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Originally published February 10, 2012 at 9:48 PM | Page modified February 10, 2012 at 9:55 PM

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Obama creates 'accommodation' to settle birth-control controversy

The question now is whether the maneuver will tamp down the birth-control furor and allow President Obama to refocus his re-election drive on the more favorable news coming from the economy.

Tribune Washington bureau

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WASHINGTON — President Obama for days had been hammered over a regulation in the health-care law that required religiously affiliated hospitals, charities and universities to provide birth control for female employees even if that conflicted with church teachings.

He tried to end the debate Friday with what he called an "accommodation." The employees will be offered free birth-control coverage, but the benefit will come directly from insurers and no religious groups' money will be used.

Insurers in 28 states, including Washington, already are required to cover contraceptives.

The question now is whether the maneuver will tamp down the political fire and allow Obama to refocus public attention and his re-election drive on the more favorable news coming from the economy.

He appeared to have made progress, winning over the Catholic hospital association and Catholic Charities — although not the U.S. Conference of Catholic Bishops — and reassuring wavering Democrats while keeping the support of groups such as Planned Parenthood.

Under the new plan, administration officials believe insurers will comply for free because the coverage may not cost them anything. Evidence suggests providing birth-control coverage reduces overall costs for health plans because birth control is much cheaper than pregnancy, according to administration officials and some health-industry analysts.

The fact that the compromise had not been proposed earlier angered the president, who felt let down by his staff, officials said. Obama waded into details this week and personally crafted the solution, according to a Democratic official who spoke on condition of anonymity.

From the beginning, the fight over the requirement that all health plans offer free birth-control coverage was animated by politics, deeply held beliefs and the personalities of the people involved. Several prominent members of the president's team, including Health and Human Services Secretary Kathleen Sebelius and senior adviser Valerie Jarrett, argued strongly for the president's commitment to make contraceptives available to everyone.

But others in Obama's circle for months had warned of political trouble ahead. In November, then-chief of staff Bill Daley, a Roman Catholic, asked Obama to sit down with New York Archbishop Timothy Dolan, head of the bishops conference, to talk about the coming contraceptives mandate.

According to Democratic officials with knowledge of the conversations, some policy experts and lawyers in the administration believed the White House should not compromise because no birth-control mandate would win the bishops' support.

Obama ultimately agreed with that position and signed off on the rule, announced in late January. Churches and other houses of worship would be exempted from the mandate, but religiously affiliated employers such as schools, hospitals and charities would be required to ensure their employees had contraceptive coverage.

Yet, even as he made calls to Dolan and Sister Carol Keehan, head of the Catholic Health Association, to explain the initial policy before it was announced, Obama emphasized changes could come before the mandate takes effect.

The bishops responded angrily and publicly to the policy, putting the administration on the defensive. Republicans soon joined the chorus, as did some Catholic Democrats in Congress. As the fight grew louder and more threatening over the past week, Obama decided to move quickly to tamp down the problem, a senior administration official said.

Some are won over

Announcing the change Friday at the White House, Obama said he always had been sensitive to the concerns about religious liberty, saying, "We live in a pluralistic society where we're not going to agree on every single issue or share every belief."

"That doesn't mean that we have to choose between individual liberty and basic fairness for all Americans," Obama added. "We are unique among nations for having been founded upon both these principles, and our obligation as citizens is to carry them forward. I have complete faith that we can do that."

The administration plan most closely resembles Hawaii's, in which employees at religious institutions whose health-insurance plans do not offer free contraception can get birth control through side benefits. The difference, though, is that whereas in Hawaii the employees nominally pay for the benefits, the Obama proposal would shift the cost to insurers.

Obama's shift quickly won the support he was seeking. "The framework developed has responded to the issues we identified that needed to be fixed," said Sister Keehan, who supported Obama's effort to pass the health-care law but had opposed the birth-control mandate.

Obama also won over a range of prominent Catholics who had criticized the policy, and Planned Parenthood also announced its approval.

Reserving judgment

Others remained opposed or on the sidelines. Dolan, of the bishops conference, called the move a "step in the right direction," but said the bishops would reserve judgment until they had the details. A spokesman for America's Health Insurance Plans, the insurance industry's Washington, D.C.-based lobbying arm, expressed reservations about the president's proposal, while noting health plans long have offered contraceptive coverage.

The policy shift showed little sign of satisfying Obama's toughest critics on the right. Republican presidential hopefuls made it clear they plan to keep the pressure on the president, and an aide to House Speaker John Boehner, R-Ohio, said the House will pursue legislative measures to ensure there is no "attack on religious freedom."

Information from Seattle Times archives and The New York Times also is included.

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