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October 6, 2011 – Nebraska’s Senator Ben Nelson has written to a top health official to make clear that Nebraskans should not have to pay for health insurance plans that cover services to which they have moral or religious objections, such as contraceptives.
The new health care law will require insurance providers to fully cover certain preventive services for women, including some forms of contraception. The law includes exemptions so that religious employers will not have to pay for health plans that include the costs for practices the employers find objectionable as a matter of religious conscience.
The U.S. Department of Health and Human Services’ Center for Medicare and Medicaid Services had been accepting public comments as it determines a final definition for the term “religious employer.”
Nelson, who is pro-life, wrote to CMS Administrator Donald Berwick to make two important points:
- The proposed definition of “religious employer” should be broadened. Many religious charities, colleges and hospitals would not qualify for the exemption under the current definition; and
- Individuals with religious or moral objections should receive the same conscience protections afforded to religious employers. The exemption should not depend upon the individual’s employer.
“No one with moral or religious objections to contraception should have to pay for it through his or her health insurance premiums,” Senator Nelson said. “I appreciate that the health care law intends to respect the objections of conscience of those who disagree with the mandated coverage of contraception, but the exceptions must be constructed in a way that is meaningful and broad enough so that every objector may be included.”
Under the current definition of “religious employer,” at least 11 Catholic health facilities in Nebraska would not qualify for the exemption.
“Obviously, this must be fixed,” Nelson said. “Additionally, the values of individual Nebraskans who oppose contraception must also be respected. Many Nebraskans have personal beliefs that differ from their employers and they should have the option of choosing a health plan that is true to their own values.
“I regularly hear from Nebraskans who are already benefitting from protections in the new health care law: young adults who can remain on their parents’ insurance, seniors who no longer have gaps in their prescription drug coverage, and the parents of children who can no longer be denied coverage because of pre-existing conditions. When it is fully implemented, the law will help control medical costs that have been rising for years and reduce the $57 billion hidden tax insured Americans pay every year for those who don’t have insurance but get health care in emergency rooms anyway.
“We should continue to improve the law, and that means making sure it respects the values of every American,” Nelson said.
Full text of Senator Nelson’s letter follows:
September 30, 2011
Dr. Don Berwick, Administrator
Centers for Medicare & Medicaid Services
Department of Health and Human Services
Washington, DC 20201
Dear Dr. Berwick:
I am writing concerning the Interim Final Rule (IFR) on Preventive Services published in the August 3, 2011, edition of the Federal Register (76 Fed. Reg. 46621).
As you are aware, the Patient Protection and Affordable Care Act requires that certain preventive services for women, to be determined by the U.S. Department of Health and Human Services (HHS), be provided at no cost to the individual in all non-grandfathered health insurance plans. HHS has determined that these preventive services for women will include certain contraceptives, which many individuals and religious employers find objectionable as a matter of conscience. In the IFR, HHS requests comment on its proposed exemption to this requirement for health plans offered by religious employers, specifically, the definition of “religious employer,” as proposed by the IFR.
Having spoken with numerous constituents and stakeholders, it is clear the proposed definition of religious employer is not nearly broad enough; many religious charities, institutions of higher education, and hospitals would not qualify under the current definition. It is also clear that sufficient public comment has been offered on how to expand the definition so as to exempt these religious employers. However, in the IFR, HHS has limited the scope of the proposed exemption such that “health insurance issuers in the individual health insurance market would not be covered under any such exemption.” Since HHS only sought comment on the rule’s definition of “religious employer,” I believe it should re-open the public comment period for additional input on this issue.
I believe that exemptions from the preventive services regulation should be offered to individuals with religious or moral objections regardless of their employment status (self-employed or unemployed) or the religious status of their employers. Additionally, this exemption should be equal to that provided to religious employers. Under current law, there is nothing to prevent private insurers from accommodating individuals with moral or religious objections to contraceptives or other services. In fact, there is precedent for individuals who claim a religious or moral exemption to purchase individual or group insurance plans that exclude government-mandated contraceptive coverage (the State of Connecticut, for example).
One way for HHS to facilitate insurers providing a religious exemption for individuals would be to allow for those plans that provide or do not provide preventive services coverage (specifically contraceptives) to be considered actuarially equivalent. Under this scenario, individuals would not have a financial benefit from claiming a religious or moral exemption to the preventive services regulation; and the insurer would face less of an administrative burden in offering coverage to individuals with conscience objections.
Thank you for your consideration of these comments. I look forward to your response.
Sincerely,
E. Benjamin Nelson
United States Senator
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