By Patti Brown
Iowa Governor Terry E. Branstad and Bishop Richard E. Pates of the Diocese of Des Moines led more than 1,000 Iowans in a march on July 1 from St. Ambrose Cathedral to the east side of the State Capitol to demonstrate support for religious liberty and to protest the federal HHS mandate. The State of Iowa, however, has had its own version of the Obamacare Health and Human Service mandate for the past 12 years.
Iowa law has required all employer health care insurance plans to cover all contraception drugs or prescription contraception devices approved by the U.S. Food and Drug Administration. Iowa Code §514C.19 was signed into law by Governor Tom Vilsack on April 20, 2000.
Iowa specifically prohibits health insurance plans that provide benefits for outpatient prescription drugs, devices or services from excluding or restricting benefits for FDA-approved prescription contraception drugs, devices or outpatient services. This law regulates health care insurance plans provided by faith-based charities, schools, universities, or hospitals including the four Catholic dioceses of Iowa.
Iowa is not alone having such a mandate. Twenty-six states have passed legislation requiring insurance plans that cover prescription drugs to also provide coverage of FDA-approved contraception. Additionally two other states require insurance plans to cover prescription contraception on the basis of an administrative ruling or a state’s Attorney General opinion.
Twenty-one of the 28 states provide an exemption for religious reasons which allows many employers to avoid the contraception mandate by self-insuring their prescription drug coverage, dropping prescription drug coverage all together or opting for regulations under the federal Employee Retirement Insurance Security Act (ERISA) that pre-empts state law. Iowa’s statue does not provide these provisions.
The health insurance plan for the employees of the Diocese of Des Moines administered by Wellmark is mandated by state law to provide prescription coverage for contraception and coverage for any and all FDA approved contraceptive devices and outpatient procedures.
The health care plan covering employees at Mercy Medical Center in Des Moines is a self-insured plan through Catholic Health Initiatives in Englewood, Colorado and falls under ERISA.
“CHI’s medical plan follows Catholic social teaching and the church’s Ethical and Religious Directives for Catholic Health Care Services. The policy does not cover elective abortion, sterilization or contraceptives for contraceptive purposes,” said Michael Romano, national director of media relations for Catholic Health Initiatives. Wellmark provides claim processing services for CHI in Des Moines.
These state mandates requiring coverage without exemptions or restrictions came about as a result of federal sex discrimination law and specifically the Pregnancy Discrimination Act. In a ruling by the U.S. Equal Employment Opportunity Commission, Title VII of the Civil Rights Act of 1964, 42 U.S. C. § 2000e-2(a)(1) has been interpreted as prohibiting employers who offer comprehensive health care benefits including prescription drugs, devices and outpatient services to specifically exclude coverage of prescription contraception.
A statement provided to The Iowa Republican and signed by the four Catholic bishops of Iowa, Archbishop Jerome Hanus of Dubuque, Bishop R. Walker Nickless of Sioux City, Bishop Martin Amos of Davenport, and Bishop Richard Pates, of Des Moines said “The recent passage of the Affordable Care Act, the publication of the HHS mandates, and the Supreme Court decision regarding the Affordable Care Act have served to intensify the efforts of the Dioceses of Iowa to determine a resolution of health care provisions under diocesan supervision which will be in conformity with long-standing Church teaching. At the present time, serious consideration is being given to several options which attempt to synchronize both state and national efforts on this question.”
The United States Council of Catholic Bishops has led the charge against the federal HHS mandate requiring coverage of sterilization, abortion-inducing drugs and devices as well as contraception be provided in almost all private health plans with a narrow exemption for some employers. While the federal mandate is more sweeping than those in most of the 28 states though requiring coverage, Iowa’s statue is among the broadest.
Tea Party activist Ryan Rhodes said he was not surprised to learn of the Iowa health insurance mandate. “We’ve allowed Republicans to get away with things that we now get mad at Democrats for, and this was passed when Republicans were in control of the legislature,” said Rhodes. “We are demanding a higher standard than before and laws like this need to be repealed.”
Rep. Chris Hagenow, a Republican representing House District 59, was also surprised to learn about the Iowa mandate. “This needs to be fixed,” said Hagenow. “I fully support an exemption for faith-based employers, and if we need a legislative fix, I will be very supportive,” said Hagenow.
The Iowa legislation was introduced during the 78th General Assembly in the Iowa Senate as SB 2126 on February 10, 2000. The co-sponsored included seven Republicans and 10 Democrats: JoAnn Johnson R-Adel, Nancy Boettger, R-Harlan, Kitty Rehberg, R-Rowley, Elaine Szymoniak, D-Des Moines, Larry McKibben, R-Marshalltown, Mary Lundby, R-Marion, Mary Soukup, D-New Hampton, Patricia Harper, D-Waterloo, Matt McCoy, D-Des Moines, Joe Bolkcom, D-Iowa City, Maggie Tinsman, R-Davenport, Mark Shearer, D-Washington, Robert Dvorsky, D-Coralville, Johnie Hammond, D-Ames, Dick Dearden, D-Des Moines, Michael Gronstal, D-Council Bluffs, and O. Gene Maddox, R-Clive.
The bill was presented for a vote in the House April 11, 2000 where it passed 85 to 12. Two days later the bill passed the Senate 44 to 5 and was signed into law the following week.