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The United States’ Catholic bishops argue that religious freedom is at stake in arguing against a proposed federal mandate that would require Catholic institutions to provide contraceptive coverage to their employees. 

But are the bishops imposing Catholic values on their employees, many of whom are non-Catholic and do not agree with Church teachings against birth control? 

Critics say yes, and argue that the religious freedom argument distracts from the current reality that several Catholic institutions already offer contraceptive coverage to employees, many of whom are Catholics who use contraception. 

“I think calling it religious freedom is really a distraction, because whose religious freedoms are we talking about?” asked Judy Waxman, vice president of health and reproductive rights at the National Women’s Law Center, which argues that current federal civil rights law already guarantees contraceptive coverage in health care plans that offer prescription drugs. 

Imposing beliefs?

“I think we should be thinking about the religious freedom of the employees to decide whether or not they are going to use contraceptives. The bishops can teach what they like, but they cannot impose their beliefs on all the employees who work in a nonprofit hospital or non-profit university where the public is employed and where the public is served,” Waxman said. 

“You wouldn’t work for an Orthodox Jewish organization and expect to find barbecued pork chops being served in the cafeteria.”  
Richard M. Doerflinger, associate director of pro-life activities for the U.S. Conference of Catholic Bishops.

“This is the bishops trying to get the federal government to do to Catholics what Catholics themselves don’t agree with,” said David Nolan, communications director for Catholics for Choice, a Washington, D.C.-based nonprofit that advocates for legalized abortion and access to contraceptives. 

“The HHS rules do not require anyone to use family planning. They’re just saying the insurance has to cover that. The bishops want to force people to pay for a prescription everyone else in the county has access to,” Nolan said. 

But Richard M. Doerflinger, associate director of pro-life activities for the U.S. Conference of Catholic Bishops, told Our Sunday Visitor that the real issue at stake is the federal government trying to force religious institutions to violate their own ethical standards. 

“You wouldn’t work for an Orthodox Jewish organization and expect to find barbecued pork chops being served in the cafeteria,” Doerflinger said. 

“People can choose to work for a Catholic organization, knowing the kind of health care plan they will get, or they can work for someone else. 

“The federal mandate being proposed would represent the government taking away the Church’s ability to impose its own values on itself. It means that a Catholic facility couldn’t be able to offer a Catholic health plan to its employees,” he said. 

Narrow exemption

On Aug. 1, the U.S. Department of Health and Human Services announced federal rules that would require almost every health insurance plan cover all government-approved methods of contraception, as well as surgical sterilization. 

The HHS guidelines were created in response to the 2010 federal health care law championed by President Barack Obama’s administration. The guidelines require all new health insurance plans to cover “women’s preventive services,” including breastfeeding support, domestic violence screening and contraception without charging co-pays or a deductible. 

The Institute of Medicine, an independent, nonprofit organization that serves as the health arm of the National Academy of Sciences, recommended those guidelines in July to address what it said were gaps in preventive health services for women. The proposed mandate, which is still under review, would offer exemptions only for a religious employer that has “the inculcation of religious values as its purpose,” “primarily employs persons who shares its religious tenets,” and “primarily serves persons who share its religious tenets.” 

That exemption, the bishops say, is too narrow, as it would not pertain to Catholic social service agencies, hospitals, schools and universities, which usually hire non-Catholics and are engaged in non-sectarian enterprises such as providing education and health care. 

The National Women’s Law Center argues that federal law does not guarantee, or even allow, a religious organization to refuse to comply with guaranteed contraceptive coverage. 

“It is not up to the bishops to impose requirements on their employees’ lives,” Waxman said. “This is about women’s health and a preventive health service that all women should have access to. They don’t have to take contraception of course, but all women should be able to use it.” 

Doerflinger said he found it ironic that the federal government is classifying contraception as preventive health care. 

“We think it’s very strange to be classifying pregnancy and an unborn child as a disease,” he said. 

“We think this is a step towards abortion coverage. If an employer has to prevent it, why wouldn’t we then have to pay to cover it as well?”

Eliminating choice

“This is getting very serious,” said Father Michael Orsi, chaplain and research fellow in law and religion at Ave Maria University in Florida. “There has always been a First Amendment right to freedom of religion, freedom to practice our faith, and protection from government interference in the Church.” 

He said the government would force Catholic institutions to “cooperate with evil” if the guidelines are adopted. 

“In this case, you are forcing the Church’s institutions to supply birth control pills, including the morning-after pill, known as Plan B. ... If the people who work in Catholic institutions, including non-Catholics, should have access to these things, then the institution can no longer be fully Catholic.” 

Doerflinger added that the HHS mandate is a one-size-fits-all approach. “Nobody has a choice anymore,” he said. 

However, critics say those statements distract from the present reality that many states already have some form of mandated contraceptive coverage, with Catholic facilities across the country already offering those services without talk of their religious freedom being compromised. 

According to the National Women’s Law Center, 28 states have laws and policies that guarantee health insurance coverage of prescription contraceptives in insurance policies that cover other prescription drugs and devices. Eight states offer no religious exemptions. 

Fordham University in New York City, Georgetown University in Washington, D.C., and the Catholic Healthcare West System, a chain of 40 hospitals, offer contraceptive coverage to their employees, according to multiple published reports.

“We see this all over the country,” Waxman said. 

If so, Father Orsi said that still does not legitimize a contraception mandate. 

“The issue is that this shouldn’t be happening at all. When institutions do things like this, you have to look at their charter and see whether they can still be considered Catholic,” Father Orsi said. 

Doerflinger added that the states do not have anything as comprehensive as the HHS mandates. 

“They have broader exemptions. In states like New York, California, New Mexico, Catholic institutions can become self-insurers. You can choose not to have prescription coverage. No state has done anything as sweeping as this new mandate. It will cause a crisis of conscience for our Catholic institutions,” Doerflinger said. 

Brian Fraga writes from Massachusetts.