The Affordable Care Act requires that most health plans offer birth control to women.

Around the country, Catholic employers have been arguing in court that having anything to do with insurance coverage of contraceptives violates their freedom of religion.

But when the insurance companies themselves are Catholic, contraceptive coverage comes without a hitch.

Several Catholic insurance companies have been quietly arranging for contraceptive coverage for many years, often making it available to their policyholders through third-party providers, according to Julie Rovner of Kaiser Health News, a partner of NPR.

"For example, the second-most popular insurance plan on New York's health exchange this year is a Catholic plan called Fidelis," she told NPR's Wade Goodwyn. "It doesn't provide contraceptive coverage directly, but it has arranged coverage through an outside provider in Michigan."

The number of Catholic insurance companies is expected to grow as many Catholic hospital systems start their own plans, Rovner says, so she went on to explain the contradiction.


Interview Highlights

What Catholic universities and hospitals argue

You might remember that purely religious employers — churches or places where everyone is of the same religion — they're exempt from the requirement that their insurance cover most birth control without any additional cost to the woman. But the administration has made several attempts to help religious organizations that hire people of all faiths to arrange coverage from sort of an arm's-length distance.

These are mostly hospitals and universities. They've claimed that even filing a form to the government saying they object to offering such coverage makes them "complicit in the sin of artificial birth control."

Why Catholic insurance plans don't raise the same objections

Both the insurers and the hospitals and universities say they're interpreting a document that lays out the rules for Catholic health care. But the insurers, at least if they want to sell to the public, in more than half the states are required to offer contraceptive coverage. And those laws long predated the Affordable Care Act or the fights over it now.

Why it's OK for the insurance companies to arrange for coverage, but not OK for the hospitals and universities

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