President Barack Obama's announcement that his administration had found a way to provide free contraceptives to employees of Catholic agencies without the employer having to pay for them or refer employees to insurers was greeted cautiously by the Catholic bishops.
"Today's decision to revise how individuals obtain services that are morally objectionable to religious entities and people of faith is a first step in the right direction," Cardinal-designate Timothy Dolan of New York, president of the U.S. Conference of Catholic Bishops, said Friday.
He said that the bishops would "reserve judgment on details until we see them" and that they hoped to work with the administration to finalize them.
At stake was an impending federal rule requiring all employers to cover contraception, sterilization and "morning after" drugs in health insurance plans. Until Friday, the religious exemption was so narrow that it covered only houses of worship, not religiously affiliated hospitals, colleges or social service agencies.
Catholic bishops had warned since August that their agencies might have to drop all health insurance, resulting in heavy fines that could force them to close. Although the Catholic Church is virtually the only faith to oppose drugs and devices to prevent fertilization, many religious leaders supported the bishops' protest on religious liberty grounds. It had become a Republican campaign issue.
Mr. Obama said that a "core principle" of providing access to free contraceptives remains. "But if a woman's employer is a charity or a hospital that has a religious objection to providing contraceptive services as part of their health plan, the insurance company -- not the hospital, not the charity -- will be required to reach out and offer the woman contraceptive care free of charge, without co-pays and without hassles," he said.
The American Civil Liberties Union had been among the strongest backers of the original mandate, but on Friday indicated that the revision was acceptable.
In a background call with reporters, senior administration officials said that insurance companies would be required to offer plans without contraceptive coverage to nonprofit religious agencies, and then independently contact employees to offer birth control coverage at no extra cost. The religious agency would not have to subsidize the cost, the administration officials said, saying that insurers would rather pay $360 a year for pills than thousands for a pregnancy.
"Nonprofit religious agencies don't have to cover it, they don't have to pay for it and they don't have to refer women to it," an official said.
Religious agencies have until August to comply. Parishes and groups that primarily employ and serve members of their own faith remain fully exempt.
Senior administration officials said that questions regarding self-insured groups and individual employers with religious objections remained to be worked out.
"We are developing regulations," an official said. "There will be plenty of opportunity for public input on where these lines are drawn."
Bishop David Zubik of the Catholic Diocese of Pittsburgh drew national attention last month for writing that the Obama administration had told the Catholic Church "to hell with you."
On Friday he said he would wait for a detailed analysis.
"We have to take time to evaluate this," he said. "My concerns haven't been alleviated, but at least the president seems to have heard how upset people are."
The church's own research shows that most Catholics ignore its ban on contraceptives. But the earlier rule nevertheless outraged many Catholics -- including some who had provided crucial support for health care reform.
Sister Carol Keehan, president of the Catholic Health Association, representing 600 facilities, was a key backer of the Obama health care plan and had worked hard for a compromise. On Friday she said her association was "very pleased" with the revision.
Nicholas Cafardi, dean emeritus of Duquesne University Law School and a high-profile Catholic backer of the Obama campaign in 2008, had also worked for revision.
"The benefit is that there is no referral required. The other benefit is that it's not provided by the employer. Those were the bishops' major concerns and they have been met," said Mr. Cafardi, who is also a canon lawyer.
Officials from the White House Office for Faith-Based and Neighborhood Partnerships "understood from the beginning that this was a problem and they were instrumental in this quick resolution," he said.
Some religious groups with no qualms over contraception had supported the bishops on religious liberty grounds. Leaders of the Southern Baptist Convention, the Lutheran Church-Missouri Synod, all Orthodox bishops, the Anglican Church in North America, the National Association of Evangelicals and the Union of Orthodox Jewish Congregations of America condemned the mandate. With the Catholics, they represent more than 90 million people.
On the other side, the United Methodist General Board of Church and Society, the United Church of Christ, the Unitarian Universalist Association and agencies or affiliates of the Episcopal Church, the Disciples of Christ and Reform, Conservative and Reconstructionist Judaism had backed the earlier, unamended rule. They have about 18 million members.
After Mr. Obama's announcement, the Religious Coalition for Reproductive Choice praised the president for preserving contraceptives.
However one member of the coalition blasted the president's decision. Jon O'Brien, president of the independent group Catholics for Choice, expressed regret that relying on insurance companies to provide free contraceptives "gives victory number one to the bishops on their 'religious liberty' shopping list."
Likewise Cecile Richards, president of Planned Parenthood, said, "We believe the compliance mechanism does not compromise a woman's ability to access these critical birth control benefits.
One bill in the House and two in the Senate offer exemption for religious or moral objections. Sen. Pat Toomey, R-Pa., co-sponsored both Senate bills.
Sen. Bob Casey, D-Pa., had written to Mr. Obama, saying that the mandate for religious agencies was "the wrong decision."
"I appreciate the administration's attempt to find a solution to protect religious liberty," Mr. Casey said Friday.
Rep. Mark Critz, D-Johnstown, Rep. Bill Shuster, R-Somerset, Rep. Jason Altmire, D-McCandless, and Rep. Tim Murphy, R-Upper St. Clair, had all criticized the original rule.
On Friday, Mr. Murphy said the revision was insufficient.
"The cost for contraception and abortion-inducing drugs will simply be tacked onto other health care plans or passed along to the taxpayers," he said. "The only solution is to fully repeal this unconstitutional mandate and the entire health care law while we're at it."
The newest parties to the furor are insurance companies, who are being told to provide free contraceptive coverage to these employees. Michael Weinstein, a spokesman for Highmark, said it was complicated from a business standpoint because of issues such as the self-insured groups for which Highmark provides administrative services,
"We have to evaluate this," he said. "We don't have a full understanding from a business standpoint of what we would have to do."
Correction/Clarification: (Published February 13, 2012) President Barack Obama said that "the insurance company -- not the hospital, not the charity -- will be required to reach out and offer the woman contraceptive care free of charge." A story in Saturday's paper used an incorrect verb.
Ann Rodgers: firstname.lastname@example.org or 412-263-1416. First Published February 11, 2012 5:00 AM