A Clash of Conscience
The contraception mandate is a predicable byproduct of Obamacare.


James C. Capretta

The decision last week by Health and Human Services Secretary Kathleen Sebelius to reject the appeals of scores of religious leaders and retain a very narrow “religious” exemption from Obamacare’s so-called contraception mandate has ignited an uproar among Catholic leaders, as well it should — because it’s hard to fathom a government dictate more offensive than this one.

Here’s how we got where we are: Obamacare includes within its massive delegation of power to the federal government the authority to define what constitutes “preventive services” that must be covered by all health-insurance plans sold and purchased in the United States, including plans sponsored by employers. Services defined by HHS as preventive for purposes of this provision are required under the new law to be covered by the insurer or employer with no charge to the insurance plan’s enrollees.

Last August, in the course of writing a rule that would determine preventive health services for women, HHS decided that free contraception and sterilization services are a must. As a practical matter, that means all health-insurance plans sold in the United States in the very near future will include full coverage of products that terminate pregnancies, since some products classified by the FDA as contraceptives — and thus covered under the HHS definition — also act as abortifacients. While it is true that many insurance plans cover such products today, that’s mainly been the choice of the insurers and employers sponsoring the plans. HHS has now made such coverage obligatory nationwide, thus forcing tens of millions of pro-life Americans to pay for “services” with their health-insurance premiums that they find morally objectionable. (Grandfathered plans are exempt from this and other Obamacare rules, but the number qualifying for grandfathered status is expected to decline precipitously in the next couple of years.)

Bad as all that is, it gets worse. Not only must Catholics who work for non-Catholic employers pay for such products with their premiums, HHS also wants religious employers to cover such products in their health plans. Knowing that Catholic leaders and others would strongly object to this requirement, HHS included in the regulation issued last August a narrow exemption from this requirement for employers that are basically houses of worship. Much larger religiously affiliated institutions, such as Catholic universities, hospitals, and charitable enterprises, do not fit within the HHS exemption.

Not surprisingly, Catholic leaders were more than alarmed by the promulgation of this rule and have spent the time since its publication imploring the Obama White House and HHS to reverse course and loosen the exemption definition so that the full array of Catholic institutions and social-service agencies could get out from under this onerous and pernicious requirement. Among the more prominent groups that have weighed in on this are Catholic Charities USA, the University of Notre Dame, and the network of Catholic hospitals that serve millions of U.S. patients every year.

This is not exactly a who’s-who list of the Catholic Right. If ever there were a group of Catholic institutions to which you would think that the Obama administration would want to be accommodating, this would be it.

And so, what was the administration’s reaction to the pleadings of these friendly leaders? Basically, the back of the hand. Last Friday, Secretary Sebelius announced that religious organizations that do not fit within the previously stated exemption criteria will have only one additional year to comply with the regulation’s requirements.