And here’s how it works after the compromise: “Our policy is saying that the Catholic hospital doesn’t want to cover contraceptives, and they don’t include that in their policy. It also says that Aetna needs to provide contraceptive services for free to workers in the plan. Aetna sets the premium, but it cannot be higher than it would have been without birth control. The premium does not include contraception.”

And, in the end, that leaves Aetna with the bill. “There is a sort of bank account,” says the official, “and Aetna is sucking it up.”