Self-Insurance Complicates Deal on Birth Control

Excerpt from an article in The New York Times
Thursday, February 16, 2012

Self-Insurance Complicates Deal on Birth Control 

By KATIE THOMAS

The Obama administration thought it had found a way to ease mounting objections to a requirement in the new health care act that all employers — including religiously affiliated hospitals and universities — offer coverage for birth control to women free of charge.

It would make the insurers cover the costs, rather than the organizations themselves.

But the administration announced the compromise plan before it had figured out how to address one conspicuous point: Like most large employers, many religiously affiliated organizations choose to insure themselves rather than hire an outside company to assume the risk.

Now, the organizations are trying to determine how to reconcile their objections to offering birth control on religious grounds with their role as insurers — or whether there can be any reconciliation at all. And the administration still cannot put the thorny issue to rest.

“We’re all kind of waiting and seeing,” said Jim Liske, chief executive of the Prison Fellowship, a Christian charity that insures itself and objects to offering the morning-after pill to its employees.

The administration has remained mostly silent on how self-insured institutions will be treated, other than to say that the details will be worked out in meetings with religious leaders in the days and weeks to come.

“This policy will be developed collaboratively so that the ultimate outcome works for religious employers, their workers and the public,” an administration official said Wednesday.

But some expressed skepticism that any satisfactory solution could be reached. “That’s quite a trick,” said Richard M. Doerflinger, associate director of “pro-life activities” at the United States Conference of Catholic Bishops, which has been among the most vocal critics of the birth control mandate.

“Putting the obligation on the insurer and not the employer doesn’t help much if they are the same person,” he said.