Administration issues proposed rules on contraceptive coverage exemption for non-profit religious instituitons

Howard Friedman, Religion Clause

The Centers for Medicare & Medicaid Services today issued a Notice of Proposed Rulemaking building on last March’s Advance Notice, designed to accommodate objections of religious non-profit organizations to the Affordable Care Act contraceptive coverage mandate. Under today’s proposal: 

Group health plans of “religious employers” are totally exempt from the contraceptive coverage mandate.  Today’s proposal revises the definition of “religious employer” from the March release. The proposed exemption now conforms to language in Internal Revenue Code Sec. 6033 — any church, integrated auxiliary of a church, convention or association of churches, or religious order is a “religious employer.” This eliminates a narrower test suggested in the Advance Notice. 

Today’s proposal also fleshes out accommodations for non-profit religious organizations that do not meet the definition of “religious employer”, but oppose providing coverage for some or all contraceptive services  They may self-certify their objection to their health insurance  issuer or third-party administrator. The health insurer will issue the organization’s employees (or students if the religious organization is a college or university) an individual market contraceptive coverage policy at no cost. The insurer can afford to do this because the policies cover the same set of individuals they are already insuring, and they will experience lower costs from improvements in women’s health and fewer childbirths. 

Today’s proposals give no relief to for-profit businesses whose owners object on religious grounds to the contraceptive coverage mandate.