Catholic legal experts warn HHS against requiring coverage of contraception and sterilization

Health and Human Services secretary Kathleen Sebelius and USCCB General Counsel Anthony Picarello
Health and Human Services secretary Kathleen Sebelius and USCCB General Counsel Anthony Picarello


Officials with the U.S. Catholic bishops’ conference have urged the Department of Health and Human Services not to require coverage of contraception and sterilization, saying such mandates could compel coverage for abortion-causing drugs and could threaten freedom of conscience.

Anthony Picarello, general counsel of the U.S. Conference of Catholic Bishops (USCCB), and Michael Moses, USCCB associate general counsel, in a September 17 letter to HHS, said that the drugs, devices and procedures under consideration “prevent not a disease condition, but the healthy condition known as fertility.” Contraception and sterilization pose “significant risks” to women’s lives and health, while mandating their coverage would pose “an unprecedented threat to rights of conscience.”

According to the USCCB, Picarello and Moses said such a mandate would threaten the rights of conscience for religious employers and others with moral or religious objections to these procedures.

“In this regard, the Administration’s promise that Americans who like their current coverage will be able to keep it under health care reform would be a hollow pledge,” they argued.

Any mandated coverage would contradict “longstanding federal precedents” about respecting conscientious objection to such procedures. Precedents include the Church Amendment, which has protected conscientious objection to abortion and sterilization since 1973.

The two counsels for the USCCB also challenged the categorization of contraception as “preventive” medicine, noting that abortion is not a disease condition but “a separate procedure that is performed only by agreement between a woman and a health professional.” They cited studies indicating that contraception does not prevent abortion, as the percentage of unintended pregnancies that are ended by abortion is higher if the pregnancy occurred during a period of contraceptive use.

The two also contended that because at least one FDA-approved drug for “emergency contraception” actually causes early abortions, mandating prescription contraception coverage could be in “direct tension” with a statutory prohibition against mandating any abortion service.

“We hope that these considerations will be taken into account as the Department continues deliberations on a final list of required preventive services for women,” Picarello’s and Moses’ letter concluded.

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