WASHINGTON—– For days President Obama had been hammered by critics — including Cardinal-designate Edwin F. O'Brien of the Archdiocese of Baltimore — over a regulation in the healthcare law that required religiously affiliated hospitals, charities and universities to provide birth control coverage for female employees even if that conflicted with church teachings.
On Friday Obama tried to end the debate with what he called an "accommodation." The employees still will be offered free birth control coverage. But the benefit will come directly from their insurers, meaning that the religious groups' money will not be used to provide the services and pills.
O'Brien, who had threatened not to offer health insurance rather than offer birth control coverage, chose to remain silent on Obama's proposal. But the president appeared to have made progress, winning over the Catholic hospital association and Catholic Charities – although not the nation's bishops – and reassuring wavering Democrats while keeping the support of groups such as Planned Parenthood.
Stuart Swetland, vice president for Catholic identity and mission at Mount St. Mary's University in Emmitsburg, said the proposal appeared to be a good compromise, but he wanted to examine the details. "It shows [Obama] and the administration are listening to our concerns and are attempting to address them," Swetland said.
Under the new plan, administration officials believe insurers will comply for free because the coverage may not actually cost them anything. Evidence suggests that providing birth control coverage reduces overall costs for health plans because birth control is much cheaper than pregnancy, according to administration officials and some health industry analysts.
The fact the compromise had not been proposed earlier angered the President, who felt let down by his staff, officials said. Obama waded into the details of the dispute himself this week and personally crafted the solution, according to a Democratic official who spoke on condition of anonymity to discuss a sensitive matter.
From the beginning, the fight over the requirement that all health plans offer free birth control coverage was animated by politics, deeply held beliefs and the personalities of the people involved. Several prominent members of the president's team, including Health and Human Services Secretary Kathleen Sebelius and senior advisor Valerie Jarrett, argued strongly for the president's commitment to make contraceptives available to everyone.
But since November, others in Obama's circle had issued warnings of political trouble ahead. That month, chief of staff, Bill Daley, who is Catholic, asked Obama to sit down with New York Archbishop Timothy Dolan, head of the bishops conference, to talk about the coming contraceptives mandate.
According to Democratic officials with knowledge of the conversations, some policy experts and lawyers in the White House felt the administration should not compromise because no birth-control mandate would win the bishops' support.
Obama ultimately agreed with that position and signed off on the rule announced in late January, exempting churches and other houses of worship from the mandate but requiring religiously affiliated employers such as schools and hospitals to make sure their employees had contraceptive coverage. But even as he made calls to Dolan and Sister Carol Keehan, the head of the Catholic Health Association, to explain the initial policy just before it was announced, Obama emphasized that changes could come during the year before the mandate takes effect.
The bishops responded angrily and publicly to the policy, putting the administration on the defensive. Republicans soon joined the chorus, as did some Catholic Democrats in Congress. As the fight grew louder and more threatening over the past week, Obama decided to move quickly to tamp down the problem, a senior administration officials said.
Announcing the change on Friday at the White House, Obama said he had always been sensitive to the concerns about religious liberty, telling reporters that "we live in a pluralistic society where we're not going to agree on every single issue or share every belief."
"That doesn't mean that we have to choose between individual liberty and basic fairness for all Americans," Obama said. "We are unique among nations for having been founded upon both these principles, and our obligation as citizens is to carry them forward. I have complete faith that we can do that."
His words quickly won the support he was looking for. "The framework developed has responded to the issues we identified that needed to be fixed," said Sister Keehan, who supported Obama's effort to pass health reform, but had opposed the birth-control mandate.
Obama also won over a range of prominent Catholics who had criticized the policy, including Douglas W. Kmiec, his former Malta ambassador, and E.J. Dionne, a columnist and senior fellow at the Brookings Institution.
Planned Parenthood announced its approval. Nancy Keenan, president of NARAL Pro-Choice America, said the decision showed that "President Obama is firmly committed to protecting women's health."
Others remained opposed or on the sidelines. The bishops have not embraced the plan. A spokesman for America's Health Insurance Plans, the insurance industry's Washington-based lobbying arm, expressed reservations about the president's proposal, while noting that health plans have long offered contraceptive coverage.
"We are concerned about the precedent this proposed rule would set," said Robert Zirklebach.
The policy shift also showed little sign of satisfying his toughest critics on the right. Republican presidential hopefuls made it clear they plan to keep the pressure on the president, and an aide to House Speaker John Boehner (R-Ohio) said the House will pursue legislative measures to ensure there is no "attack on religious freedom."
But as supporters stepped back into his corner on Friday, Obama felt empowered to turn the political spotlight back on his critics – and to issue a new appeal for support.
"I understand some folks in Washington may want to treat this as another political wedge issue, but it shouldn't be," he said. "I certainly never saw it that way . . . Religious liberty will be protected, and a law that requires free preventive care will not discriminate against women."
Baltimore Sun reporter Andrea K. Walker contributed to this report. Lisa Mascaro also contributed from Washington.