Last week, responding to an outcry from Catholic leaders and lawmakers on both sides of the aisle, the Obama administration modified regulations requiring insurers and employers to provide contraception as part of their health care plans without additional co-payments. Under the new rule, religiously affiliated colleges, universities, and hospitals that raise religious objections to birth control can decline the benefit and their employees will still receive contraception coverage directly from the insurer.

Most Republicans are not satisfied with the modification, however, and are co-sponsoring legislation that would significantly broaden the conscience exclusion. On Monday night, Sen. Scott Brown (R-MA) joined the pack, with a spokesperson telling the Washington Post’s Greg Sargent that the senator “appreciates President Obama’s willingness to revisit this issue, but believes it needs to be clarified through legislation” that would permit any employer or insurance plan to exclude any health service, no matter how essential, from coverage if they morally object to it.

But Massachusetts already requires insurers to carry contraceptive coverage for women and Brown voted for the provision as a member of the Massachusetts House on Jan. 30, 2002, ThinkProgress has learned. At the time, the Catholic Conference of Massachusetts, lobbied against the measure and urged lawmakers to adopt an amendment exempting organizations that are affiliated with the Catholic church or have a moral objection to contraception. Brown supported that provision, but once it failed in a vote of 106 to 49, he voted ‘YES’ on the underlying bill, which only exempted “an employer that is a church or qualified church-controlled organization” from offering birth control:

Since Obama’s new federal standard would allow church-affiliated nonprofits to eschew birth control coverage, it could offer greater conscience protections to Massachusetts’ Catholic colleges, universities, and hospitals. For instance, if Boston College is required to provide birth control under the Brown-approved law, it could drop the coverage — and leave the matter to its insurer — under Obama’s regulation.

Interestingly, Brown also voted for a 2005 bill mandating hospitals to offer emergency contraception to rape victims, even after lawmakers defeated his amendment to allow religious hospitals to opt out of the requirement. Brown split with then-Gov. Mitt Romney on the matter and joined the legislature in overriding his veto.

Brown’s office did not immediately respond to ThinkProgress’ request for comment.

Mitt Romney has launched a petition accusing the Obama administration of “using Obamacare to impose a secular vision on Americans who believe that they should not have their religious freedom taken away.” The move is the latest in a concerted campaign effort to rally the conservative base around a supposed “war against religion” and misrepresent or outright lie about a new regulation requiring employers and insurers to offer contraception coverage.

“We must have a president who is willing to protect America’s first right, a right to worship God, according to the dictates of our own conscience,” Romney told an audience of nearly 3,000 people in Colorado. “We’ll either have a government that protects religious diversity and freedom, or we’ll have a government that tells us what kind of conscience they think we ought to have.” But Romney’s new-found outrage is a stark contrast from his record as Massachusetts governor, when he tacitly endorsed a very similar coverage mandate and greatly expanded government-funded contraceptive services.

In 2002 — the very same year Romney campaigned for governor of Massachusetts — the state enacted a “contraceptive equity” law that required insurers that provide outpatient benefits to cover hormone replacement therapy and all FDA-approved contraceptive methods. Similar to the Obama regulation, the law exempted “an employer that is a church or qualified church-controlled organization” from the requirement and the legislature soundly defeated an amendment that “would have allowed affiliated institutions such as hospitals, universities, and nursing homes to deny their employees coverage.” The defeated amendment closely mirrors the expanded conscience protections religious groups are now clamoring for.

Romney remained mum on the requirement — which passed unanimously in the Senate and in a 140 to 16 vote in the House — and pledged to maintain the status quo on family-planning related policy throughout his gubernatorial campaign. He even promised to expand access to emergency contraception and restore state funding for family-planning and teen pregnancy prevention programs.

After all, before deciding to run for President, Romney had been a strong supporter of expanding public access to birth control. In 2007, the Boston Globe reported that “Romney’s wife, Ann, made a $150 contribution to Planned Parenthood in 1994, the year Romney ran for Senate as a candidate supporting abortion rights” from “the Romneys’ joint checking account.” And in 2005, he “signed a bill that could expand the number of people who get family-planning services, including the morning-after pill.” Romney even pressured the state Department of Health and Human Services to issue regulations that required Catholic hospitals to issue the morning after pill to rape victims, despite initially vetoing the bill and claiming that the pill constituted an “abortifacient.”

But perhaps his greatest contribution to expanding the public availability of birth control came from his health care reform law. The state’s Commonwealth Care, which offers subsidized, low or no-cost insurance program for low-income residents without access to employer-sponsored health insurance, offers primary and preventive care that includes “family planning services” and prescription contraceptives.

Newt Gingrich doubled down on his claims that the Obama administration is engaged in a “war against religion,” during a town hall in Florida this morning, and accused Mitt Romney of acting in the same “dictatorial” fashion while serving as governor of Massachusetts.

“The Obama administration is engaged in a war against religion,” Gingrich began. “Their decision last week that they would impose on every Catholic institution, every Jewish institution, every Protestant institution the Obamacare standard of what you have to buy as insurance is a direct violation of freedom of religion, an example of the dictatorial attitude of this administration,” he charged, ignoring the regulation’s religious exemption. He then went after Romney:

GINGRICH: Let me just note that in a similar circumstance, Governor Romney imposed activities on the Catholic hospitals against their opposition. Refused to allow them the right of conscience in Romneycare. Just as, by the way, he eliminated serving Kosher food to elderly Jewish residents under Medicaid.

Watch it:

In reality, Romney’s position on allowing religious institutions like Catholic hospitals to opt out of providing emergency contraception to rape victims is more complicated. In 2005, the governor vetoed a “widely supported bill” making the morning-after pill available over the counter and requiring hospitals to offer emergency contraception to rape victims, even after pledging to support such measures while running for governor. By September, the state legislature “easily overrode” his veto, but the Department of Public Health, which is overseen by Romney, began drafting regulations that exempted religious hospitals from the requirement.

Then suddenly, in December 2005, Romney “abruptly ordered his administration to reverse course… and require Catholic hospitals to provide emergency contraception medication to rape victims.” “My personal view in my heart of hearts is that people who are subject to rape should have the option of having emergency contraceptives or emergency contraceptive information,” he told the Boston Herald. Romney has since said that he would support broader federal conscience protections for health care workers and pledged to eliminate the Title X program which provides “reproductive health services like birth control” to millions of women.

Romney also angered the Jewish community in 2003 after he “nixed the funding of about $5 per day” that allocated additional dollars for “poor Jewish nursing-home residents to get kosher meals.” The governor warned that the subsidy would lead to an “increased rate for nursing facilities,” but the Massachusetts Legislature “approved an amendment to restore the $600,000 to finance the kosher meals.”

Our guest blogger is Emily Oshima, a Research Associate/Policy Analyst with the Health Policy team at American Progress.

On Monday, Gov. Deval Patrick of Massachusetts again urged state lawmakers to address rising health care costs in his annual state of the state address. Patrick first introduced a bill, “An Act Improving the Quality of Health Care and Controlling Costs by Reforming Health Systems and Payments,” in February 2011 in an effort to achieve comprehensive delivery system and payment reform.

Patrick’s proposal calls for replacing the current fee-for-service payment system, which creates incentives for providers to deliver more services – even unnecessary care, with a global payment system, which encourages more coordinated patient care and rewards providers for better patient health. It aims to “significantly reduce” fee-for-service payments by the end of 2015 and, as Patrick explained, “stop paying for the amount of care, and start paying for the quality of care.”

The Massachusetts bill encourages greater price transparency, consumer protections against rate increases, and medical malpractice reform to reduce the costs of defensive medicine. The legislation creates incentives for providers to better coordinate patient care and lower costs through Accountable Care Organizations (ACO). Such arrangements have already improved care for more than 100,000 Blue Shield of California patients in California and San Francisco, where better coordination among health care providers has flattened premium increases, lowered hospital readmissions by more than 20 percent, and saved $20 million in 2011.

Numerous hospitals, physician groups and insurers across the nation are adopting the ACO model in hopes of duplicating this success. For instance, Massachusetts is already home to nine ACO entities and 32 health care organizations are participating in HHS’ Pioneer ACO initiative to improve care and lower costs for Medicare patients.

Health reform in Massachusetts was wildly successful in expanding coverage to more than 98 percent of the population and now lawmakers must tackle their next big challenge: cost control.

At last night’s GOP presidential debate, Rick Santorum challenged Mitt Romney on the similarities between the health care reform he signed into law as governor of Massachusetts and President Obama’s Affordable Care Act. “Your mandate is no different than Barack Obama’s mandate. It is the same mandate,” Santorum charged. “You take over 100 percent, just like he takes over 100 percent, requires the mandate. The same fines that you put in place in Massachusetts are fines that he puts in place in the federal level. Same programs.”

The comparison immediately put Romney on the defense, who claimed, “I didn’t say I’m in favor of top- down government-run health care,” and explained that he expanded access to “private insurance” and allowed people to “choose any plan” within a state-run exchange. “There’s no government plan,” he added. “And if you don’t want to buy insurance, then you have to help pay for the cost of the state picking up your bill, because under federal law if someone doesn’t have insurance, then we have to care for them in the hospitals, give them free care. So we said, no more, no more free riders.”

Romney’s description of his plan sounded so much like Obama’s rational for the federal health care law that ThinkProgress has compiled a video comparing how both politicians describe their reforms. Watch it:

Indeed, Romneycare and Obamacare share more than a dozen common provisions, for a full comparison, click here.

Via Politico’s Pulse, a new report from John McDonough, formerly the executive director of Health Care for All, identifies 15 similarities between Romneycare and Obamacare:

As Families USA Executive Director Ron Pollack — whose group published the comparison — told Pulse, the Romney and Obama plans “are fraternal, and almost appear like identical, twins,’ Pollack said. ‘It is therefore quite strange for Gov. Romney to criticize, and to claim he will repeal, legislation that mirrors his own creation.” Read the full report here.

Don’t tell Mitt Romney or the Republicans who argue that Romneycare is the blueprint for the Affordable Care Act, but a new analysis of Massachusetts’ 2006 health care reform published yesterday in Health Affairs finds that the law has lowered the number of uninsured, increased employer-sponsored coverage, and reduced first-time emergency department visits. Here are the full results in four graphs:

1) Health insurance coverage among nonelderly adults in Massachusetts increased from 86.6 percent in 2006 to 94.2 percent in 2010. More than two-thirds of nonelderly adults (68.0 percent) also reported coverage through an employer. This is significantly higher than the level in 2006 (64.4 percent), before health reform:

2) In 2010 compared to 2006, nonelderly adults were more likely to have a usual place to go when they were sick or needed advice about their health (up 4.7 percentage points), and were more likely to have had a preventive care visit (up 5.9 percentage points), a specialist visit (up 3.7 percentage points), multiple doctor visits (up 5.0 percentage points) and a dental care visit (up 5.0 percentage points):

3) During the 2006–10 period there were drops in the shares of adults reporting a hospital stay and using the emergency department—the first shifts in those measures since 2006:

4) There have been gains in the affordability of care for adults since 2006, as evident in a lower burden from out-of-pocket health care spending (excluding premiums) and less unmet need for care because of cost. The share of nonelderly adults who reported high levels of out-of-pocket health care spending (10 percent or more of family income) was lower in 2010 (6.1 percent) than in 2006 (9.8 percent):

The state is still experiences gaps in coverage and Gov. Deval Patrick (D) is urging lawmakers to control costs by adopting reforms that reward providers for delivering care more efficiently But overall, “The Bay State’s 2006 health reform initiative has continued to fare well despite a severe economic downturn and the continued escalation of health care costs in the state” and the very dire predictions of many conservative pessimists.