: No nonprofit religious institution will be forced to pay for or provide contraceptive coverage.

ROVNER: But at the same time, she said, of those covered by religious universities or hospitals...

BROOKS-LASURE: Women who work, or go to school, at these institutions will have free contraceptive coverage and will no longer have to pay hundreds of dollars a year that could be going towards rent or groceries.

CORNISH: So Julie, help us understand this. If religious institutions won't have to pay for this contraceptive coverage and women won't, either - I mean, who will?

ROVNER: Well, that's been the big question all along since the administration first floated this concept last year. The idea is that since paying for birth control is less expensive, in the aggregate, than paying for pregnancy and childbirth, the health insurance company would be happy to pay for it; and that's what the rules require.

But not every employer has health insurance through a health insurance company. Many are big enough to be what's called self-insured. That means they cover their own health bills and hire a company just to process the claims. But those claims-processing companies wouldn't save money by paying for contraception because they're not really acting as insurers.

CORNISH: So in that case, who would pay for the contraception?

ROVNER: Well, what the administration is proposing is that those third-party companies go out and find an insurance company to partner with. And both the insurance company and the third-party claims payer would get paid through a reduction in fees the insurance company will start paying next year. to participate in these new health market places called health exchanges. It's kind of - no, it's very complicated, but the hope is that it could produce a workable compromise to what's been a very thorny issue for the administration.

CORNISH: So what's been the reaction to this?

ROVNER: Well, the loudest complaints had been coming from the Catholic Church. They've, obviously, got the biggest dog in this fight with thousands of schools, universities, hospitals and charities waiting to see how this would all play out. The U.S. Conference of Catholic Bishops this afternoon issued a very cautious statement, saying they want to take a closer look at the details. But a couple of reporters did catch up with Conference President Cardinal Timothy Dolan, who said he was, quote, "pleasantly surprised by what he'd seen" - though that is no guarantee of an endorsement.

CORNISH: And the reaction on the flipside?

ROVNER: Well, most women's health groups said they were pleased that women who work for religious employers won't be denied this benefit. But those who are most unhappy are the those who represent the for-profit companies who have been suing over the requirement. These are people who own everything from bookstores to heating and cooling companies. They say they don't want to offer contraceptive coverage to their workers because of their own, personal religious beliefs. They are not included in this latest attempt at a compromise; only nonprofits who are affiliated with organized religions are. And remember, this still isn't the final word. Final rules aren't expected until later this summer.

CORNISH: Julie, thank you for explaining it.

ROVNER: Thank you, Audie.

CORNISH: NPR's health policy correspondent, Julie Rovner.

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