February 26, 2012

Contraceptive debate has familiar echoes in Maine

By John Richardson jrichardson@pressherald.com
Staff Writer

AUGUSTA -- Democrats insisted all women deserve access to birth control.

click image to enlarge

Pam Cahill of Woolwich with newly appointed Maine Attorney General Bill Schneider of Durham.


Maine — 1999 state law mandates that employer-purchased health insurance plans cover contraception, unless the employer is a church or a religious primary or secondary school. Many church-affiliated hospitals, nursing homes and nonprofit organizations have avoided the mandate by self-insuring, or paying medical claims directly. State law applies only to commercial insurance plans and does not require employers to provide insurance.
U.S. — A new rule based on the 2010 Affordable Care Act requires employer-provided health insurance plans to cover contraception, unless the employer is a church. The Obama administration is developing a compromise to allow religious schools, hospitals, nursing homes and nonprofit organizations to avoid paying directly for contraceptive coverage while still including it in their plans. Employers are required to offer insurance or pay fees, but it is not yet clear how the mandate will apply to self-insured employers.

The Catholic Church called mandatory health insurance coverage of contraceptives a violation of religious liberty.

It sounds a lot like the debate that has raged for the past several weeks in Washington, D.C. But that was the story in Maine in the spring of 1999.

Maine's Legislature settled the issue relatively easily, adopting a contraception-coverage mandate by a wide margin and then, for the most part, forgetting all about it. Until now.

Maine has been swept into the national contraception debate, nearly 13 years after it appeared to have settled the issue. That was clear last week after the state attorney general's stand against a federal contraception mandate ignited a backlash and revealed that Mainers still have strong feelings about the topic.

"A lot of people are outraged" about the federal mandate, said Marc Mutty, lobbyist for Maine's Roman Catholic Diocese.

Many others are frustrated that birth control is even an issue anymore.

"It seems ridiculous that we are going back to arguing about birth control," said Charlotte Warren, associate director of the Maine Women's Lobby.

The controversial federal rule, part of the 2010 health care reform law, requires employers to provide heath insurance coverage for contraceptives and other preventive health services. It exempts churches, but covers other religious organizations, including schools and hospitals.

It is more than a political dispute for many Mainers.

The federal mandate could directly affect the state's Catholic schools, hospitals and nursing homes, as well as their employees. That's because, despite Maine's mandate, those employers do not provide workers with health insurance coverage for birth control.

Catholic schools have been exempt under Maine law, but won't be under the federal mandate. Catholic hospitals, nursing homes and nonprofits are not exempt but avoided Maine's mandate by becoming self-insured, which means that the employers pay medical claims directly.

Maine law applies only to employers that buy commercial insurance plans. The federal mandate will apply to commercial plans, too, but may also apply to employers that self-insure.

The Obama administration is seeking a compromise with religious employers who self-insure.

Among those watching closely is Catholic Charities of Maine, a nonprofit social service agency that is affiliated with Maine's Catholic Diocese and has about 350 full-time employees.

"As a self-insured entity and a Catholic entity, we do not cover birth control," said Bonny Bagley, associate director of the agency. "Being mandated to provide birth control really feels like an infringement on our religious liberty."

The federal mandate is still being finalized after protests by the Catholic Church and others led to a reconsideration by the administration. The revised rule would expand contraceptive coverage without requiring religious employers to pay for it directly, the administration says.

But so far, that compromise has not settled the arguments.

Schneider supports both

Maine Attorney General William Schneider signed on to a Feb. 10 letter from 13 attorneys general calling the federal mandate an unconstitutional infringement on the freedom of religious employers.

Schneider, as it happens, voted for the 1999 Maine contraception law as a Republican legislator. He said last week that he still supports access to contraception and is waiting to see the final details of the rule. But, he argued, federal law is more binding than Maine's version because it doesn't allow employers to simply not offer health insurance if the rules violate their beliefs.

When the Maine Women's Lobby and other groups learned last week about Schneider's stand, they launched an online petition drive to try to change his mind.

On Friday, all 32 Democratic women in the Maine Legislature urged him to take his name off the letter.

(Continued on page 2)

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