.- The federal government’s new contraceptive and sterilization insurance coverage mandate includes a religious exemption whose language was designed specifically to counter Catholic institutions’ conscience protections, one Catholic health care leader told a U.S. House of Representatives subcommittee Nov. 2.
The exemption’s “highly flawed” definition originated in a California debate about a state-level contraception mandate, William J. Cox, president and CEO of the California-based Alliance of Catholic Health Care, told a Nov. 2 hearing of the Energy and Commerce Committee’s Subcommittee on Health.
The definition was “painstakingly crafted by the American Civil Liberties Union to specifically exclude religious institutional missions like health care providers, universities and social service agencies,” Cox stated.
During the debate, the then-head of Planned Parenthood in California said the wording was designed to close the “Catholic gap” in contraceptive coverage.
The proposed guidelines, announced by Health and Human Services Secretary Kathleen Sebelius on Aug. 1, mandate that all new healthcare plans cover all FDA-approved birth control, surgical sterilization, and counseling for such services.
An exemption is available only for those religious employers that have teaching religious values as their purpose and primarily employ and serve people who share its religious tenets.
By issuing its rule, Cox charged, the Department of Health and Human Services “turned its back” on the contributions of Catholic health care and “undid centuries of religious tolerance.”
The mandate will have a “disproportionate impact” on Catholic institutions, he added, criticizing the exemption’s “exceedingly narrow” definition of religious employer.
The federal rule is the “most radical” of the 28 states with such coverage mandates. It would include all FDA-approved contraceptive methods and sterilization procedures. It mandates coverage for at least one drug that can cause an abortion when taken to avoid pregnancy.
If conscience rights issues are not addressed, the mandates will force providers and others to choose between “violating their consciences or no longer providing or paying for health care and other services,” he said.
This would end in reduced access to care, especially for “some of the weakest among us,” said Cox, whose organization represents 54 hospitals and more than 40 nursing homes, hospices, assisted living and other facilities and services throughout the California.
Jane G. Belford, chancellor of the Catholic Archdiocese of Washington, told the hearing that if the mandate is not rescinded then its religious exemption would fail to protect “the vast majority of religious stakeholders in the process of providing health insurance.”
“Until now, federal law has never prevented religious employers, like the Archdiocese of Washington, from providing for the needs of their employees with a health plan that is consistent with the Church’s moral teachings.”
Under the new rules, she said, Catholic schools that teach abortion is morally wrong could be forced to pay for abortifacient drugs for their employees. Catholic health clinics that refuse to provide contraception or sterilization for patients could have to subsidize contraception and sterilization for their employees.
“Currently, the archdiocese is free under federal law to offer health benefits coverage that excludes contraception and sterilization,” Belford continued. “We would lose this freedom of conscience under the HHS mandate’s current definition of an exempted religious organization.”
The mandate goes beyond forcing religious institutions to contradict the belief that sterilization and contraception are immoral. Its grant of religious freedom to groups which employ and serve only co-religionists also significantly burdens Catholics’ “deeply held belief that God calls us to serve our neighbors,” she said.
David L. Stevens, M.D., the CEO of the Christian Medical Association, said the religious exemption is “meaningless.” The mandate could trigger a decrease in health care access for patients in underserved regions and populations. It also contributes to “an increasingly hostile environment” for medical students, residents and graduate physicians who face “discrimination, job loss and ostracism” for having pro-life views on abortion, contraceptives and other issues.
He warned that the mandate creates “a climate of coercion” that could prompt pro-life health care professionals to limit the scope of their practice and discourage medical students and residents from choosing careers in specialties likely to involve conflicts of conscience.
“The contraceptive mandate rule sweepingly tramples conscience rights, which have not only provided a foundation for American civil liberties but also a foundation for the ethical and professional practice of medicine,” Stevens said. “The administration should rescind this mandate entirely.”
Stevens’ organization and the Archdiocese of Washington encouraged Congress to pass the Respect for Rights of Conscience Act.
Cox suggested that Health and Human Services use the definition of religious employer used under the Internal Revenue Code. It should also amend the rule to ensure that individuals and non-religious employers are similarly protected.
“Nearly 160 years ago, the Sisters of Mercy responded with compassion and care when government was unable to tend to the victims of the San Francisco cholera epidemic. Today, it is time for government to honor this noble legacy by strengthening once and for all federal conscience protections so all health care providers today, tomorrow and well into the future can carry out their vocations absent the threat of government discrimination,” said Cox.
Jon O’Brien, president of the dissenting group Catholics for Choice, said his organization represents those who respect others’ right to follow his or her own conscience. However, he endorsed the mandate.
He contended that exemptions threaten the conscience rights of every patient seeking care for services he characterized as “essential health care.”
“It is incredible to suggest that a hospital or an insurance plan has a conscience. Granting institutions, or entities like these, legal protection for the rights of conscience that properly belongs to individuals is an affront to our ideals of conscience and religious freedom,” O’Brien argued.
O’Brien charged that the U.S. bishops and some Catholic organizations are asking to be allowed to deny condoms as part of HIV outreach, to “ban” employees and their dependents from getting “the benefit of no-cost contraceptive coverage,” to opt out of providing emergency contraception to victims of sexual violence, and to “deny abortion care to everybody,” even to women in life-threatening situations.
In 2000, the U.S. bishops said that O’Brien’s organization, then called Catholics for a Free Choice, is not a Catholic organization. It does not speak for the Catholic Church and promotes positions contrary to the teaching of the Church.
Many large foundations back Catholics for Choice. The Ford Foundation, whose trustees now include Planned Parenthood Federation of America president Cecile Richards, gave a $300,000 grant to the pro-abortion rights group in 2011.
In his prepared remarks, House subcommittee chairman Rep. Joe Pitts (R-Pa.) charged that the Department of Health and Human Services mandate is “forcing every single person in this country to pay for services that they may morally oppose.”
“Groups who have for centuries cared for the sick and poor will now be forced to violate their religious beliefs if they want to continue to serve their communities,” he continued. “Whether one supports or opposes the health care law, we should universally support the notion that the federal government should be prohibited from taking coercive actions to force people to abandon their religious principles.”