Published in POLITICO
President Barack Obama is facing a decision that could threaten inroads he made in 2008 with Catholic voters and other religious voters.
But this time, the issue isn’t abortion. It’s contraception.
A new rule issued under his health care law requires virtually all insurance plans to cover contraceptives, and Obama is now personally involved in a decision about how broad an exemption for religious employers should be.
And after a separate administration decision Wednesday that limited access to the morning-after pill for teenage girls, both sides will be watching the broader decision more closely than ever.
The contraceptive coverage mandate was included in a rule that HHS issued in August, which outlines what preventive health services plans will have to cover right away. Its rules on services for women were based on an Institute of Medicine recommendation, which said all FDA-approved contraceptives should be covered by insurance with no out-of-pocket costs to patients.
HHS exempted a narrow set of religious employers from this requirement — essentially allowing churches to deny contraception coverage to their employees, but not organizations like religiously affiliated universities or hospitals.
This pleased neither religious leaders nor reproductive rights groups.
The United States Conference of Catholic Bishops called the requirement “an unprecedented attack on religious liberty,” and the National Association of Evangelicals denounced it as “a dangerous and damaging federal policy.”
Anna Franzonello, staff counsel with Americans United for Life, said that although Obama has said he favors a “robust” conscience clause, “what this actually shows is that robust to him means a fig leaf of protection.” The group maintains that emergency contraceptives that would be covered by this mandate are a form of abortion.
But reproductive rights groups said even this exemption gives employers too much power over their employees’ decisions.
Planned Parenthood wrote that the question is whether to permit “an organization to refuse to allow its employees to choose which health care services are right for them,” and the National Women’s Law Center argued that the administration didn’t have authorization from Congress to exempt any employers from the coverage requirement.
Both sides are sure to watch the final ruling closely, but the stakes may be even higher now with the administration’s allies. That’s because HHS Secretary Kathleen Sebelius overruled the FDA on Wednesday and declared that teenage girls won’t be able to get the morning-after pill over the counter.
The decision was a big disappointment to Democratic lawmakers and abortion-rights groups, who said the Obama administration unnecessarily restricted access to contraceptives that could prevent unintended pregnancies.
Now, Obama has been brought into the discussions about whether to broaden the contraceptive coverage exemption under the health care law. Reproductive rights advocates have heard from the White House that Sebelius has briefed him on the issue, and they’re expecting a decision any day. Senior White House advisers have held conversations with Democratic members of Congress who are urging him not to expand the exemption.
This decision may be especially tricky for Obama, because he may need constituencies on both sides of this issue in order to win reelection.
Thanks to a concerted outreach effort in 2008, Obama made inroads with religious voters who have voted overwhelmingly Republican in recent elections. He outperformed John Kerry by 3 percentage points among white evangelicals overall, but he did even better in swing states such as Colorado, Michigan and Pennsylvania, where his margin in 2012 will likely be closer than it was in 2008.
He also beat John McCain by 9 points among Catholics, who have long been a hotly contested swing vote in national elections.
It’s an open question about whether Obama can repeat this in 2012. But alienating religious voters might not help him win reelection.
The US Conference of Catholic Bishops declined to comment, but Kristen Day, executive director of Democrats for Life of America, said, “The Catholic vote is in jeopardy here if the president forces Catholic institutions to pay for contraception.”
Evangelicals, said the National Association of Evangelicals’s Galen Carey, “will be watching to see what the administration does and whether the administration is sensitive to religious liberty or not.”
But lawmakers and groups on the other side say the religious politics are not so simple, and that Obama will pay at the polls if he waivers on women’s access to contraception.
They point to research that shows Catholics in the pews do not share their bishops’ opposition to contraception. According to a Guttmacher Institute analysis of CDC data on women who have been sexually active, 98 percent of Catholic women have used contraception.
Sen. Jeanne Shaheen of New Hampshire, one of the Democratic lawmakers who has been pressuring the White House to hold the line, said Obama is kidding himself if he thinks he can win over religious conservative voters on this issue.
Those who see contraceptive coverage as an assault on religious liberty, Shaheen said, “are probably going to be so far out on this issue that they are not going to support a Democrat for president” regardless of this decision.
Nancy Keenan, president of NARAL Pro-Choice America, says caving here could cost him key support among women.
She pointed to a recent poll by her organization of women voters who supported Obama in 2008 but who aren’t planning on doing it again. Sixty-six percent of these support abortion rights, and their results suggest he can return a majority to his camp by contrasting his support of abortion rights with an anti-abortion Republican opponent.