Most healthcare plans will be required to cover birth control without charging co-pays or deductibles starting Aug. 1, the Obama administration announced Friday.

The final regulation retains the approach federal health officials proposed last summer, despite the deluge of complaints from religious groups and congressional Republicans that has poured in since then. Churches, synagogues and other houses of worship are exempt from the requirement, but religious-affiliated hospitals and universities only get a one-year delay and must comply by Aug. 1, 2013.

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“This decision was made after very careful consideration, including the important concerns some have raised about religious liberty,” Health and Human Services Secretary Kathleen Sebelius Kathleen SebeliusSpecial counsel investigating DeVos for potential Hatch Act violation: report The Hill's Coronavirus Report: Mike Roman says 3M on track to deliver 2 billion respirators globally and 1 billion in US by end of year; US, Pfizer agree to 100M doses of COVID-19 vaccine that will be free to Americans The Hill's Coronavirus Report: Former HHS Secretary Sebelius gives Trump administration a D in handling pandemic; Oxford, AstraZeneca report positive dual immunity results from early vaccine trial MORE said in a statement. “I believe this proposal strikes the appropriate balance between respecting religious freedom and increasing access to important preventive services."

Congressional Republicans slammed the decision as an assault on religious freedom.

"This ruling forces religious organizations to violate the fundamental tenets of their faith, or stop offering health insurance coverage to their employees," said the Republican Policy Committee. "Time will tell whether those institutions choose the former or the latter course — but neither option should be necessary, if the administration had not taken such an unbending approach to appease its liberal base."

Access to birth control is the most controversial aspect of the healthcare reform law's preventive care provisions, which require plans to cover such care without co-pays and deductibles. The assumption is that such coverage will prevent people from getting sick and keep healthcare costs down.

The provision has attracted more than 200,000 comments, HHS said — most of them in favor of access to birth control, which the vast majority of healthcare plans already cover. Some religious institutions, however, said they would sooner close their doors than cover birth control, which they liken to abortion in some cases.

"What war and disease could not do to the congregation, the government of the United States will do," Nashville's Dominican congregation said. "It will shut them down."

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Abortion-rights groups immediately applauded the decision.

"Birth control is not just basic health care for women, it is an economic concern," Cecile Richards, president of Planned Parenthood Federation of America, said in a statement. "This common sense 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."

And Nancy Keegan, president of NARAL Pro-Choice America, praised the administration for standing "firm against intensive lobbying efforts from anti-birth-control organizations trying to expand the refusal option even further to allow organizations and corporations to deny their employees contraceptive coverage.

"As a result, millions will get access to contraception — and they will not have to ask their bosses for permission," she said.

The regulation comes after Sebelius rejected her agency's recommendation to allow over-the-counter sales of the Plan B morning-after pill to minors, a political decision that had infuriated Democrats' natural allies in the abortion-rights community.