Obama weighs steps to cover contraception

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WASHINGTON -- The Obama administration, reeling from back-to-back blows from the Supreme Court this week, is weighing options that would provide contraceptive coverage to thousands of women who are about to lose it or never had it because of their employers' religious objections.

The administration must move fast. Legal and health care experts expect a rush to court involving scores of employers seeking to take advantage of the two decisions, one involving Hobby Lobby Stores, which affects for-profit businesses, and the other on Wheaton College that concerns religiously affiliated nonprofit groups. About 100 cases are pending.

One proposal the White House is studying would put companies' insurers or health plan administrators on the spot for contraceptive coverage, with details of reimbursement to be worked out later. Another would give the administration itself a larger role in offering cost-free coverage to women who cannot get it through their employers, although the option for a new government entitlement appears unrealistic for financial and political reasons.

The White House is under such pressure that no one has been able to work out details of how the alternatives would be financed or administered.

Administration officials said they were determined to ensure the broadest possible coverage of contraceptives for the largest number of women without requiring employers to violate their religious beliefs.

Mark L. Rienzi, a lawyer who represented both Hobby Lobby and Wheaton College, said the administration had the tools to make an alternative solution work. "The government can find other ways to deliver contraceptives to people without forcing nuns and religious colleges to participate," he said.

That is not the way Justice Sonia Sotomayor looks at it. In her dissent in the Wheaton College case Thursday, she said the challenge facing the government was "daunting -- if not impossible."

Still, the administration has another motivation to act, as quickly as possible: It is eager to court the votes of women dismayed by the rulings. The Democratic National Committee is already urging voters to fight back against the Hobby Lobby decision, and to "stand up for Obamacare" in the November elections. The Supreme Court said family-owned for-profit corporations like Hobby Lobby were not required to provide coverage of contraceptives if they objected on religious grounds.

Whatever the choice, no plan can be turned around in two weeks, or two months. It took more than two years for the administration to figure out how to provide contraceptive coverage for women at nonprofit groups that have religious objections. That arrangement allowed religious organizations to fill out a form that would transfer the delivery of free coverage under the Affordable Care Act to others.

But many of the nonprofit groups say that even notifying an insurer of their objections through the opt-out form would make them complicit in a moral wrong. Some consider all contraception to be wrong; others object only to devices and drugs like the morning-after pill that they believe may cause abortions.

One of those groups was Wheaton College, a Christian liberal arts school in Illinois, and the Supreme Court granted it a temporary exemption in the ruling Thursday.

That move divided the court along gender lines, with Justices Ruth Bader Ginsburg and Elena Kagan joining Justice Sotomayor's unsparing dissent. They said the court majority had endorsed the opt-out form just three days earlier in the Hobby Lobby case, in which Justice Stephen G. Breyer joined the three female justices in dissent in the 5-4 ruling.

The court's conservative majority -- all men -- was sanguine about the availability of other ways for the administration to deliver coverage for every form of birth control approved by the Food and Drug Administration.

Yet officials are struggling to make sense of a sunny sentence in the court's order Thursday exempting Wheaton from the opt-out form.

"Nothing in this interim order affects the ability of the applicant's employees and students to obtain, without cost, the full range of FDA-approved contraceptives," the majority said in the unsigned opinion.



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