WASHINGTON — The Obama administration said Friday that most health insurance plans must cover contraceptives for women free of charge, and it rejected a broad exemption sought by the Roman Catholic Church for insurance provided to employees of Catholic hospitals, colleges and charities.
Federal officials said they would give such church-affiliated organizations one additional year — until Aug. 1, 2013 — to comply with the requirement. Most other employers and insurers must comply by this Aug. 1.
Leaders of the Roman Catholic Church had personally appealed to President Obama to grant the broad exemption. He made the final decision on the issue after hearing from them, as well as from family planning advocates, scientific experts and members of Congress, administration officials said.
The rule takes a big step to remove cost as a barrier to birth control, a longtime goal of advocates for women’s rights and experts on women’s health.
In announcing details of the final rule on Friday, Kathleen Sebelius, the secretary of health and human services, said it “strikes the appropriate balance between respecting religious freedom and increasing access to important preventive services.”
“Scientists have abundant evidence that birth control has significant health benefits for women,” Ms. Sebelius said, and “it is documented to significantly reduce health costs.”
Catholic bishops issued a statement saying they would fight the “edict” from the government.
“In effect, the president is saying we have a year to figure out how to violate our consciences,” said Archbishop Timothy M. Dolan of New York, the president of the United States Conference of Catholic Bishops.
In an interview, Archbishop Dolan, who is to become a cardinal next month, said, “We’re unable to live with this.”
Other opponents of the rule said they would seek legislation to block it and might challenge it in court as well.
The rule includes an exemption for certain “religious employers,” including houses of worship. But church groups said the exemption was so narrow that it was almost meaningless. A religious employer cannot qualify for the exemption if it employs or serves large numbers of people of a different faith, as many Catholic hospitals, universities and social service agencies do.
Ms. Sebelius said the one-year grace period would be available to certain “nonprofit employers who, based on religious beliefs, do not currently provide contraceptive coverage in their insurance plan.” The extra time will allow them to “adapt to the new rule,” Ms. Sebelius said.
Chris Jacobs, a health policy analyst for Senate Republicans, said, “This decision looks suspiciously like yet another political stunt designed to delay the controversy by a year, until after the president’s re-election campaign.”
Senator Orrin G. Hatch, Republican of Utah, said the transition period was pointless.
“The problem is not that religious institutions do not have enough time to comply,” Mr. Hatch said. “It’s that they are forced to comply at all. Unfortunately, the administration has shown a complete lack of regard for our constitutional commitment to religious liberty.”
The National Association of Evangelicals said that as a result of the White House decision, “Employers with religious objections to contraception will be forced to pay for services and procedures they believe are morally wrong.”
The Becket Fund for Religious Liberty, a nonprofit law firm, has filed lawsuits challenging an earlier version of the rule in federal courts on behalf of a Catholic college connected to a monastery in North Carolina and an evangelical university in Colorado.
The 2010 health care law says insurers must cover “preventive health services” and cannot charge for them.
The new rule interprets this mandate. It requires coverage of the full range of contraceptive methods approved by the Food and Drug Administration. Among the drugs and devices that must be covered are emergency contraceptives including pills known as ella and Plan B. The rule also requires coverage of sterilization procedures for women without co-payments or deductibles.
The issue forced Mr. Obama to weigh competing claims of Catholic leaders and advocates for women’s rights.
The administration said in August that it intended to require coverage of contraceptives for women, as recommended by an expert panel of the National Academy of Sciences. But the White House reconsidered the issue after hearing protests from the Catholic Church and many Republicans in Congress.
The protests prompted debate within the administration. Ms. Sebelius and the president’s health policy team strongly supported the new rule. But Democratic members of Congress who lobbied the White House said they believed that Mr. Obama’s chief of staff, William M. Daley, and his special assistant for religious affairs, Joshua DuBois, favored a broader exemption.
Senator Richard Blumenthal, Democrat of Connecticut, described the final rule as a huge victory for women’s health. It will, he said, “ensure that women have access to full health care services, regardless of their employer, so they can make the best health choices for themselves and their families.”
Representative Lois Capps, Democrat of California, said, “The administration deserves credit for standing its ground and following the science.”
Cecile Richards, president of the Planned Parenthood Federation of America, said the decision “means that millions of women, who would otherwise pay $15 to $50 a month, will have access to affordable birth control, helping them save hundreds of dollars each year.”
Archbishop Dolan said he discussed the issue with Mr. Obama last November and came away reassured that the president understood the Catholic Church’s position. Now, the archbishop said in the interview, “The sentiments of hope that stemmed from reassurances that I thought I received in November were apparently misplaced.”
The archbishop said he had heard from evangelical, Greek Orthodox and Orthodox Jewish leaders who were also concerned about the rule.
Under the government’s narrow criteria, the bishops said, “even the ministry of Jesus and the early Christian Church would not qualify as ‘religious,’ because they did not confine their ministry to their co-religionists,” but urged compassion for the sick and the poor, regardless of faith or creed.