Health Law’s Contraceptive Rule Eased for Business With Religious Objections

WASHINGTON — The Obama administration issued new rules on Friday that allow closely held for-profit corporations like Hobby Lobby Stores to opt out of providing women with insurance coverage for contraceptives if the companies have religious objections.

Women enrolled in such health plans would still be able to get birth control at no cost, the administration said. Insurers would pay for contraceptive services, but the payments would be separate from the employer’s health plan.

The rules came in response to a decision by the Supreme Court in June 2014. In that case, Burwell v. Hobby Lobby Stores, the court said that requiring family-owned corporations to pay for coverage of contraception under the Affordable Care Act violated a federal law protecting religious freedom.

The administration had argued against that conclusion, saying there was no precedent for granting “a religious exemption” to commercial enterprises like the Hobby Lobby craft stores.

But under the rules issued by the administration on Friday, certain for-profit businesses will be able to obtain an accommodation like the one already available to nonprofit religious groups, including Roman Catholic universities, hospitals and charities that object to covering the costs of contraceptives.

Contraceptive coverage has been the focus of fierce political debate for five years, as the administration struggled to meet the health needs of women while recognizing the concerns of people who have deep religious convictions against some or all forms of contraception.

Sylvia Mathews Burwell, the secretary of health and human services, said Friday that the new rules would “secure women’s access to contraceptive services while respecting religious beliefs.”

Family planning advocates, usually supportive of the administration, criticized the final rules.

Senator Patty Murray of Washington, the senior Democrat on the Senate health committee, said the rules allowed a wide range of businesses to have “power over the health care decisions of the women they employ.” The rules, she said, show why “the Supreme Court’s deeply harmful ruling in Burwell v. Hobby Lobby is completely unacceptable.”

Mrs. Murray is planning to introduce legislation to override the court decision. Senate Republicans blocked a similar bill last year and now, with more seats, could probably do so again.

Marcia D. Greenberger, co-president of the National Women’s Law Center, a research and advocacy group, said, “The rules go beyond the facts of the Hobby Lobby decision and will allow a broader set of for-profit employers to exempt themselves from the general requirement that contraception be covered as part of preventive health care for women.”

In an explanation of the rules, the administration confirmed that its definition of eligible closely held for-profit entities “goes beyond what is required” by the Hobby Lobby decision.

A study this week by researchers at the University of Pennsylvania estimated that women saved $1.4 billion a year on birth control pills because of the requirement in the Affordable Care Act for coverage of contraceptives without co-payments or other charges.

Under the law, employers with 50 or more full-time employees are generally required to offer health coverage or pay substantial penalties. Under a sheaf of rules issued in the last few years, such insurance must cover preventive services, including all forms of contraception approved for women by the Food and Drug Administration.

If they report their objections, and adhere to procedures described by the government, they can be excused from having to provide or pay for contraceptive coverage.

These companies can, in effect, opt out of providing or paying for contraceptive coverage. But their insurance carriers must, under the rules, make separate payments for contraceptives, so women would still have access to them, and insurers could be reimbursed by the government..

Relying on terms used in federal tax law, the rules define a “closely held for-profit entity” as a company that is not publicly traded and that has an ownership structure under which more than 50 percent of the ownership interest is held by five or fewer individuals.

Family members, including brothers, sisters and spouses, “count as a single owner for purposes of these final regulations,” the government said.

In addition, a closely held for-profit business may qualify if it has an ownership structure that is “substantially similar” to the one described in the rules.

Based on available data, the administration said it believed that its definition would encompass all the for-profit companies that have challenged the contraceptive coverage requirement on religious grounds. In addition, it predicted that at least 87 closely held for-profit businesses would try to opt out of providing contraceptive coverage.

To qualify under the rules, the “highest governing body” of a for-profit entity, such as the board of directors or trustees, must adopt a resolution certifying that “it objects to covering some or all of the contraceptive services on account of the owners’ sincerely held religious beliefs.”

Employers can register their objections by sending a letter to the government, or by sending a federal form directly to their insurers and the companies that administer their health plans.