ANPRM: The Turner translation

Over at NRO, Grace-Marie Turner translates and comments on the Obama administration’s “advance notice of proposed rule making” (or ANPRM, in the acronym used in the notice). The ANPRM is a document that requires translation; whatever it is saying is not-self-evident. It is opaque, in the style best suited to our bureaucratic masters. Turner elaborates:

It is clear that the Obama administration is not backing down from its anti-conscience mandate but hopes to bury the controversy with bureaucratic delay. In its “Advanced Notice of Proposed Rulemaking,” the government now officially promises to take action at some time in the future to address the conflict.

The notice, issued on Friday, takes 32 pages to explain that the president still doesn’t have a clue how to balance the demands of the Left, which insists that all women should have free access to drugs that cause early abortion, sterilization procedures, and contraceptives, and the Catholic Church, which believes the mandate is a government violation of conscience and religious liberty.

The March “notice” about February’s “accommodation” to January’s “final rule” also is an admission that the administration still has no idea who should be forced to pay for its mandate.

You will recall that on February 10, President Obama announced he would require health insurance companies to pay for the offending services so Catholic institutions didn’t have to.

That was widely derided as a shell game because the insurers would simply pass the costs along indirectly to religious organizations through higher premiums. And it left no escape for self-insured religious organizations that pay health costs directly for their employees.

In an admission that the original idea had failed, Friday’s notice lists several ways that health plans could get money to pay for the mandate without dipping directly into premiums: through rebates the plans get from prescription drug companies, service fees, savings from disease management programs, or private non-profit contributions. It also proposes having the Office of Personnel Management in Washington require health plans to provide the mandated services for free as a price for participating in ObamaCare’s coming multi-state health-insurance plans.

But the religious organizations would still be required to make sure all of their employees have access to the offending coverage. So nothing has changed.

Friday’s announcement falls apart in another key way. The administration’s notice repeatedly refers to the mandate as only covering contraceptives, not the full contingent of “All Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity” which are actually covered by the mandate, as defined by the Health Resources and Services Administration.

Friday’s notice refers only to contraceptives, which it repeatedly says save money: “Actuaries and experts have found that coverage of contraceptives is at least cost neutral, and may save money, when taking into account all costs and benefits for the issuer.” (It then proceeds to cite a study done Feb. 9, the day before the president’s original accommodation announcement, by two of his senior administration appointees.)

But the administration is, once again, completely out of touch with the reality of the cost of its mandate. It’s not just contraceptives, which can be obtained for as little as $9 a month.

Sterilization is expensive surgery. According to Planned Parenthood website, “Sterilization for Women at a Glance,” this “surgery that prevents pregnancy” is “safe and highly effective” and “costs between $1,500 and $6,000.”

There is simply no way that these costs can be hidden in fees and rebates. When this administration can’t tax or deficit spend, it has no idea where to get the money to carry out its directives.

Turner has more in her translation and commentary, all of it worth reading.


Books to read from Power Line