The Obama administration announced yesterday that most health insurance plans are now mandated to cover contraceptives (including Plan B and sterilization) for women free of charge. The move significantly narrows the conscience clause exemption for religious organizations like the Catholic Church. Church-affiliated organizations have an extra year (until Aug. 1, 2013) to comply with the requirement, which head of Health and Human Services Kathleen Sebelius said struck “the appropriate balance between respecting religious freedom and increasing access to important preventive services.” Archbishop (soon-to-be-Cardinal) Timothy Dolan has been an outspoken critic of the HHS mandate and has appealed personally to President Obama to grant a broad exemption for religious organizations, a request the president denied, though the rule still includes an exemption for religious employers at houses of worships which serve only their “co-religionists” and not people of different faiths like hospitals, universities, and social service agencies.
“In effect, the president is saying we have a year to figure out how to violate our consciences,” said Archbishop Timothy M. Dolan.
The Archbishop is clearly concerned with Catholic organizations cooperating in something they see as a grave evil, namely, artificial contraception, which everybody knows the Church opposes. Other evangelical allies see this as a violation of the First Amendment and the all-American value of separation of Church and State, as Senator Orrin Hatch of Utah made clear in his response:
“The problem is not that religious institutions do not have enough time to comply. It’s that they are forced to comply at all. Unfortunately, the administration has shown a complete lack of regard for our constitutional commitment to religious liberty.”
The Commonweal blog has started a great discussion on the question of religious liberty and cooperation. Grant Galllicho argues against the mandate for something akin to the Hawaii Compromise:
Under Hawaii law, a religious organization that objects to providing contraception coverage to its employees can invoke a refusal clause that would allow the institution to exclude such services from employee health plans. Religious groups that invoke the refusal clause must — as required by the HHS ruling — provide written notice to employees informing them that contraception is not included in their health plans, and they must tell employees where such services can be obtained. A refusal clause only pertains to contraception services intended to avoid pregnancy. An employer must provide coverage for contraception prescribed to treat, for example, the symptoms of menopause. According to the law, an employee is entitled to buy contraception coverage form her insurer at a cost that is no higher than the enrollee’s pro-rata share of the price the employer would have paid had it not exercised the religious exemption. So religious institutions do not have to subsidize insurance coverage including contraceptive services, and employees who want such coverage can purchase a separate rider with their own money.
He concludes that Obama’s decision, while not forcing Catholic organizations to cooperate significantly in evil, is nevertheless “politically daft and illiberal.” This seems a pretty reasonable assessment to me (not to mention the fact that the mandate won’t even take effect until almost a year after the election, at which point Obama might not even be president. Odd move for an election year). In addition to these arguments, the Society of Catholic Social Sciences has questioned the alleged “scientific” basis of the decision, as expressed by Sebelius:
“Scientists have abundant evidence that birth control has significant health benefits for women,” Ms. Sebelius said, and “it is documented to significantly reduce health costs.”
I don’t have enough access to the data to be able to judge whether free access to contraceptives is actually better for women’s health. I do know, however, that no matter how good access to contraception is, there are still going to be unplanned pregnancies. Making contraception free and readily available in no way guarantees that sexually-active individuals will use it consistently or reliably. It is important that attention to women’s health and well-being include social and financial support for those women who do experience an unwanted pregnancy and choose not to terminate, including improved access to pre- and post-natal care, streamlined adoption processes, financial assistance for family-friendly housing, and better childcare options. Feminists for Life has been a leader in this area, attending especially to how college campuses can find ways to meet the needs of their students who experience an unplanned pregnancy so that they do not feel the need to terminate.
Catholic Charities and other religiously-affiliated social services agencies also do laudable work helping women choose adoption over abortion, including for babies who have special needs. Comprehensive reproductive health coverage for women includes a variety of services not covered in the HHS mandate but which are the focus of organizations like Catholic Charities who are adversely affected by this mandate. Whatever you think of the HHS mandate, what it is not is a “huge victory for women’s health” unless you narrowly restrict “health” to mean “not having a pregnancy you didn’t want.” It is important to remember on this anniversary of Roe v. Wade that “greater reproductive liberty” does not actually equate with healthier and better-off women.