Originally posted by Louise Radnofsky on July 10, 2015 on wsj.com.

WASHINGTON—The Obama administration on Friday set final rules for contraception coverage in workers’ health insurance plans, putting in place rules that are unlikely to satisfy some religious employers who object to birth control.

The rules reaffirmed that most health plans have to include birth control with no out-of-pocket costs as part of the 2010 Affordable Care Act. The regulations include alternative arrangements for employers such as Catholic universities that have moral objections to most forms of contraception, and other Christian institutions that object specifically to forms of emergency contraception such as the “morning-after pill.”

Under the rules, employers with such objections must tell their insurance company or the federal government. The insurance company then takes over responsibility for providing the coverage to employees who want it.

Federal officials said the arrangements also would be available to closely held for-profit companies such as Hobby Lobby Stores Inc. that last year won a Supreme Court case against the coverage requirement under the Affordable Care Act.

The high court said the Obama administration hadn’t done enough to take into account the religious objections of the owners of companies such as the arts-and-crafts chain. The justices didn’t specify what the federal government should do to address those concerns.

The White House and Christian leaders have tussled for years over the health law’s requirement that most insurance plans cover preventive services without charging co-pays or deductibles, and that prescription methods of contraception such as the pill and intrauterine device be counted among them.

Churches are excluded from the requirement, but Catholic bishops, in particular, have argued that religiously affiliated hospitals, universities and charities should be given the same exemption so they do not have to violate Catholic teachings by paying for something they believe to be immoral.

Women’s health advocates, for their part, have pushed the White House to hold firm and ensure that the provision of the 2010 health law is widely available.

To qualify for the alternative system outlined by the government, companies must be privately held and controlled by five or fewer individuals, federal officials said Friday. The company’s board must adopt a resolution stating the company’s objection to covering some or all forms of contraception.

Catholic bishops and other religious leaders have said the revised system is inadequate because it still uses the insurance plan they set up to provide something they believe to be wrong.

They have challenged the alternative system in the courts. Many of those challenges are working their way through the legal system, and the federal government has prevailed in several cases so far.

Attorneys representing many of the religiously affiliated litigants in those cases derided the final rules.

“The government keeps digging the hole deeper,” said Adèle Auxier Keim, legal counsel at the Becket Fund for Religious Liberty, adding that “there is no reason at all the government needs religious employers to help it distribute these products.”

A spokeswoman for the Department of Health and Human Services said she couldn’t comment on continuing litigation.

In a statement, HHS Secretary Sylvia Mathews Burwell said the regulations were intended to balance the religious objections with the government’s desire to guarantee access to no-cost contraception for women, regardless of where they worked.

“Women across the country should have access to preventive services, including contraception,” Ms. Burwell said.

“At the same time, we recognize the deeply held views on these issues, and we are committed to securing women’s access to important preventive services at no additional cost under the Affordable Care Act, while respecting religious beliefs,” she said.