Minor children on their parents' health care plans will have free coverage of sterilization and contraception, including abortion-causing drugs, under the controversial HHS mandate – and depending on the state, they can obtain access without parental consent.

Matt Bowman, senior counsel for the religious liberty legal group Alliance Defending Freedom, said the mandate "tramples parental rights" because it requires them to "pay for and sponsor coverage of abortifacients, sterilization, contraception and education in favor of the same for their own children."

The Department of Health and Human Services ruled in January 2012 that most employers who have 50 or more employees must provide the coverage as "preventive care" for "all women with reproductive capacity."

The mandate also requires the coverage for beneficiaries, including minors, on the affected health plans, Bowman told CNA Sept. 20. That means that a minor on her parents' plan could be sterilized if she finds a doctor willing to perform the procedure.

"She can be sterilized at no cost," Bowman stated. "Whether her parents will know and/or consent might differ by state. But the Guttmacher Institute and other abortion advocates explicitly advocated for this mandated coverage of minors so that access without parental involvement might be able to increase."

The Guttmacher Institute, in a Sept. 1 briefing on state policies, said that an increase in minors' access to reproductive health care over the last 30 years shows a broader recognition that "while parental involvement in minors' health care decisions is desirable, many minors will not avail themselves of important services if they are forced to involve their parents."

The institute, the former research arm of abortion provider Planned Parenthood, said that 26 states and the District of Columbia allow all minors 12 years and older to consent to contraceptive services. At least one state, Oregon, allows 15-year-olds to consent to sterilization.

CNA repeatedly contacted the Department of Health and Human Services for comment but did not receive a response.

Employers who do not comply with the mandate face fines of $100 per employee per day. Large employers like the University of Notre Dame could face annual fines in the millions.

There are presently 30 lawsuits challenging the HHS mandate in federal court on religious freedom grounds. The 80 plaintiffs include Catholic dioceses, universities, health care systems and charities.

The mandate's narrow religious exemption would not apply to many Catholic institutions, despite Catholics' moral and religious objections to the covered procedures and drugs. Several Protestant institutions have also challenged the law, citing objections to abortion-causing drugs.

The Obama administration has said it will accommodate some religious objections, though the details of those arrangements remain unclear.

Bowman rejected the idea that the Obama administration's proposed accommodations will affect the coverage of minors.

"The accommodation does not even claim it will change this part of the mandate," he said.

Legislation to allow all employers with religious or moral objections to opt out of the coverage failed in the U.S. Senate earlier this year.

Defenders of the Obama administration have depicted resistance to the mandate as a "war on women."

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At the same time, a grassroots campaign called The Women Speak for Themselves has garnered the support of 34,000 women. The group says those backing the mandate are trying to "shout down anyone who disagrees" with them by invoking "women's health," while ignoring the negative physical and social effects of contraception for women.

Updated at Sept. 25, 2012 at 9:44 a.m. MST. Adds fines for employers in ninth paragraph.