Pressure mounts on White House over contraception decision

Updated 12:35 p.m. ET

Almost three weeks after the Obama administration ruled employers must provide health insurance that includes birth control and other preventative health services for women, the backlash continues to grow. And it could be enough for the administration to reverse or alter its decision - largely because some of the fall-out is coming from the crucial swing voters Mr. Obama will need to win re-election.

In Pennsylvania, a key swing state with plenty of Catholic voters, Sen. Bob Casey, has called on the president to "immediately" reverse his decision to mandate that religious-affiliated organizations, including hospitals and schools, provide coverage for contraception in employee health insurance plans. (Churches do not have to comply).

In a letter to the president, the pro-choice Catholic lawmaker said "religiously-affiliated organizations like hospitals and universities should not be compelled by our federal government to purchase insurance policies that violate their religious and moral conviction."

Casey said 90 Catholic organizations in Pennsylvania, including charities, hospitals and universities, would be forced to comply.

At the same time, liberal Sen. Barbara Boxer praised the administration's decision on the Senate floor and said her progressive colleagues "are not going to go quietly into the night on this one."

Some religious organizations are also behind the administration's decision. In their own letter to the president, 23 religious organizations, including Catholics for Choice and Episcopal Divinity School, wrote that they support the decision.

"We respect individuals' moral agency to make decisions about their sexuality and reproductive health without governmental interference or legal restrictions," the coalition wrote. "We do not believe that specific religious doctrine belongs in health care reform - as we value our nation's commitment to church-state separation."

That puts the Obama administration in a difficult spot. The politics of reproduction in the United States are contentious.

Susan G. Komen for the Cure's decision to cut, and then reinstate, funding for Planned Parenthood caused a firestorm among women and pro-choice advocates. And the right - and some in the left - are voicing concerns about the president's decision on health insurance and contraception.

Some high-profile liberals say the move could backfire on the president.

Liberal Washington Post columnist E.J Dionne, who is mostly supportive of Mr. Obama, wrote in a column over the weekend that the president "utterly botched" this decision. "Obama threw his progressive Catholic allies under the bus, strengthened the very forces inside the Church that sought to derail the health care law, and created unnecessary problems for himself in the 2012 election," Dionne wrote.

But evidence also shows that the decision might not be that unpopular among voters. According to a poll by the Public Religion Research Institute, 55 percent of all Americans and 58 percent of Catholics think contraception should be covered by an employer, although that number drops slightly when religious institutions have the require contraception.

The president has strong support behind the decision. A group of women members of Congress are taking on the critics. In an op-ed in the Wall Street Journal Tuesday, Democratic Senators Barbara Boxer of California, Patty Murray of Washington and Jeanne Shaheen of New Hampshire said the decision will help millions of women get the affordable care they need."

"Catholic hospitals and charities are woven into the fabric of our broader society," the senators wrote. "They serve the public, receive government funds, and get special tax benefits. We have a long history of asking these institutions to play by the same rules as all our other public institutions."

Catholic organizations in Texas announced that they will not abide by the new decision. A Catholic hospital network there, Seton Healthcare Family, said it has "no plans to change" its restriction on contraceptive coverage, according to the Texas Tribune.

The Catholic church strongly denounced the rule change immediately after it was announced January 20. A letter was read during mass that said the president "has cast aside the first amendment to the Constitution of the United States, denying to Catholics our nation's first and most fundamental freedom, that of religious liberty."

A top adviser to the Obama campaign, David Axelrod, signaled Tuesday that Mr. Obama may be open to changes.

"We're going to look for a way to move forward that both provides women with the preventive care that they need and respects the prerogatives of religious institutions," he said in an interview on MSNBC.

And White House spokesperson Jay Carney left the door open for possible tweaks to the policy.

"The president is committed to making sure that all women have access to these important preventive services," he said Tuesday. "But I think it is important to remember what was clearly stated when this policy decision was announced and that is that we will be working with those organizations and individuals who have concerns about the implementation of this rule."

Republican presidential candidates have also jumped on this decision calling it an "attack" and a "war" on religious freedom.