The Washington PostDemocracy Dies in Darkness

Here’s Obamacare’s most controversial regulation

The Affordable Care Act changes the health care system in myriad ways --  everything from allowing insurers to charge tobacco smokers higher premiums to guaranteeing free coverage of breast pumps.

One provision, however, has engendered more controversy than any other: The requirement that contraceptives be covered without co-payment has drawn more than 147,000 public comments, according to an analysis from the Sunlight Foundation. These are the letters that companies, non-profits and private citizens send to the federal government, hoping to sway the regulatory process.

That is more than any other regulatory proposal on any subject, health care or otherwise, the non-profit finds.

To put that in perspective, the second-most commented on health care regulation trailed  by over 100,000 comments, receiving 4,700 responses. Eighty-nine percent of all federal rules, by the Sunlight Foundation's count, get fewer than 100 responses.

How'd this particular regulation rise to the top? Most of it has to do with opponents and supporters of the requirement rallying their troops to submit letters to the federal government.

The Catholic Church has led the charge, urging parishioners to write with messages such as "Pregnancy is not a disease, and drugs and surgeries to prevent it are not basic health care that the government should require all Americans to purchase."


Women's groups and liberal organizations have also organized over the issue, which is also reflected in comments seen in the dockets. For example, the National Organization for Women sent out this alert in 2011, giving activists suggested language such as "Birth control is basic health care for all women, and the federal government should not permit a solitary religious viewpoint to override good public health policy."


Despite the heavy level of comments, the Obama administration has shown little inclination in changing the regulation. It has repeatedly rebuffed requests from private companies to opt-out of the contraceptives mandate, due to their own moral objections. Those requests are currently winding their way through the legal system.