Washington, USA - President Barack Obama ended months of internal White House debate by siding with a group of mostly female advisers who urged him not to limit a health-care law mandate to provide contraceptives, even at the risk of alienating Catholic voters in November, people familiar with the discussions said.
Health and Human Services Secretary Kathleen Sebelius, a Catholic and a two-term governor of Kansas, was joined by several female Obama advisers in urging against a broad exemption for religious organizations. To do so would leave too many women without coverage and sap the enthusiasm for Obama among women's rights advocates, they said, according to the people, who spoke about the deliberations on condition of anonymity.
Vice President Joe Biden and then-White House chief of staff Bill Daley, also Catholics, warned that the mandate would be seen as a government intrusion on religious institutions. Even moderate Catholic voters in battleground states might be alienated, they warned, according to the people familiar with the discussions.
The administration's decision, announced Jan. 20, has quickly entered the presidential campaign. Republican rivals accuse Obama of trampling on religious freedom and Catholic bishops have ordered lectures from the pulpits across the nation.
Former Massachusetts Governor Mitt Romney, campaigning in Colorado in advance of Republican caucuses there, charged yesterday that Obama was waging "an assault on religion" that would require Catholic schools and hospitals to provide "free contraceptives and morning after pills in violation of their religious conscience."
Addressing 'Concerns'
White House Press Secretary Jay Carney told reporters at his daily briefing that Obama understands the religious concerns and that the administration will "see if the implementation of the policy can be done in a way that allays some of those concerns."
At the same time, Carney indicated there was no move to fundamentally alter the plan. Obama's interest is "making sure that all American women, all women here, have access to the same preventive care services," he said.
Biden has not commented publicly on the decision.
The public debate follows a struggle within the White House that dragged on for months. White House advisers hunted repeatedly for a middle ground that might accommodate both sides, only to run into legal obstacles.
Hawaii Model
Sebelius was backed by adviser Valerie Jarrett, Tina Tchen, the first lady's chief of staff, and Melody Barnes, then director of the Domestic Policy Council, the people said. Among the ideas considered and discarded because of legal objections was an option modeled on a Hawaii law that provides broad exemptions for religious agencies while requiring private insurers to offer contraceptive coverage to the employees.
Reproductive rights groups, such as Planned Parenthood Federation of America, and Democratic U.S. senators including Barbara Boxer of California, Jeanne Shaheen of New Hampshire and Patty Murray of Washington, pressed the administration to stick with a preliminary rule announced by Sebelius in August.
Shaheen spoke to Obama about the issue when he visited New Hampshire in November. Her communications director, Jonathan Lipman, said she talked "several times with senior White House staff," including two conference calls with other senators.
Advocates countered warnings of alienating Catholics with arguments that an exemption might depress enthusiasm for Obama among women, a disproportionate share of Democratic voters. Women's advocates intensified their efforts after Obama met in November with Catholic Archbishop Timothy Dolan of New York.
'Energizing Issue'
Judith L. Lichtman, a senior adviser with the National Partnership for Women and Families in Washington, among the groups that favored minimizing religious exemptions, said the ruling would help Obama in November.
"Contraception is not a politically controversial issue in this country," she said. "It's an energizing issue for all women reflecting all demographics."
Sebelius, in a three-minute interview in Washington on her way from a speech to her car, said Obama was "briefed along the way" before the Jan. 20 announcement. She said that she and Obama had met privately on the issue. She declined to discuss internal deliberations, including divisions among the administration or details of her discussions with Obama. "The decision was made by our department," she said.
Asked how the decision and response has affected her as a Catholic, she said it was a policy decision and that the administration balanced the needs of millions of women who rely on contraceptives with the concerns of religious organizations.
Limited Exemptions
The decision will require most employers to cover contraception through their employee health insurance at no added cost to the employees. Nonprofits that don't cover contraceptives now have until August 2013 to adjust. Houses of worship and nonprofit religious groups that primarily employ and serve people of the same religious faith would be exempt, while religious hospitals and universities would not.
Controversy over the decision has been fueled by Republican presidential hopefuls Romney and Newt Gingrich and even some Democrats. Democratic Senator Robert Casey Jr. of Pennsylvania, who had weighed in with the White House for a broader exemption to religious organizations, called last week on the administration to reverse course.
Casey released a Feb. 3 letter to Obama saying religious- affiliated organizations "should not be compelled by our federal government to purchase insurance policies that violate their religious and moral convictions."
Looking for 'Resolution'
Obama campaign adviser David Axelrod said in an interview on MSNBC yesterday that the president doesn't want to limit religious freedom and wants to look for a "resolution" to the conflict. He did not promise any changes to the policy.
Anthony R. Picarello, Jr., associate general secretary and general counsel for the U.S. Conference of Catholic Bishops in Washington, said has group has been "baffled by the political calculus" of Obama and his team.
Picarello said hours after Axelrod's comments on MSNBC that "we have still heard nothing" from the administration. "And until we do -- and until there's an acceptable solution -- words like 'work this thing through' is just the sugar-coated way of saying 'force you to comply.'"
John Green, director of the University of Akron's Ray C. Bliss Institute of Applied Politics in Akron, Ohio, said the impact on Obama's re-election prospects depends on how independent white, Catholic voters view it.
Swing Voters
"To the extent Catholic voters think of this as a religious liberty issue, it does have the potential to pull Catholic voters toward Republicans or away from Democrats," said Green, a political science professor who studies U.S. religious voter patterns. He said the biggest impact might be among white religious swing voters in battleground states including Ohio, Michigan and Pennsylvania.
The decision is less likely to hurt Obama if voters see it as a policy decision because "there are a lot of Catholics that not only use contraception but think it should be available," he said.
One in four U.S. voters are Catholic, Green said. The white Catholic vote accounts for roughly 16 percent and is divided among Democrats, Republicans and independents. Those independents comprise eight to 10 percent of U.S. voters, Green said.
In 2008, Green said, Obama won the Catholic vote 54 percent to 46 percent based on exit polls. He lost the white Catholic vote, however, 47 percent to 53 percent.
Among Catholics who attend mass once a week or more, Obama lost the vote 41 percent to 59 percent, while he won the support of white Catholic who aren't regular churchgoers, 52 percent to 48 percent.
There's also "potential for it to extend beyond Catholics," Green said of any blow-back. "There are mainline Protestants, evangelical Protestants and other groups that may be concerned about the potential damage" to religious freedom.