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HHS compromise leaves questions for University

Sarah Mervosh | Monday, February 20, 2012

The revised contraception mandate, which shifts responsibility for funding contraception from religiously affiliated institutions to insurance companies, will apply to self-insured employers like Notre Dame, Health and Human Services Secretary Kathleen Sebelius announced last week.

However, Notre Dame professors say the Obama administration has not specified how this exemption would work for institutions like the University.

“The problem is that, it’s not clear how this compromise is going to be handled for firms that self-insure, which are the majority of large firms,” economics professor William Evans said.

Law professor Carter Snead called last week’s announcement a “vague, unenforceable promise.”

“[The Obama administration] promised to try to ‘work it out’ for self-insurers,” Snead said. “No elaboration.”

University Spokesman Dennis Brown said finding a solution for self-insured employers is among the “unresolved” issues University President Fr. John Jenkins and other religious leaders are working with the Obama administration to sort out.

Evans said it would not be financially feasible for Notre Dame to buy health insurance from a provider as a way for the University to not directly fund contraception.

“I think the costs would be prohibitive,” Evans said. “If it were a cost-efficient way to be providing health insurance, they’d be doing it right now and they’re not.”

Evans said most large firms self-insure so risks are spread out among a large pool of employees.

“It is a lot cheaper for them to be their own insurance company than to pay someone else,” he said. “You want a large risk pool. If you have some fairly high expenses, that’s going to be averaged out by people who have low expenses.”

Brown said it would be “feasible, but very expensive” for Notre Dame to switch from self-insurance to an outside insurance company, adding this option was a “moot point” based on Sebelius’ announcement last week.

Though the University is self-insured, Notre Dame works with Meritain Health, a third-party administrator that processes insurance claims and provides administrative services to the University.

Donna Hofmeister, director of marketing for Meritain, said the company is “still evaluating” if and how the latest policy changes will affect Meritain. However, she said if the law requires Meritain to pay for contraception for Notre Dame employees, the company plans to do so.

“We intend to fully comply with any obligations that result from this change,” she said.

As it stands, Evans said the Obama administration has not figured out how to accommodate religiously affiliated employers that self-insure.

“I have no idea what their path is going to be and how to get out of this box,” he said. “There is no easy solution to this.”