Among the many mandates included in the Affordable Care Act, the requirement that insurance plans cover women’s preventive services – including contraceptive services – has drawn some of the fiercest outcries and spawned dozens of lawsuits from religious organizations across the country.
Late last month, the U.S. Department of Health and Human Services announced it would delay implementation of final rules regarding the preventive services coverage requirement for religious organizations until January 2014. The delay, and the final set of rules, were in response to public feedback earlier this year.
In addition to keeping up with federal regulatory shuffling, Colorado businesses also must comply with a 2010 state law requiring all insurance plans sold in Colorado to provide contraception coverage. That law does not allow religious nonprofits any exemptions. More than half of states now have laws that require insurers to cover contraceptives.
Yet even with the changes in state and federal laws, employees of Durango’s religious employers and nonprofit religious organizations are unlikely to see changes in how preventive services are covered, or not.
Mercy Regional Medical Center, which is part of the Catholic-based nonprofit health-care network Centura Health, has a self-funded health plan, exempting it from Colorado’s law, Mercy spokesman David Bruzzese wrote in an email. That’s because the state’s law applies only to plans sold by insurance carriers, not to companies that self-insure.
Certain types of hormonal birth-control methods, such as birth-control pills, are covered to some degree under Mercy’s health plan, but there’s a catch. Those hormonal therapies cannot be meant for contraceptive purposes. Instead, they must be prescribed for “treatment for other conditions as medically necessary,” such as severe cramping or bleeding, Bruzzese said.
Bruzzese said he didn’t know how many of Mercy’s 1,000 employees are covered under the nonprofit’s health insurance.
The health-insurance coverage offered to employees at St. Columba Catholic Church completely excludes contraceptives and reproductive services that are not in accord with Catholic teaching. Because the parish is under the Diocese of Pueblo, St. Columba’s employees are covered by the diocese’s insurance plan, which, as a religious organization, is exempt from federal requirements to cover contraceptive services.
However, Colorado’s 2010 law forced the diocese to scramble to find another insurance model after its previous insurer was informed it would be required to include contraceptive coverage in the diocese’s plan, said Paul Guarnere, director of human services at the Diocese of Pueblo.
It took two months of work, but the diocese eventually switched to becoming self-insured to avoid the state’s contraceptive coverage mandate.
“To be consistent with the Catholic teaching and what we believe is the right thing to do, we aren’t going to pay for abortions, and we are not going to pay for sterilizations,” Guarnere said.
As a self-insured organization, the diocese now covers the medical costs of the employees in all of the parishes, charities and schools within its 48,000-square-mile territory.
Because the diocese is not paying health insurance premiums, Guarnere said it actually might be saving money. He planned to put the money saved toward a tele-med service that allows employees to call or Skype doctors to ask medical questions instead of heading directly to a doctor’s office or the hospital.
Guarnere acknowledged that it took work to understand the intricacies of new health-insurance laws.
“The whole arena is a little bit confusing in many regards,” he said.
ecowan@durangoherald.com
