Friday, February 17, 2012

Has the administration caved on contraception?

Last Friday I wondered how the administration's contraception compromise, which mandates that health insurance companies, rather than the employers who hire them, pay for contraception, would apply to self-insured health plans, where there is no outside insurer, only a third-party administrator (TPA) and sometimes a stop-loss insurer to cover highly expensive treatment. 

Now HHS Secretary Sebelius says that self-insured plans will be "exempted." What exactly does that mean? Here's the Washington Times*:
Secretary of Health and Human Services Kathleen Sebelius said Wednesday that self-insuring religious employers will be exempted from a contraception coverage mandate, clearing up a question raised by Catholic groups and other opponents who continued protesting the rule this week.

“Yes, I think that we will apply it to both,” Mrs. Sebelius told reporters, saying a new rule the administration offered last week to quell criticism will apply both to religious employers who buy plans for their workers and to those who self-insure.

“Whether it’s an insured plan or self-insured plan, that the employer who has a religious objection doesn’t have to directly offer or pay for contraception,” she said as reporters gathered around her Wednesday after a hearing on President Obama’s proposed budget before the Senate Finance Committee (my emphasis).
About 60% of Americans who get their healthcare from their employers are covered by self-insured plans, according to Kaiser Healthcare.  No stats are readily available on the percentage of employees of Catholic organizations that are in self-insured plans -- but if such plans really can avoid offering contraception coverage, the percentage of Catholic employers adopting them is sure to soar.  What remains unclear to me from this brief report, and other similar ones, is whether members of such plans will be denied contraception coverage. There is that word "directly" -- does it suggest that some other entity, such as the TPA or perhaps a stop-loss insurer under some special endorsement, will have to offer the coverage?  If not, it looks like the administration stealth-caved in two stages.

* I've updated this post by substituting the Wash Times excerpt for one from Modern Healthcare, which was even more ambiguous.

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