Marilyn Tavenner, Acting AdministratorJune 15, 2012Page 2 of 5care services as set forth in guidelines by the Health Resources and ServicesAdministration (HRSA). On August 1, 2011 HRSA issued its Guidelines onWomen's Preventive Services: Required Health Plan Coverage (HRSAGuidelines) requiring coverage without cost sharing of all Food and DrugAdministration approved contraceptive methods, sterilization procedures andpatient education and counseling for women of reproductive age. At the sametime, the Departments issued an Interim Final Regulation (76 Fed. Reg. 46621)proposing to create an exemption to the contraceptive coverage requirement forcertain religious employers, defining the term “religious employer” so narrowly asto exclude Catholic hospitals and health care organizations as well as otherreligious institutional employers. CHA objected strenuously to the inappropriatelynarrow definition in its comment letter date September 22, 2011 and objectedagain when it was announced in January 2012 that the Administration would notmake any changes to the definition.The final rule released on February 10, 2012 implemented the narrow religiousexemption as proposed, but also indicated the Administration’s intent to proposeadditional rules to implement the contraceptive coverage requirement in a waythat would accommodate the concerns of nonexempt religious employers withobjections to providing, paying for or referring for contraceptive coverage. Whilethis new development seemed at the time to be a good first step, ourexamination and study of the proposal as outlined then and in the ANPRM hasnot relieved our initial concerns. Accordingly, for the reasons set forth below, wecontinue to believe that it is imperative for the Administration to abandon thenarrow definition of “religious employer” and instead use an expanded definitionto exempt from the contraceptive mandate not only churches, but also Catholichospitals, health care organizations and other ministries of the Church
. If thegovernment continues to pursue the policy that all employees should haveaccess to contraceptive services, then it should find a way to provide and pay forthese services directly without requiring any direct or indirect involvement of“religious employers,” as broadly defined.
The Definition Of “Religious Employer” Must Be Broadened To Cover AllMinistries Of The Church.
The Departments state in the ANPRM the two goals they seek to achieve:
To maintain the provision of contraceptive coverage without cost sharing toindividuals who receive coverage through non-exempt, non-profit religious
As the representative of Catholic hospitals and health care providers, which will be impacted in their roleas employers, CHA focuses its comments on this aspect of the APRNM. We acknowledge, but will notaddress here the issues about whether the mandate itself is constitutional and whether it should apply toother entities, such as, insurers or individuals. The United States Conference of Catholic Bishops haspersuasively addresses these points it its comment letter.