HHS Nonsense

I’m trying to make sense of the HHS mandate.  I’ve been reading all about it on fellow Catholic blogs, and it isn’t hard to see how most Catholics feel about it, but I am having trouble getting to the meat of what the HHS mandate actually IS.

In my search, I have not found anything where I can actually read the bill and make my own opinion on it.  Here is a handy fact sheet from the Bishops
“6 Things to Know About the HHS Mandate” and the Fact Sheet from HHS.  It has been incredibly difficult to wade through opinion and outrage in order to find out what is actually going on.   However,  this is how I understand the debate to be shaking out:

1.) Obama included the “mandate” (conservative language) or “Women’s Preventative Service” (HHS language) into the Affordable Care Act in January of 2012.  This mandate requires all insurers/employers to include free preventative services for women (some awesome, like counseling for domestic violence and screening for various diseases like diabetes and breast cancer) and some controversial (like providing free contraception).

2.) That really pissed off Catholics (and many other Christian faiths) because providing contraceptive services directly violates the teachings of the Church and the US is supposed to be a place where people have the freedom of religion.

3.) In February, the Obama administration included an exemption for religious employers.

 A religious employer is one that:  (1) has the inculcation of religious values as its purpose; (2) primarily employs persons who share its religious tenets; (3) primarily serves persons who share its religious tenets; and (4) is a non-profit organization under Internal Revenue Code section 6033(a)(1) and section 6033(a)(3)(A)(i) or (iii).

4.) Catholics were still not satisfied because of condition 3.  Many Catholic hospitals and charities serve everyone, and they always have.  Think Mother Theresa.  She didn’t just serve  the poor Catholics of Calcutta, she served everyone who asked her.   Then there was the matter of who pays for the contraception if not the employer.  According to Catholic blogger Scott Reichert:

So how will insurance companies make up the money they spend on providing contraceptives to women who are employed by religious institutions?

By raising premiums.

Who pays the premiums?

The religious institutions who object to providing contraceptives to their employees.

5.) So as I understand it, even if Catholic employers (Like the Archdiocese of Seattle, say) qualify for the religious exemption (as opposed to the Sister of Providence, whose hospital system employs and serves everyone, including the uninsured I may add) as an employee, I could get free birth control, but the Archdiocese would still technically be paying for it as an increase in premiums? See it gets kind of confusing!

6.) The last thing that confuses me is this claim, made by the USCCB:  I can find no other non-Catholic source that makes this claim, and this is sort of a big deal for me.

The mandate forces coverage of sterilization and abortion-inducing drugs and devices as well as contraception. Though commonly called the “contraceptive mandate,” HHS’s mandate also forces employers to sponsor and subsidize coverage of sterilization. And by including all drugs approved by the FDA for use as contraceptives, the HHS mandate includes drugs that can induce abortion, such as “Ella,” a close cousin of the abortion pill RU-486.

I just looked up this “Ella” pill, and it is basically the morning after pill.  However, it said on the front page of it’s website: ” ella may also work by preventing attachment to the uterus1” Since Catholics believe life starts at conception, preventing an already fertilized egg from attaching to the uterus technically counts as abortion.

OK so now that we are all caught up with the pertinent information, here is my take on the issue.  Despite my limited legal or healthcare knowledge, I am actually sort of the perfect person to discuss this for a few reasons.  This law applies directly to me!  I am insured by Christian Brothers, paid for by the Archdiocese of Seattle and I am a woman in my child-bearing years. Also, I am both liberal and conservative at the same time.  I am what one might call an independent, or confused.  Or merely wise enough to see merit and value to both sides.

To me, the main issue is whether or not this is a violation of the freedom of religion granted to us by the 1st amendment of the U.S. Constitution.  I will take this on claim by claim, if I’m misunderstanding/misrepresenting your opinions, please correct me.

Arguments against the HHS Mandate:

1.) A religious organization should not be required by law to do something (provide contraceptive/abortive services) that violates their belief system.  This makes sense to me.  If I have the freedom of religion, then I should not be forced by the government to do something that violate my beliefs.  I wonder about how this plays out in everyday health care related situations.  Is a Catholic doctor required to perform an abortion if he/she feels it not medically necessary?  Can he/she just refer the patient to another doctor because he/she feels that providing the service goes against the “do no harm” portion of the Hippocratic oath?  At it’s most basic level, it seems to me that if the Archdiocese of Seattle doesn’t want to pay for my birth control (whether or not it’s use is relate to sexual activity), as a person working for the Catholics, I can’t really expect them to.

2.) Catholic hospitals and charities should not be punished for providing a public good where the government has failed to do so.  Catholic heath care systems, universities, and charities who do not serve predominately Catholic populations would be required to provide contraceptive services despite the fact that doing so violates their beliefs. These Catholic charities and hospital systems have grown because at some point in history, the government wasn’t taking care of people well enough so Catholics came in to fill a needed void, and should not be punished for doing so.  Sidebar: I went to a Catholic university and you couldn’t get condoms from the health center.  It wasn’t really a big deal, people just went to planned parenthood or the local drugstore.  In my area of the world, free or low cost contraction is widely available.

3.) Even under the religious exemption, faithful Catholics are still required to pay for contraceptive services through higher premiums, which is unconstitutional.  I think this argument is a bit bogus.  First of all, the cost of birth-control is so minimal that requiring insurance to pay for it will probably not increase premiums.  Secondly, I have read many commenters who say something along the lines of “I’m not going to use birth control, so why should I pay for it?”  Well, that’s just silly!  When you pay an insurance premium, you technically “pay for” all kinds of things you wont use.  Just because I will not need coverage for testicular cancer does not mean I shouldn’t being paying into a system that would cover the cost of treatment for someone who actually has balls and wants to keep them.

Arguments in support of the HHS Mandate:

1.) Corporations are not people, and are therefore not granted all rights extended to individuals.  The problem with this is that most Catholic organizations affected by this are non-profits, not corporations.  So does the Bill of Rights extend to large organizations? Should it?  What if I was black and homeless, but the shelter I went to only serves white homeless people because their religion believes that black people are the devil’s warriors or something like that.  Are they allowed to discriminate against me based on race (violating the Civil Rights Act of 1964) because they are guaranteed the freedom or religion?  Obviously this is extreme, but in this sense it would seem the Civil Rights Act sort of trumps religious freedom because your religion sucks.  Since the “suckiness” of various religions is largely a matter of opinion and worldview, at what point does the freedom of religion get in the way of public good?  Shouldn’t the Catholics swallow this small violation of religious freedom because that is what is best for the people?

2.) Freedom of Religion also means freedom FROM religion.  In my area of the country, I can choose between Catholic and non-catholic health care system/providers/etc.  If I don’t like that my doctor wont do X,Y,Z, I can go somewhere else.  In many states, this is not the case.  In rural areas, there may only be one choice of health care provider.  Let’s say I live in nowhere Kansas, and I go to the only pharmacy in town and the Catholic pharmacist happens to be against the morning after pill, but I really need the prescription because I DON’T WANT NO BABY!  Doesn’t freedom of religion protect me from letting my pharmacists religion get in the way of my life decisions? Shouldn’t it?

***

I am a huge fan of the Affordable Care Act.  In my opinion, this whole issue could have been avoided if health care reform was more progressive and expansive.  If the Obama administration got rid of private insurers entirely, then they could decide unilaterally what qualifies as necessary preventative services. Problem solved!  But obviously that would never happen.

So what is the answer? Honestly, I haven’t quite made up my mind about it.  That’s why I’m asking for help.  Liberal friends, what other arguments do you have? Catholic friends, is there something I’m not seeing? Help!

3 comments

  1. Mary Roberson

    A few additional details to add. I hope they will be helpful as you mull over this issue, and that you can navigate my thoughts….

    You mentioned not finding info from a non-Catholic source about the HHS mandated coverage including sterilization and abortion-inducing drugs. Which part of the claim can’t you find? Is it that the drugs are abortion-inducing? That’s in the fine print warnings/disclaimers of the drugs. If it’s the coverage of these things, it can be found stated by the government itself here: ww.hrsa.gov/womensguidelines/
    It says sterilization and all FDA approved contraceptive methods.

    I would tend to agree that contraception coverage wouldn’t make premiums rise, but sterilization is more costly, so maybe that would cause an increase. But even with no increase, the premiums are still going toward paying contraception. The moral problem remains.

    Today there is a great divergence of world views and opinions, as you say. Should religious freedom be violated for the sake of public good? If so, who determines what is the public good and that it is more important than religious liberty? (We Catholics would say contraception is bad for the common good.) Then we have the issue of the U.S. Constitution, its force and role, the safeguards it intends and the dangers of compromising it.

    We Catholics say that truth can be known and is objective, not a matter of opinion. Catholics see the issue of contraception (including types that aren’t abortifacient) not as a religious issue (a law from divine revelation) but part of the natural law, a truth that a person can reason to without a revelation from God.

    And yes, with insurance you pay for services you won’t use, but others will. But there is a difference between contraception and costly, medically necessary care. The argument is based on the idea that somehow people need to have sex at any time they choose without possible pregnancy, that this is a “human right” that others should pay for. But if you don’t want a baby, don’t have sex when you could conceive. This is a crazy thought these days, but before the 20th century, contraception was generally condemned by all major Christian churches. The Catholic faith accepts natural family planning for just, serious reasons (ruling out selfishness) for married couples, and when correctly taught and followed is in the effective range of “the pill.” And practicing it is free and has no side affects and health dangers unlike many contraceptive drugs.

    Another side note: there are medications people need to stay alive and be without pain, that are not morally wrong, that are not covered for free, and sometimes not covered at all under insurance.

    Speaking of, everyone should pay for my toothpaste and vitamins. ;)

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