A Way Out, Wrapped in a Fig Leaf

Ruth Marcus on Feb 10, 2012

WASHINGTON -- I write today in praise of fig leaves. In politics, as in religion, fig leaves have an important place.

The compromise -- or, in the administration's assessment, non-compromise -- announced by the White House is, in essence, a huge regulatory fig leaf.

Women who work for religiously affiliated institutions with moral objections to contraception will nonetheless have access to contraceptive coverage free of charge, just as women who work for other employers. They won't have to sign up for any different coverage, or pay any additional money.

The employers, for their part, won't have to pay for the coverage, or say they offer it, or even direct employees to places where they can obtain it. The extra cost, and here is where the fig leaf comes in, will be borne by the insurance companies themselves.

This is, of course, a dodge -- a quite clever and positive one. Everyone gets to say that the religious institutions aren't "paying for" contraception. But if covering contraception ends up costing them money, you can be sure those costs will be passed along, as costs always are, to customers.

The beauty of this dodge is that it is entirely possible, even likely, that adding the coverage will not raise rates. Easier, cheaper access to contraception means fewer pregnancies. Pregnancies -- and the resulting babies -- cost insurers far more than birth control pills. According to the Guttmacher Institute, the federal government reported no increase in costs after Congress required coverage of contraceptives for federal employees in 1998. Think of it as immaculate contraceptive coverage.

Of course, fig leaves can leave gaps. One big gap in the administration's plan involves how to treat religiously affiliated institutions that are self-insured. In those situations, the employer pays an insurance company to administer the plan but bears the cost of medical care directly. The administration's approach does not necessarily solve the problem for such entities.

The biggest puzzle is how the administration landed itself in this fix. There was going to be no satisfying the Catholic bishops. From the church's point of view, no exemption could be broad enough. In a letter to the Department of Health and Human Services, the U.S. Conference of Catholic Bishops argued that contraception "is not properly seen as basic health care" and that the mandate "should be rescinded in its entirety."

But the public was not in an uproar about the mandate itself. The White House's self-inflicted wound involved its refusal to write a large-enough exemption. The administration, balancing between the ire of women's groups already worked up about its refusal to explain access to emergency contraceptives and the need to avoid alienating Catholics, botched the call.

The president, in his prickly way, admitted as much in the news conference announcing the new plan. Originally, he noted, religious institutions were given a one-year grace period to figure out how to comply with the coverage mandate.

"Now, after the many genuine concerns that have been raised over the last few weeks, as well as, frankly, the more cynical desire on the part of some to make this into a political football," Obama said, "it became clear that spending months hammering out a solution was not going to be an option, that we needed to move this faster." Uh, yeah.

It is excessive and malicious to accuse Obama of waging a war on religion. But you don't have to be conservative or Catholic -- or male, for that matter -- to think he flubbed this call and to be relieved that the administration seems to have found a way out.

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Ruth Marcus' email address is ruthmarcus(at symbol)washpost.com.