The Affordable Care Act aka Obamacare, included a provision for insurance to cover the cost of birth control.  After all, it has been estimated that 99% of all women use birth control at some point in their lives.  This is not just non-Catholic women.  Contraception is not cheap.  Without insurance, birth control pills can cost up to $100 a month.  Not affordable to lower income women who are also ones who can least afford to have unplanned children.  The pill is used for hormone regulation, not just birth control, a fact often ignored.

In fact, regardless of what the Pope and Cardinals and Archbishops in the United States think, Catholic women do use birth control.  I’m sorry, but no one has explained to me why a bunch of celibate men want to control women.  If you are against abortion, birth control would seem to be reasonable.  Of course, if you believe that life begins at the moment of conception, then some methods are problematic.  But we have no idea how many fertilized eggs just naturally abort, but I guess the distinction here is one is natural and the other has an artificial cause.  I should say that birth control also faces opposition from fundamentalist churches that are not Catholic.  The other thing that plays into the objection to birth control is that sex is to be reserved for marriage and for procreation.  There:   The objections to both birth control and gay marriage in one neat package.

The Obama administration has been twisting itself into knots to make sure that women who choose to use birth control have it covered under their health insurance.  The most recent proposal was outlined by the New York Times.

The Obama administration on Friday proposed yet another compromise to address strenuous objections from religious organizations about a policy requiring health insurance plans to provide free contraceptives, but the change did not end the political furor or legal fight over the issue.

The proposal could expand the number of groups that do not need to pay directly for birth control coverage, encompassing not only churches and other religious organizations, but also some religiously affiliated hospitals, universities and social service agencies. Health insurance companies would pay for the coverage.

The latest proposed change is the third in the last 15 months, all announced on Fridays, as President Obama has struggled to balance women’s rights, health care and religious liberty. Legal experts said the fight could end up in the Supreme Court

You can see the Department of Health and Human Services (HHS)  fact sheet here.

Religious groups dissatisfied with the new proposal want a broader, more explicit exemption for religious organizations and protection for secular businesses owned by people with religious objections to contraceptive coverage.

The tortured history of the rule has played out in several chapters. The Obama administration first issued standards requiring insurers to cover contraceptives for women in August 2011, less than a month after receiving recommendations to that effect from the National Academy of Sciences. In January 2012, the administration rejected a broad exemption sought by the Roman Catholic Church for insurance provided by Catholic hospitals, colleges and charities. After a firestorm of criticism from Catholic bishops and Republican lawmakers, the administration offered a possible compromise that February. But it left many questions unanswered and did not say how coverage would be provided for self-insured religious organizations.

Under the new proposal, churches and nonprofit religious organizations that object to providing birth control coverage on religious grounds would not have to pay for it.

Female employees could get free contraceptive coverage through a separate plan that would be provided by a health insurer. Institutions objecting to the coverage would not pay for the contraceptives.

Yesterday the Catholic Bishops weighed in

“The administration’s proposal maintains its inaccurate distinction among religious ministries,” said Cardinal Timothy M. Dolan of New York, the president of the United States Conference of Catholic Bishops. “It appears to offer second-class status to our first-class institutions in Catholic health care, Catholic education and Catholic charities. The Department of Health and Human Services offers what it calls an ‘accommodation,’ rather than accepting the fact that these ministries are integral to our church and worthy of the same exemption as our Catholic churches.”

The bishops’ statement, issued after they had reviewed President Obama’s proposal for six days, was more moderate and measured than their criticisms of the original rule issued by the White House early last year. Cardinal Dolan said the bishops wanted to work with the administration to find a solution.

The administration had no immediate reaction to the bishops’ statement, other than to say it was not a surprise.

One thing is clear, the Obama administration does not want to start saying the private business owners can opt out of paying for insurance that covers things they find objectionable.  What if we go from birth control to vaccinations to flu shots?

The birth control issue will end up in court and probably the Supreme Court.  For people who say they don’t want the ACA because they don’t want government controlling their health care, this the ultimate irony.  In case they haven’t noticed.  The Supreme Court is a branch of government.

So until the courts decide, Emily Douglas at the Nation has prepared this handy chart for you.

I guess I sound bitter, but I thought we already had this fight 40 years ago.  Contraception is supposed to be a routine option for women’s health care.

Related articles

• The bishops prove hard to please (maddowblog.msnbc.com)
• Bishops Reject Latest Proposal on Controversial Contraception Mandate (news.health.com)
• E.J. Dionne: Obama seeks peace with Catholics over contraception (sacbee.com)
• Why the religious right rejects the Obama compromise over birth control (secularnewsdaily.com)
• Obama offers faith groups new birth control rule (newsobserver.com)