Health

The furor over President Obama's birth-control mandate has swiftly entered a new phase, with supporters and opponents alike calling the subject a potent weapon for the November elections and taking it to the public in campaigns to shape the issue: Is it about religious liberty or women's health?

Roman Catholic bishops, evangelicals, other conservatives and the Republican presidential candidates have dismissed as meaningless the effort by Obama last week to soften the rule, which requires that employees of religiously affiliated institutions such as schools and hospitals, but not churches, receive free contraception in their health plans.

Sensing an opportunity, congressional Republicans have leapt into the fray. An amendment to block any health mandate that violates a business owner's beliefs is before the Senate — and a target of intense lobbying. A House committee is holding a hearing Thursday to ask, "Has the Obama Administration Trampled on Freedom of Religion and Freedom of Conscience?"

But political repercussions could be much wider.

"This was an unexpected gift," said Ralph Reed, chairman of the Faith and Freedom Coalition and a Republican strategist.

He said religious conservatives saw the mandate as part of a web of Obama assaults on faith and values, and an ominous sign of how the president would implement his health-care law if re-elected.

Liberal women's health and rights groups point to evidence, including a New York Times/CBS News poll released Tuesday, indicating most Americans, including a majority of Catholics, support requiring religiously affiliated institutions to provide contraception coverage.

With ad campaigns, phone banks and appeals to members of Congress during their home leave next week, supporters of Obama's move hope to re-brand the debate as one over women's access to basic health care. They make comparisons to the outpouring of support for Planned Parenthood that prompted the Susan G. Komen for the Cure foundation for breast-cancer research this month to reverse its decision to halt donations.

"The United States is more than 51 percent women, and I can say that we will mobilize our base and we will outnumber the other side," said Stephanie Schriock, president of EMILY's List, which works to elect women who support abortion rights to Congress.

Her organization is one of more than 40, including the Planned Parenthood Federation of America, NARAL Pro-Choice America, MoveOn.org and a large labor group, the Service Employees International Union, that formed a new Coalition to Protect Women's Health Care and are asking millions of supporters to get involved.

Obama sought to defuse the conflict Friday by saying insurance companies, rather than religious employers themselves, would pay the costs of birth control.

But the Catholic bishops said their basic objection remained.

"We will therefore continue — with no less vigor, no less sense of urgency — our efforts to correct this problem through the other two branches of government," they declared.

Other "preventive services" mandated by the health-care law are aimed at disease, the bishops wrote, "and pregnancy is not a disease," an implicit rejection of the administration's characterization of this as a health issue.

The bishops and others are pushing for a reversal in Congress, which some say could happen in the Republican-controlled House. However, with the Senate in Democratic hands, a legislative resolution is unlikely, so both sides are pressing their cases more widely, with an eye to November's battle for control of Congress and the presidency.

To that end, bishops are planning media campaigns, including radio and television ads, to denounce what they call a violation of conscience and the First Amendment. At the same time, they are asking parish priests to raise the matter with congregations and to circulate petitions.

Conservative evangelical groups, even though most do not oppose contraception on theological grounds, have taken up the cause with equal force. Their leaders argue that a government mandate forcing any religious group to act against its beliefs is a threat to all religions. Major evangelical groups that openly opposed Obama and the health-care law in the past see this as a new affront and a new opportunity for attack.

The National Association of Evangelicals, which represents thousands of churches in 40 denominations, "will be working vigorously" against the mandate, said Galen Carey, the association's vice president for government relations — lending substance to the statement last week by Mike Huckabee, the former Arkansas governor and a Baptist minister, that "we are all Catholics now."

Evangelical leaders say they would be outraged by the mandate in any case, but many also believe it will bring them political gains. Reed, the conservative strategist, said that even if a majority of Americans expressed general support for requiring contraceptive coverage — and even if, as he believes, the economy remained the primary issue — firing up conservative and religious voters could make a difference.

"Among key voter groups in key battleground states," Reed said, "this issue in combination with others is not going to be helpful to Obama."

Women's health advocates, though, insist they will win this fight.

"Women are coming out of the woodwork, saying, 'They're attacking birth control? You've got to be kidding!' " said Dawn Laguens, executive vice president for policy and communications of Planned Parenthood. "The people who vote against birth control and vote against health care — they are going to have boxed themselves into a very small corner."