WASHINGTON - Many church-affiliated institutions will have to cover free birth control for employees, the Obama administration announced Friday in an election-year move that outraged religious groups, fueling a national debate about the reach of government.
In a concession, Health and Human Services Secretary Kathleen Sebelius said that non-profit institutions such as church-affiliated hospitals, colleges and social-service agencies will have one additional year to comply with the requirement, issued in regulations under President Barack Obama's health-care overhaul.
"I believe this proposal strikes the appropriate balance between respecting religious freedom and increasing access to important preventive services," Sebelius said in a statement.
Yet the concession was unlikely to stop a determined effort by opponents to block or overturn the rule. If they fail, some predicted that religious employers would simply drop coverage for their workers, opting instead to pay fines to the federal government under the health-care law.
"Never before has the federal government forced individuals and organizations to go out into the marketplace and buy a product that violates their conscience," said New York Cardinal-designate Timothy Dolan, president of the U.S. Conference of Catholic Bishops. "This shouldn't happen in a land where free exercise of religion ranks first in the Bill of Rights."
Officials said the administration's ruling was carefully considered, after reviewing more than 200,000 comments from interested parties and the public.
The one-year extension, they said, responds to concerns raised by religious employers about making adjustments.
Administration officials stressed that individual decisions about whether or not to use birth control, and what kind, remain in the hands of women and their doctors.
Underscoring the sensitivity of the decision, Obama personally spoke with Dolan on Friday to inform him of the announcement, an administration official said.
Liberals and women's rights groups praised the decision, saying that women who work for religious employers should not have to accept a lower standard of health coverage.