Washington (dpa) – Passing a major reform of the US health insurance system was President Barack Obama's signature legislative achievement, the culmination of decades of efforts by center-left Democrats to change the system. But the measure has caused him lots of trouble since he signed it into law in 2010. It galvanized the opposition Republican base and spawned the small-government tea party movement, which helped the conservative party wrest control of the House of Representatives from Obama's Democrats in the November 2010 Congressional midterms. Most of the health-care reform legislation only takes effect in coming years, but the process of writing regulations to implement the law has begun. A new regulation issued by the Health and Human Services Department requires employers offering health insurance to include full birth control coverage for free, including contraceptives, the so-called morning-after pill and sterilization services. An exemption was included for churches – but not for church-affiliated institutions such as charities, hospitals, schools and universities. The Catholic Church, which opposes contraception and has by far the largest network of affiliated institutions, reacted strongly against the policy, and the White House was reportedly under mounting pressure from Catholic legislators from Obama's own Democratic Party. In an attempt to douse the firestorm over alleged infringements of the religious liberty of such institutions, Obama on Friday himself announced a revision of the policy. Church-affiliated non-profits would be allowed to offer health plans that do not directly pay for birth-control services. Instead, the insurance companies hired to administer the coverage must offer free birth control to those workers. “No woman's health should depend on who she is or where she works or how much money she makes,” Obama said. “Now, as we move to implement this rule, however, we've been mindful that there's another principle at stake here, and that's the principle of religious liberty, an unalienable right that is enshrined in our Constitution.” He acknowledged “the many genuine concerns that have been raised over the last few weeks,” and called Friday's change a “solution that works for everyone.” “Religious liberty will be protected, and a law that requires free preventive care will not discriminate against women,” Obama said. His supporters called it a compromise, but Obama critics said it was a sleight of hand, because insurance companies would still have to account for the cost of birth control, which will ultimately be borne by the institutions. The US Conference of Catholic Bishops later called it a “first step in the right direction.” They said they would “reserve judgement” to await details, but it clearly suggested that they don't consider the issue settled. The bishops previously argued that the policy would force institutions to choose between subsidizing contraception, which the church teaches against, or cancelling health insurance for Catholic and non-Catholic workers alike. With Obama seeking a second four-year term in the November presidential elections, the issue threatened to undermine his support among Catholics, from whom he won 54 percent support in 2008. Losing just a few percentage points of the Catholic vote in key swing states – such as Pennsylvania, Ohio, Florida, Michigan and Missouri – could be the difference between re-election and defeat. While Obama announced his changes at the White House, conservative activists at the annual meeting of the Conservative Political Action Committee (CPAC) across town saw an opportunity. Tony Perkins, president of the social conservative Family Research Council, called the changes “paperwork gimmicks … that don't change the fact that religious employers who object to coverage of these services will now have to drop health insurance altogether to maintain their conscience.” The promise of birth control, paid for by neither the employee nor the religious-affiliated institution, “won't be free, because the insurance companies will increase the premium and administrative costs to the employer,” he said. The highlights of the CPAC meeting were appearances by top Republican candidates for the conservative party's presidential nomination. Speaking just minutes after Obama, front-runner Mitt Romney recounted his record as governor of Massachusetts, where he “defended the right of the Catholic Church to serve the community in ways that were consistent with their conscience.” Newt Gingrich, a former speaker of the House of Representatives trying to establish himself as the conservative alternative to the more moderate Romney, took direct aim at Obama, charging that he planned to “wage war on the Catholic Church the morning after he's re-elected.” BM ShortURL: http://goo.gl/YQQ3a Tags: Birth Control, Debate, Obama, rights Section: Health, North America, Women