Mandated Contraception: Preventing the Unthinkable
News Analysis: Can Church leaders avoid a clash between Obamacare and Catholic doctrine?
BY JOAN FRAWLEY DESMOND
| Posted 8/11/11 at 3:45 PM
WASHINGTON — Catholic leaders have joined the U.S. Conference of Catholic Bishops to protest new rules that mandate contraceptive services for employee health insurance. And they are seeking to avoid an impasse that could force a drastic resolution.
The USCCB has asked the Department of Health and Human Services to broaden the rule’s religious exemption, characterizing it as too “narrow.” HHS has not signaled whether it will review the exemption; it has provided a 60-day period to register comments.
The definition of what constitutes a religious organization that could be exempted from the coverage requirements is a main cause of concern for Church leaders.
Cardinal Daniel DiNardo, archbishop of Galveston-Houston and chairman of the USCCB Committee on Pro-Life Activities, issued a statement that underscores the Church’s key objection.
“Although this new rule gives the agency the discretion to authorize a ‘religious’ exemption, it is so narrow as to exclude most Catholic social-service agencies and health-care providers,” stated Cardinal DiNardo.
Meanwhile, as the bishops’ conference lobbies for the passage of a bill that strengthens religious freedom in the context of the new health law — the Respect for Rights of Conscience Act (H.R. 1179), introduced by Reps. Jeff Fortenberry, R-Neb., and Dan Boren, D-Okla. — Church leaders have stepped forward to join the chorus of protests.
Making their concerns public, they hope to forestall the unthinkable: If the exemption isn’t broadened, they could be forced to choose between paying for services that violate Church teaching or halting health benefits for employees. Challenging the HHS standards in court would be another option.
In a move that could signal the beginning of a more intensive lobbying campaign, Sister Carol Keehan, the president of the Catholic Health Association, issued a carefully worded statement that began with praise for mandated co-pay-free breast exams, then segued into the contentious issue of contraceptive services.
“As it stands, the language is not broad enough to protect our Catholic health providers. Catholic hospitals are a significant part of this nation’s health care, especially in the care of the most vulnerable. It is critical that we be allowed to serve our nation without compromising our conscience,” she said in the statement, released after HHS approved the new standards.
Sister Carol’s decision to issue a public statement was especially significant. In the bruising final weeks of the passage of the Obama administration’s signature
health-insurance reform bill, she endorsed the measure in the face of USCCB opposition. She received one of the pens Obama used to sign the health bill, signifying her critical role in preparing the ground for its passage.
This time, Sister Carol, a member of the Daughters of Charity, threw her weight behind the USCCB and its campaign to broaden the religious exemption, underscoring her membership’s fears about the new policy’s impact on their operations.
“HHS is accepting comments on its definition of ‘religious employer’ and has invited alternative definitions. We will be submitting written comments to HHS and will continue our dialogue with government officials on the essential need for adequate conscience protections,” Sister Carol’s statement continued.
Some opponents of the new standards criticized Sister Carol’s statement because it seemed to suggest that the mandated contraception services would not include abortifacients.
In her statement, Sister Carol said: “We appreciate that the administration does not intend to include abortifacient drugs as covered contraception. Our comments will address our concerns about the mechanism of action of certain FDA-approved contraceptive drugs.”
In fact, it was hard to tell whether her statement sought to create the impression that abortifacients would be excluded from Food and Drug Administration-approved birth control covered in the mandated services, or if her remarks were designed as a friendly warning to HHS. Sister Carol was traveling and could not be reached for further comment.
Candy Hill, senior vice president of social policy and government affairs for Catholic Charities USA, said her organization is working closely with the USCCB, which has spearheaded the Church’s response to the new HHS standards.
“We’re connected with the activity that is going on at the bishops’ conference and have communicated with our membership,” said Hill, who noted that Catholic Charities USA did not speak for individual agencies and was not a lobby, but focused on federal policy dealing with poverty issues.
What Is Catholic Charities’ Stand?
So far, Catholic Charities USA has not taken a public stand on the controversy. For now, Hill has worked behind the scenes, but that strategy could change soon.
“We have messaged to our members, providing them with a copy of Cardinal DiNardo’s letter. We are making our own calls to the White House and HHS and encouraging them to adopt a broader definition of a religious-affiliated organization,” she said.
Across the nation, Catholic Charities agencies serve an estimated 10.2 million people. Approximately 65,000 full- and part-time employees could be affected by any change in benefits.
Hill stressed that HHS is still “welcoming comments, and we hold out hope they will listen to us. If we feel we need to be heard in a broader way, we will ask all our agencies’ directors to make calls.”
She did not speculate on what individual agencies will do if the exemption isn’t broadened, noting that each local bishop directs the policy of agencies under his jurisdiction.
In the recent past, when state or local statutes have threatened the religious freedom of local Church agencies, some bishops have discontinued programs rather than accommodate illicit practices. Several Catholic adoption agencies closed, for example, rather than accommodate rules that required them to place children with same-sex couples.
In 2010, when Catholic Charities in Washington, D.C., was required to provide benefits for the spouses in same-sex unions, following the legalization of same-sex “marriage,” the Church agency discontinued health benefits for the spouses of new hires and those not already enrolled in the benefits program.
Catholics universities, which educate and employ many non-Catholics, could also be affected by the rules. John Garvey, the president of The Catholic University of America, and the former dean of Boston College Law School, registered his alarm in an “open letter,” posted on the website of the Jesuit magazine America , the day HHS approved the new standards.
“[T]he issue before HHS is not whether to allow sterilization, contraception and abortion. It is whether to order insurance companies to cover these services, and employers and employees to pay for them, even if they view them as morally wrong. It is in just this situation that the respect for religious freedom comes into play,” wrote Garvey.
Asked to explain his decision to speak out on the issue, Garvey noted that he had both an academic and an institutional interest in a just resolution to the impasse.
“As an academic, I have had a strong interest in religious liberty and wrote a book on religion and the Constitution. Closer to home, Catholic University of America has a health-care plan for our faculty and staff and another for our students that will be affected by the new rules,” said Garvey in an interview.
Catholic educators like CUA’s president have only begun to grapple with their options should HHS refuse to alter the religious exemption. For now, few seem prepared to openly confront the unthinkable — a collision between federal policy and Catholic doctrine that could produce a classic moral dilemma, just the kind explored in ethics courses at CUA.
While Garvey states that “it would be wrong” for CUA to be forced to cover co-pay-free abortifacients, he did not seem prepared to call the HHS’ bluff.
Asked if the university would consider adopting the path chosen by Catholic Charities in Washington — modifying or discontinuing health benefits — Garvey said, “We have many more students and employees, so that’s a big step for us to take.”
His measured response underscored the competing obligations of a modern Catholic university leader, and thus signaled the vital importance of resolving the latest threat to the religious freedom of Catholic institutions.
Register senior editor Joan Frawley Desmond writes from Chevy Chase, Maryland.
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