WASHINGTON (AP) — Sharpening an election-year confrontation over religious freedom and government health insurance rules, the nation's Catholic hospitals on Friday rejected President Barack Obama's compromise for providing birth control coverage to their women employees.

The Catholic Health Association was a key ally in Obama's health care overhaul, defying opposition from church bishops to help the president win approval in Congress. But the group said Friday it does not believe church-affiliated employers should have to provide birth control as a free preventive service, as the law now requires.

The hospital group's decision calls into question a compromise offered by the president himself only months ago, under which the cost of providing birth control would be covered by insurance companies and not religious employers. While churches and other places of worship are exempt from the birth control mandate, nonprofits affiliated with a religion, such as hospitals, are not.