Facing vocal opposition from religious leaders and an escalating political fight, the White House sought on Tuesday to ease mounting objections to a new administration rule that would require health insurance plans — including those offered by Catholic universities and charities — to offer birth control to women free of charge.
The White House has been skittish from the start about the new rule, which was announced last month only after internal debates at the White House that, to some extent, pitted women — Health and Human Services Secretary Kathleen Sebelius, who is Catholic; Valerie Jarrett, a senior adviser to the president, and Nancy-Ann DeParle, the deputy chief of staff, on one side, arguing forcefully in favor of the rule, administration officials said.
On the other side, cautioning that the administration tread carefully and look for ways to minimize another major break with the church, they said, were several Catholic men who are close advisers to Mr. Obama: Vice President Joseph R. Biden Jr. and William M. Daley, the chief of staff at the time. Also weighing in, administration officials said, was Denis R. McDonough, the deputy national security adviser, whose purview does not naturally extend to health issues, but who is a Catholic.
In the end, it was Mr. Obama himself who made the decision, aides say, calculating that at the end of the day, the issue of public health access outweighed the concerns of the religious institutions.
Just a couple of facts. Here’s the bare bones of the law:
What is considered a large business?
You are generally considered a large business if you have more than 50 employees.
Do I have to provide health insurance to my employees?
The law does not require employers to provide health insurance.
Starting in 2014, large businesses (those with 50 or more full-time workers) that do not provide adequate health insurance will be required to pay an assessment if their employees receive premium tax credits to buy their own insurance. These assessments will offset part of the cost of these tax credits. The assessment for a large employer that does not offer coverage will be $2,000 per full-time employee beyond the company’s first 30 workers.
For my part, I don’t consider these covered services “free” to the employee. My assumption has always been, as both an employee and an employer, that I earn or pay renumeration in exchange for work provided. I haven’t considered any benefit I got through an employer “free” since I was 16, working Sunday mornings at IHOP, and was told I got a “free” uniform but maybe I’m too cynical and jaded. Maybe health insurance, like employer contributions to retirement plans, is not earned but is instead yet another way dead-beat employees are scamming the system.
And here’s the services that have to be covered with no out of pocket cost to the employee:
Well-woman visits, screening for gestational diabetes, HPV testing, STD counseling, HIV testing and counseling, breastfeeding support and supplies, contraception, and screening and counseling for domestic violence.
The issue that is important to me is whether the government can effectively regulate large businesses, because that’s really a key portion of the health care law. I don’t know that I would have introduced this key portion in the context or women’s health, because we are absolutely incapable of discussing women’s health without a laser-like, exclusive focus on reproduction, but that’s water under the bridge.
I did want to mention Kathleen Sebelius, though, and thank her for at least attempting to approach this from a public health angle:
In 2011, Forbes named Secretary Sebelius the 13th most powerful woman in the world. Before her Cabinet appointment in April, 2009, she served as Governor of Kansas beginning in 2003, where she was named one of America’s Top Five Governors by Time Magazine. From 1995 to 2003 she served as Kansas Insurance Commissioner. She was a member of the Kansas House of Representatives from 1987 to 1995.
Secretary Sebelius is the first daughter of a governor to be elected governor in American history; her father John Gilligan served as Ohio’s Governor from 1971-75. She holds a Master of Public Administration degree from the University of Kansas and a Bachelor of Arts degree from Trinity Washington University. She is married to Gary Sebelius, a federal magistrate judge. They have two sons, John and Ned, and a daughter-in-law, Lisa.
She’s been plugging away on the health care law for years now and she just seems like the kind of hard-working, low-key, practical public servant that we really, really need in this country. She’s the daughter of a governor and was a governor herself, and yet she’s not a lobbyist or working for an industry she once regulated.