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GOP quiet on health law rules

By: Elizabeth Titus August 9, 2011 04:31 AM EST

Republicans who swept to power last year vowing to repeal President Barack Obamas health care law have been nearly silent about new rules that will force health insurance companies to cover birth control and other womens health services without co-pays. The new standards are a piece of the law Republicans might predictably oppose: a coverage mandate at the intersection of Americans most personal lives. But a week after the rules were announced, most Republicans have stayed mum, with Hill leaders laying off press releases and declining to comment when asked directly. Republicans dont want to be portrayed as anti-woman, and the way these stories tend to get written, thats how it gets spun, said Tevi Troy, a senior fellow at the Hudson Institute who served as deputy Health and Human Services secretary for part of the George W. Bush administration. Plus, Troy noted: Who wants to be on the side of big co-pays? As the details of the health care law roll out, Republicans who opposed the overhaul might end up pulling their punches. Health care reform did not poll well, but some of the details do setting up Republicans to miss out on hitting home their message, while Democrats eye vindication. House Speaker John Boehner (R-Ohio) used his response to jobs numbers last week to say that Republicans are working to repeal the job-crushing health care law with all of its mandates and tax hikes, but his office declined to comment when asked by POLITICO about the womens health mandates. Boehner isnt alone. The office of House Majority Leader Eric Cantor (R-Va.) and the Republican National Committee declined to comment. A spokesperson for Senate Minority Leader Mitch McConnell (R-Ky.) did not respond to a request for comment. Meanwhile, some Hill Democrats celebrated the announcement. Health reform comes through for women real coverage, wrote House Minority Leader Nancy Pelosi on Twitter the day after the new rules came out. The California Democrat said the news had been something overlooked with #SatanSandwich the previous day, referring to one Democratic caucus members disgust over the debt ceiling deal. Some Democrats hope the gradual rollout of the health care law details mirror the rise of Medicare in the 1960s, when the now-popular program faced backlash. That was a case where once things got kind of put in place and started to work, of course, people were a lot more positive and excited about it, said Peter Fenn, a Democratic media consultant. And, you know, my sense of this is once these pieces get put in place, folks will see more about it that they like than they dont like. According to an NPR/Thomson Reuters poll earlier this year, 77 percent of respondents believe private insurance should cover most or all cost of oral contraceptives, and 74 percent believe government-subsidized insurance plans should cover birth control pills.
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GOP quiet on health law rules - POLITICO.com Print View

percent believe government-subsidized insurance plans should cover birth control pills. Some observers say the news cycle is more to blame than Republicans press shops for the dialed-back reaction. The debt ceiling was an all-consuming Washington story when the rules rolled out, said Doug Heye, a former communications director for the Republican National Committee. Over the past several weeks, there had been no oxygen for anything other than the debt ceiling all other issues were crowded out, Heye said via email. The countrys deeper economic issues which are fueling Congress members messaging wars are also likely at play. If the economy improves and things look better in six to nine months, if right-track, wrongtrack numbers start to improve, my guess is youll see a lot more health care talk, Fenn said. The 2012 elections also loom large for congressional conservatives. No co-pays for contraception isnt something that fires up the ultraconservative base, said Mark Putnam, a Democratic media consultant. If it were for abortions, that would be another matter. A group that does get fired up about womens health issues, on the other hand, is young voters, Fenn said. I think the Republicans have found that they also dont want to stir up younger voters and get them energized, Fenn said. Theyd just as soon have them sort of asleep during the next 16 months. Health care reform had already required insurance plans to cover some preventive services for women without cost-sharing, such as mammograms and cervical-cancer screenings. The U.S. Department of Health and Human Services turned to the nonprofit Institute of Medicine to solicit recommendations on what other services private insurers should cover under the preventive provision. On July 19, IOM issued a 210-page report recommending eight new measures, including birth control, breastfeeding equipment, domestic-violence counseling, HIV screening and others. HHS announced its adoption of those recommendations on Aug. 1. They will take effect for insurance plans starting on or after Aug. 1, 2012. The birth-control recommendation includes all FDA-approved contraception methods. Some types of emergency contraception, or the so-called morning-after pill, are FDAapproved. Abortifacient, or abortion-causing, drugs are not included in the HHS rules. The rules allow religious employers to opt out of offering contraceptive coverage to their employees if that is inconsistent with their tenets, HHS said. Not all conservatives have been quiet.

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GOP quiet on health law rules - POLITICO.com Print View

Sen. Orrin Hatch (R-Utah) wrote to HHS Secretary Kathleen Sebelius saying he was concerned about the process by which the recommendations would be adopted, as well as with the birth-control provision. Not only will such mandates drive up health care costs for American families, but the mandates recommended by IOM are an affront to the natural rights to life, religious liberty and personal conscience, Hatch wrote. And some religious groups objected to the birth-control part of the rules. The Obama administration failed to create a meaningful conscience exemption, said Cardinal Daniel DiNardo of the United States Conference of Catholic Bishops in a statement. The Catholic Church has long opposed contraception. The bishops organization also objects to coverage of emergency contraception, like the drug Ella. The FDA does not approve the use of Ella as an abortion-causing drug. Lawmakers pushed legislation earlier this year that would create a broader exemption for religious objectors. Rep. Jeff Fortenberry (R-Neb.) introduced a House bill in March and counted Democrats among his co-sponsors. In the upper chamber, Republican Sens. Roy Blunt (Mo.), Kelly Ayotte (N.H.) and Marco Rubio (Fla.) who together run the conservative Values Action Team got behind parallel legislation. Sen. Blunt has been highly engaged in this issue and he maintains close communication with conservative groups through his leadership on the Values Action Team, which he chairs with Sens. Rubio and Ayotte, said Blunts spokeswoman Amber Marchand in a statement. Meanwhile, some insurers say the rules will lead to cost increases. Unfortunately, the preventive care coverage recommendations recently issued by the IOM would increase the number of unnecessary physician office visits and raise the cost of coverage, said Karen Ignagni, president of Americas Health Insurance Plans, in a statement. The organization says it represents almost 1,300 health insurance companies. Theres been a lot of discussion saying these are, quote, free preventive benefits, but unless hospitals and doctors stop charging for these services, theyre not free, said AHIP spokesman Robert Zirkelbach. Troy shares concerns about the costs of the new rules. I dont think health services should be quote unquote free, Troy said. Im also uncomfortable with government mandating coverage requirements or coverage decisions. Theres a cost when you impose these mandates, and thats what this is. And not all congressional Republicans have been silent on the issue. Rep. Steve King of Iowa grabbed blog headlines last week after he blasted the new rules on the House floor. Theyve called it preventative medicine, King said. Preventative medicine. Well, if you apply that preventative medicine universally, what you end up with is, youve prevented a
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GOP quiet on health law rules - POLITICO.com Print View

apply that preventative medicine universally, what you end up with is, youve prevented a generation. Preventing babies from being born is not medicine. Thats not constructive to our culture and our civilization. If we let our birth rate get down below the replacement rate, were a dying civilization. It may prove difficult, though, for more Republicans to come out opposed to the birth-control provision, both because of the near-term focus on the economy and the countrys longerterm attitudes about contraception. Family planning was once named one of 10 great public health achievements in the 20th century by the federal Centers for Disease Control and Prevention, noted Judy Waxman, vice president of health and reproductive rights at the National Womens Law Center. I mean, really, theyre going to tell women they shouldnt be getting contraceptives as a preventive service when 98 percent of American women use contraceptives? Waxman said. A CDC survey found more than 99 percent of women who had been sexually active had used at least one form of birth control, according to a report last year. I dont mean to be flip, Waxman said. I think it would be hard to come out opposed to it.
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