The Administration says this in its announcement:
Under the new policy to be announced today, women will have free preventive care that includes contraceptive services no matter where she [sic] works. The policy also ensures that if a woman works for a religious employer with objections to providing contraceptive services as part of its health plan, the religious employer will not be required to provide, pay for or refer for contraception coverage, but her insurance company will be required to directly offer her contraceptive care free of charge.
And some of the bullet points say this:
o Religious organizations will not have to provide contraceptive coverage or refer their employees to organizations that provide contraception.
o Religious organizations will not be required to subsidize the cost of contraception.
o Contraception coverage will be offered to women by their employers’ insurance companies directly, with no role for religious employers who oppose contraception.
o Insurance companies will be required to provide contraception coverage to these women free of charge.
Some thoughts after the jump.
First, the reference to contraceptive coverage being “free of charge” is specifically connected to the female employees in these statements. Second, one of the bullets does say that religious organizations will not be required to “subsidize the cost of contraception.” Third, there is recurring emphasis on the fact that the insurer will pay.
All of this leads one to think that it is the insurance company and not the religious institution which will pay for contraceptive products. So the propositions are as follows
- The employee/insured will “have free preventive care that includes contraceptive servces”;
- The employer “will not be required to subsidize the cost of contraception”; and
- The insurer will be required to subsidize such costs “for free.”
The problem then is who will foot the bill for these services. Obviously it will not be the employee. By the terms of the proposition above, it looks like it will be the insurer. But this resolution is wildly implausible. Of course the insurer will not foot the bill. It will find a way to defray the cost somehow.
One possibility is that it will pass off the costs to employers who do not object on grounds of religious conscience to these products and services by raising their premiums. One might expect, though, that such employers would be resistant to subsidizing the health care of people who are not their employees.
A more likely possibility is that the insurer will raise the premiums of the religious employers. Won’t that mean that these religious employers will, in fact, be paying for these services and products? I think the answer to that question must be yes. Indeed, I can see little difference between mandating that a religious employer subsidize these products and services explicitly (by the terms of the health plan that it offers) and implicitly (by paying increased premiums as a result of the mandate that its insurer must cover these products and services).
It might be that proponents of this change in plan would say that the insurer could not raise premiums explicitly in response to the new mandate. But the problem here is that it is not at all clear to me that the insurer needs to state explicitly, “We hereby raise your premiums by X in direct response to new government regulations requiring us to offer contraceptives and abortifacients for free to your employees.” The insurer could simply hide the cost in any number of items, and package it for the employer as a single quantum increase.
Another point of difficulty is that by the terms of the new arrangement, it appears that the religious institution is now compelling the insurer to pay for these products and services, just in virtue of contracting with the insurer. To the extent that the religious employer has a conscience objection to paying for these items, it seems to me that it would also have a conscience objection to its own compelling of someone else to pay for them.