The Obama administration has announced proposed a compromise to the Affordable Care Act that would allow religious employers to opt out of the requirement that their insurance plans cover contraception costs for female employees.

Back in 2011, an Institute of Medicine panel suggested that birth control be among the “no co-pay” items covered by insurance under the Affordable Care Act. That idea was adopted, then put into action last August, though not without protest from religious institutions who felt they should not be obligated to help pay for something they were morally opposed to.

The proposed changes expand the definition of “religious employer” by removing criteria that required qualifying businesses be primarily staffed by people sharing the employer’s values and tenets and “have the inculcation of religious values as its purpose.”

“This proposed change is intended to clarify that a house of worship would not be excluded from the exemption because, for example, it provides charitable social services to persons of different religious faiths or employs persons of different religious faiths,” explains the administration.

The White House also proposes opt-out accommodations for additional non-profit religious organizations that:
-Opposes providing coverage for some or all of any contraceptive services required to be covered under the law on account of religious objections;
-Is organized and operates as a nonprofit entity;
-Holds itself out as a religious organization; and
-Self-certifies that it meets these criteria and specifies the contraceptive services for which it objects to providing coverage.

Eligible organizations would not have to contract, arrange, pay or refer for any contraceptive coverage to which they object on religious grounds.

At the same time, the administration proposes changes that would still allow female employees to receive contraception through the insurance company but without financial input from the employer.

“Plan participants would receive contraceptive coverage through separate individual health insurance policies, without cost sharing or additional premiums,” reads a statement on the proposals. “The issuer would work to ensure a seamless process for plan participants to receive contraceptive coverage.”

An eligible organization that opt-out of contraception coverage would notify its health insurance issuer for its group plan. That insurer would then automatically provide separate, individual market contraceptive coverage at no cost for plan participants.

“Issuers generally would find that providing such contraceptive coverage is cost neutral because they would be they would be insuring the same set of individuals under both policies and would experience lower costs from improvements in women’s health and fewer childbirths,” says the White House.

For eligible organizations that self-insure, a third-party administrator would work with a health insurance issuer to provide separate, individual health insurance policies at no cost for participants.

According to the administration, the additional costs for the health insurance issuer and the third-party administrator would be offset by adjustments in Federally-facilitated Exchange user fees that insurers pay.

The proposed rule changes would also treat religious schools that offer health insurance to students the same as it does an eligible religious employer with a group health plan.

The administration is accepting comment on these proposals through April 5, 2013.

Comments can be sent in any of the following ways (please refer to file code CMS-9968-P, regardless of which method you use):

1. Electronically at Regulations.gov

2. By regular mail:
Centers for Medicare & Medicaid Services
Department of Health and Human Services
Attention: CMS-9968-P
P.O. Box 8013
Baltimore, MD 21244-1850

3. By express or overnight mail
Centers for Medicare & Medicaid Services
Department of Health and Human Services
Attention: CMS-9968-P
Mail Stop C4-26-05
7500 Security Boulevard
Baltimore, MD 21244-1850

4. By hand or courier
Centers for Medicare & Medicaid Services
Department of Health and Human Services
Room 445-G, Hubert H. Humphrey Building
200 Independence Avenue, S.W.
Washington, DC 20201

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