White House Openly Considers Caving to Bishops on Birth Control Coverage


See all our coverage of the Birth Control Mandate 2011 here

According to a New York Times article today by Robert Pear, the White House has now publicly confirmed that President Obama is considering caving to demands by the United States Conference of Catholic Bishops (USCCB) and other far right religious groups that he “expand the exemptions” from the requirement that insurance plans under health reform cover birth control without a co-pay.

If he does so, the President will be trading the health, welfare, autonomy, and economic prospects of millions of women and the opinion of the entire medical and public health communities to curry favor with a very small minority of male-dominated religious right groups such as the USCCB which has found that it can not, on its own, force women to become and remain pregnant.

And as far as I am concerned, if the President does this, he will also forfeit the right to call himself “pro-choice” under any definition of the term as I understand it.

What’s the problem here? Even the Times basically has it wrong, because the article continues to mis-characterize both the nature of contraceptive coverage (it is not “free of charge”) and of the current exemption, which not only “may” (as the Times suggest) but does exempt Churches from the requirement.

The basic problem here is this: The vast majority of women of reproductive age in the United States–99 percent–uses at least one modern form of birth control at some point in their lives. This includes Catholic women, Jewish women, Muslim women, Protestant women and the majority of women of every other religious persuasion and those who are not religiously identified, are atheists, agnostic or any other category I may be inadvertently failing to mention.

That women–Catholic women and other women–actually do control their fertility drives the Bishops and the rest of the religio-political patriarchy up a wall.  And, this summer, the Administration drove them over the top of that wall.

In August, the Department of Health and Human Services (HHS) adopted the recommendations of the Institute of Medicine to include as part of the basic package of services an array of preventive health care services for women.

Expanding access to preventive care without cost-sharing (co-pays) was ostensibly a core principal of health reform. As HHS notes:

The Affordable Care Act – the health insurance reform legislation passed by Congress and signed into law by President Obama on March 23, 2010 – helps make prevention affordable and accessible for all Americans by requiring health plans to cover recommended preventive services without cost sharing.

“Before health reform,” states an HHS press advisory, “too many Americans didn’t get the preventive health care they need to stay healthy, avoid or delay the onset of disease, lead productive lives, and reduce health care costs.  Often because of cost, Americans used preventive services at about half the recommended rate.”

Yet chronic diseases – which are responsible for 7 of 10 deaths among Americans each year and account for 75% of the nation’s health spending – often are preventable. Cost sharing (including copayments, co-insurance, and deductibles) reduces the likelihood that preventive services will be used. Especially concerning for women are studies showing that even moderate copays for preventive services such as mammograms or pap smears deter patients from receiving services. [Emphasis added.]

The preventive care services to be covered without co-pay include well-woman visits, support for breastfeeding equipment, screening and counseling for gestational diabetes, cervical cancer, sexually transmitted infections, and domestic violence, and support and supplies for breastfeeding.

And, of course, IOM strongly recommended and HHS included coverage without co-pays of contraceptive counseling and supplies. The reasons why have been extensively documented in numerous articles including one here, here, here, and here.

The HHS mandate states:

Women will have access to all Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling. These recommendations do not include abortifacient drugs. Most workers in employer-sponsored plans are currently covered for contraceptives. Family planning services are an essential preventive service for women and critical to appropriately spacing and ensuring intended pregnancies, which results in improved maternal health and better birth outcomes. [Emphasis added].

HHS exempted from this mandate certain religious employers including those that define the inculcation of religious values as their primary purpose; that primarily employ persons who share its religious tenets; that primarily serve persons who share the organization’s religious tenets; and are non-profit organizations.  Contrary to the Times story that churches may be exempt,” HHS made clear that their exemption absolutely includes churches, their integrated auxiliaries, and conventions or associations of churches, as well as exclusively religious activities of any religious order.

As HHS stated, the “interim final rule… is modeled on the most common exemption available in the 28 states that already require insurance companies to cover contraception.”

HHS, as is common practice, provided an ample comment period, during which religious right organizations went to work, claiming that their religious liberty would be infringed if they had to include in their employer-based health plans coverage of contraception for women, whether they be Catholic, Jewish, Hindu, Protestant, atheistic, agnostic or otherwise. In other words, as I have pointed out elsewhere, the only means through which the religious right can experience religious liberty is to rob everyone else of theirs.

This is not a trivial matter. Cost plays a major role in consistent access to and use fo contraception, most especially for low-income and middle class women.  Access to birth control is a major factor in preventing unintended pregnancies, ostensibly a goal of this Administration.  Moreover, it is the right of every woman to decide whether and when to bear a child and under what conditions.  No religious figure has the right to “override” the fertility and health decisions of any woman.

Now, however, HHS is punting. I called the White House last week for comment on their policy, and two days later received a call back from someone at HHS who’d been asked by White House staff to call me.  I was told by the HHS spokesperson that no decision had been made on when to finalize the policy and that technically the department could take until next summer to decide since the final rule does not go into effect until August.  When I asked what more, on top of the weight of evidence already made public, was left to consider, I was told that the department was hearing from “all stakeholders.”  Apparently, HHS considers the USCCB, the Family Research Council, Focus on the Family and other religious right organizations to be a stakeholders of your womb, because they are weighing heavily on this decision.

My question to you is this: How far do we allow an Administration to go on simply trading away the basic health and economic needs of millions of women before we call this a political foul?

_____________________________________

These groups urge you to take action:

Catholics for Choice

National Women’s Law Center

Physicians for Reproductive Choice and Health

Feminist Majority Foundation

Emily’s List

Planned Parenthood Federation of America

NARAL Pro-Choice America

Physicians for Reproductive Choice and Health

_____________________________

Follow Jodi Jacobson on Twitter: @jljacobson

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  • waterjoe

    Would a Catholic organization, such as Catholic Charities, that does not primarily employ Catholics and does not primarily serve Catholics be exempt?  If not, the Times is right.

  • jennifer-starr

    Perhaps you, as a Catholic, can explain to me why some Catholics feel as though they are being discriminated against when they can’t force non-Catholics to follow their laws? Why do they want to impose Catholic laws on people who don’t follow the Catholic faith? I don’t get it. 

  • crowepps

    So a Latter Day Saints organization, which did not primarily employ Mormons and did not primarily serve Mormons, would be allowed to pressure its  employees to listen to Mormon scriptures over a loudspeaker and penalize them if they didn’t get married and have children?

    Gosh, I sure wouldn’t want to work for a Christian Scientist — I wouldn’t be able to go to the doctor or I’d be violating his religious freedom rights to decide whether I deserved health care.

  • jodi-jacobson

    Please read the actual facts. 

    Exempt organizations are those that meet all the following four criteria.  For which inculcation of religious values as their primary purpose; that primarily employ persons who share its religious tenets; that primarily serve persons who share the organization’s religious tenets; and are non-profit organizations.

    Catholic Charities is not exempt. Churches are.

     

    Thank you.

  • jodi-jacobson

    They are not exempt NOW in many states…

     

    Its only because the Bishops have been given the opportunity to write their current interpretation of “Catholic law” into the US legal code that they are working so hard to override religious freedom in this country.

     

     

  • crowepps

    I highly recommend the superb explanation of “religious liberty” that was posted at Daily Kos yesterday.  An excerpt:

    “This is the bothersome thing: yes, religious freedom must be protected. But when a religious institution operates as another entity, as an official avenue of adoption for children in state care, or as a hospital, or as a university, then their activity ceases to be purely religious and becomes civil, or medical, or educational. When conducting those activities, it is reasonable to ask that they comply with the laws of the state. (Is there a religious exception for building codes? If a doctor cuts off your leg in a religious hospital when you came in for surgery on your arm, can the fellow claim religious exemption from malpractice, because his errant hand and incompetent mind were God-inspired? I wonder.)

    This is the difference: as religion, believe whatever you want. Preach whatever you want, hold whatever bigotries you want, consider bacon or buttons or buggery a sin, if you want. As adoption agency, or as hospital, or as university, you may face more specific civil constraints. This is the balance we strike, and it seems the only plausible one.”

    http://www.dailykos.com/story/2011/11/20/1038284/-Religious-liberty,-the-state,-and-the-law#comments

  • altered-states

    Because Altar Boys don’t need them (when having sex with the Bishops) and they want to make the “playing field” level for everyone.

  • iupapaw

    I HAVE ALWAYS BEEN A SUPPORTER OF PRESIDENT OBAMA,BUT THIS TIME I MUST GO OVER HIS HEAD AND APPEAL TO THE BEAUTIFUL FIRST LADY MICHELLE ,AS  A FEMALE AND MOTHER OF TWO DAUGHTERS IT MUST BE UP TO YOU TO TEACH YOUR DAUGHTERS ABOUT THEIR RIGHTS AS WOMEN AND FUTURE MOTHERS TO HAVE A CHOISE TO EACH OF THEM TO DETERMINE BIRTH CONTROL, GOD BLESS YOU AND ALL WOMEN

  • wendy-banks

    Please don’t type in all caps, it’s the net version of yelling in someone’s ear…

  • altered-states

    In the 1950’s, it was illegal to sell condoms in the State of Connecticut.  You could be arrested for possession and sent to jail for selling them.  If the Catholics have it their way, we might see a return of the “bad old days” when the Catholic Church ruled supreme, even though, “theoretically”, we believed in the seperation of Church and State.

    In those days, “The Church” set the standards for movies, what was written, and what was spoken on radio and TV.  I thought the “Founding Fathers” made it clear that they wanted no part of “Rome” when they were writing the Constitution.  From the way D.C. is acting, it looks like we might be making a full-circle return to “Mother Church” (as “Rome” refers to the Roman Catholic Church).

  • waterjoe

    Whether a person works for a particular organization is a choice.  The only act being compelled here is the government compelling a religious entity to violate its religious beliefs.

    We hear all the time: “If you don’t like abortions, don’t get one.”  But the proposed rule does not apply that same principle to employers and insurers.

  • jennifer-starr

     Unless someone is forcing the employer to personally use birth control themselves, I don’t see what’s being violated here. Why should it matter to an employer whether or not my insurance covers birth control or whether I use it?  It’s me, not him–and my being employed by him does not give him ownership of my uterus. I’m not Catholic, therefore, I’m not beholden to his laws–my being employed by a Catholic employer does not give that employer the right to dictate my religion–that’s a violation of the first amendment.  And before you come out with “It’s his money”, it’s not his money. If I’m working for an employer the money he pays me and the benefits are part of that payment. So it’s my money. 

  • waterjoe

    are part of a private contract negotiated between you and the employer.  You don’t have a right to every type of benefit.

    Moreover, the absence of contraception in health coverage is in no way shape or form a violation of the First Amendment, even if its done because of the employer’s religious beliefs.

  • jennifer-starr

    It is a violation if his religious beliefs are not mine. The fact that he’s my employer does not make his moral worldview superior–and does not grant him the right to impose his particular religious laws on me.  

  • colleen

    Whether a person works for a particular organization is a choice.

    I thought that was only a choice when the employee is someone that Religious right wishes to punish. When, say, a pharmacist  wishes to excercise what he mistakedly refers to as a ‘conscience’ and refuse to fill a, EC prescription for a rape victim you folks are always telling us that the poor pharmacist HAS no choice but to work there and force his vile opinions down out collective throats. Indeed we’re told  we must accommodate what folks like you mistake for a conscience.

     

  • waterjoe

    Take a basic civics class.

  • waterjoe

    Defenders of conscience rights do not always object when an employer requires a prescription to be filled.  It is when the government requires it that is objectionable.

  • ahunt

    Defenders of conscience rights do not always object when an employer requires a prescription to be filled.  It is when the government requires it that is objectionable.

    Come again?  You put the health and well being of women at the WHIM of whoever is on duty…because not ALL “defenders of conscience rights” would OBJECT?

  • jennifer-starr

    Explain to me why it’s on my employer’s conscience if my health insurance covers contraception. It has nothing to do with them at all, so I fail to see why it would trouble their conscience. 

  • waterjoe

    Suppose a married boss insisted that his assistant drive him from work to a hotel so he can have an rendevous with a prostitute.  In addition, he insists that the assistant cough up some cash to pay for the act.  What he does on his own time may not be the assistant’s business but when he insists that he or she help facilitate the act he has violated the assistant’s rights of conscience.

    Now, I am not saying that covering contraception is morally equivalent to adultery and solicitation, but the violation of conscience is equivalent.  It is a basic premise of society that one person cannot judge for another whether adhering to conscience is the “right” thing.

    Just like the boss violates the employee’s conscience by making her or him cooperate in his illicit affair, you are insisting that an employer participate in what the employer feels is a violation of her conscience.  Moreover, you are insisting that using the power of the state to force the employer to violate her conscience.

  • crowepps

    Now, I am not saying that covering contraception is morally equivalent to adultery and solicitation, but the violation of conscience is equivalent.

    Well, yeah, that is what you are saying.  You’re the one who chose those comparisons.  The subject was ‘sex without the possibility of pregnancy’ and that apparently made you think of prostitution and adultery.  You’re the one who seems to think there are only two kinds of sexually active women, mothers and sluts, and that the way to tell them apart is whether they use birth control.

    It is a basic premise of society that one person cannot judge for another whether adhering to conscience is the “right” thing.

    And yet you’re asserting that the employer gets to judge whether his employees are adhering to their conscience in the “right” way.

    Just like the boss violates the employee’s conscience by making her or him cooperate in his illicit affair, you are insisting that an employer participate in what the employer feels is a violation of her conscience.

    The only ‘cooperation’ required of the boss is to butt out.  The employer isn’t going to have any  idea at all which employees access those particular services and which do not, or even whether ANYONE uses them, since the inclusion of birth control won’t change the amount of the premiums one penny.   That’s only right, because it is so totally NOT the boss’s business to be thinking about the employee’s sex lives.

    If the boss chooses to speculate about whether there might be an employees who is having sex that he think is immoral, or disapproves of an employee or wife on the basis they aren’t doing their womanly duty and ‘dropping a calf’ biannually, well, hey, lots of people are outraged by the horror of other people stubbornly refusing to be ‘Just Like Me’.

    Personally, I think the boss interesting himself in his employees’ sexual or reproductive activities AT ALL goes over the border from paternalistic and controlling and ends up at creepy and obsessed.  His status regarding insurance is employer, not moral arbiter or father or priest.

     Moreover, you are insisting that using the power of the state to force the employer to violate her conscience.

    See how that’s really similar to your insistence that the employer has the right to economic penalities that punish employee’s private behaviors, violating the employee’s freedom of religion and right to their own conscience?

  • crowepps

    Whether or not the religious entity chooses to engage in businesses providing services to non-Catholics and continue hiring non-Catholics is their choice.  If they restrict their services to religion they fall under the exemption in the law and their religious beliefs won’t be violated.

  • jennifer-starr

    I still don’t see that.  What I do see are people who are trying to force non-adherents to their religion to comply with their laws. Why should I be denied contraceptive coverage because my boss happens to be Catholic? My use of contraception and my reasons for its use are  not my employers concern. The fact that my use would trouble ‘their’ conscience tells me that they don’t have enough of their own business to worry about. 

    The fact that you equate contraceptive use with immorality and illegal acts (though you ‘claim’ not to) is troubling and frankly offensive to me. My Grandparents have been happily married for 60 years–and after having seven kids and deciding that seven was all they wanted, they used contraception. Ditto for my parents, who had three children and have been happily married for 41 years.  People use contraception for health reasons.  And yes, so do single women who don’t wish to have a child at this point. And that’s okay.  And in case you didn’t realize, Catholic women use birth control as well.  

    I know a group of archaic and  out of touch men in Rome and most of the anti-choicers wish it wasn’t so, but it’s not immoral to want to control when you have a child and how many children you wish to have. What it is, is responsible. 

     

  • waterjoe

    to define what is a religious service?

  • colleen

    Take a basic civics class.

    You really aren’t in any position to talk with the women here the way you talk to your wife.

  • waterjoe

    I was trying to come up with an analogy that most readers here would find offensive.  I could have used any example, and that was the point.  It doesn’t matter what the act is.  If someone finds it to violate their conscience they should not be compelled to engage in it.

    Also, the act involved here, just like the question of who supports or opposes it, is irrelevant.   This is basic logic.

    But apparently the two of you have lost all ability to think reasonably on this issue to see that and have completely avoided addressing the obvious fact: You want the state to compel someone to violate their conscience.

    Let me make it easier for you: You could argue that conscience is important but that it cannot outweigh an important public interest when it is not possible to achieve that interest in another way, and that access to contraception is such an important interest. 

    We could have discussed whether the premises of that argument were true, but you chose to throw out irrelevant claims and avoided the fact that there is, in fact, compulsion occuring in the proposed rule.

     

  • prochoiceferret

    [Who are you] to define what is a religious service?

     

    Courts of law have legitimately ruled on this in the past. That’s partly why you don’t see any religions that have discrimination against racial minorities as a sacrament.

  • prochoiceferret

    Let me make it easier for you: You could argue that conscience is important but that it cannot outweigh an important public interest when it is not possible to achieve that interest in another way, and that access to contraception is such an important interest. 

     

    We could have discussed whether the premises of that argument were true, but you chose to throw out irrelevant claims and avoided the fact that there is, in fact, compulsion occuring in the proposed rule.

     

    Of course there is compulsion in the proposed rule, kind of like how there is compulsion not to discriminate against employees on the basis of race or retaliation for invoking employee protection laws. You have yet to state a good reason as to why this compulsion is a bad thing.

     

    You could certainly discuss whether the premise of enhanced contraceptive access being a public interest is true, but then, you obviously don’t want to have your hiney handed to you on a platter, so it’s understandable that you’d run your mouth about anything other than that.

  • ahunt

      who are you?...to define what is a religious service?

     

     

    Um…by your implied logic…we are to believe that any activity undertaken by religious entities constitutes “religious service?” Jus’ checkin’.

  • crowepps

    Making it more offensive doesn’t make it more convincing, so why not use an analogy that’s a lot closer to the actual facts?

    The employer provides as part of employee’s compensation various items.  Cash (minimum amount per hour compelled by the government), unemployment insurance, Workman’s Comp, maybe additional disability insurance or life insurance, and medical insurance with various coverages.  There is also a long list of safety standards and equipment and training costs with which the employer is compelled by government to comply.

    Your premise is that if the employer’s conscience is distressed by the idea that employees or their spouses might have sex without risking pregnancy, then the government shouldn’t be able to require the employer to ALLOW the employee to access the standard medical insurance provided to all other employees that includes birth control, AT NO ADDITIONAL COST TO THE EMPLOYER, and that instead the employer should be able to penalize his employee for their ‘immorality’ and put the employee at a disadvantage compared to all other similarly situated employees by REDUCING their coverage, forcing the employee to pay for birth control out of pocket, because the employer’s conscience and religious freedom override those of the (less important) employee or society in general.

    Ignoring the huge logic fail that the out of pocket expense of birth control is going to come out of the employee’s cash compensation, which ALSO came from the employer, the problem with this becomes evident when extended to other employee compensation.

    If the employer’s conscience is distressed by the fact that his employee goes out on Saturday night and has a drink, is the employer entitled to withhold part of the employee’s cash pay, so that the employer isn’t ‘complicit’ in the purchase of alcohol?

    If the employer’s moral beliefs are outraged by someone ‘laying around and doing nothing all day’ can the employer opt out of unemployment insurance or Workman’s Comp, so he won’t be ‘enabling’ former employees in being lazy?

    The amount of compulsion in the proposed rule is no more than the compulsions to provide unemployment insurance (state and federal), carry Workman’s Comp (at levels compelled by government), check the immigration status of new hires with the I.N.S., check with the state child support agency to see if new hires owe them any money, or (where appropriate) to check an employee’s driving and criminal records.

    A person whose conscience is bothered by the potential deportation of an undocumented worker would still be compelled to call the INS, and a person who felt it was unChristian not to give someone truly repentant a chance merely because of an ancient felony conviction still wouldn’t be able to hire them for some jobs.  I’ve hired people over the years, and I’m very well aware of the long, LONG list of compulsory requirements which rule employers.  Allowing employees to access a standard medical insurance policy just like everyone else’s is nowhere near the most onerous.

  • crowepps

    It isn’t my definition.

     

    The regulation in question has a specific exemption for religion INSTITUTIONS, which is an expansion of the current laws providing conscience rights to INDIVIDUALS, and would exempt nonprofit religious employers (such as churches) that are primarily devoted to “the inculcation of religious values” and serve and employ mostly people of their own faith.

  • crowepps

    So, on the importance of conscience rights, say a patient is brought into the ER at St. Joseph’s after a rape and the doctor treating her doesn’t want to be an *enabler* for the violent rapist who assaulted her, and faced with her distress his *conscience* inspires him to pull some Plan B out of his pocket and hand it to her.  His rights protected?  His job safe?

  • waterjoe

    A person whose conscience is bothered by the potential deportation of an undocumented worker would still be compelled to call the INS, and a person who felt it was unChristian not to give someone truly repentant a chance merely because of an ancient felony conviction still wouldn’t be able to hire them for some jobs.

     

    Both of which are wrong and I would – and have – argue for a religious exemption to them as well.  

     

    At least we are now talking about the balancing of rights, while before the posts seemed to ignore the existence of any conscience rights at all.  The proposed rule, as you acknowledge, compels an employer to violate its conscience.  You think that is a good thing.  I think it is a bad precedent, no matter what the issue.  

  • ahunt

    The proposed rule, as you acknowledge, compels an employer to violate its conscience.  You think that is a good thing.  I think it is a bad precedent, no matter what the issue. 

     

    Ron and Rand Paul Much?

     

     

    By your standards, there is virtually no check on the right of employers to discriminate against any class of person, and to control the lives of employees, right down to the most intimate areas of employee private life.

     

    Seriously…you need to rethink your position.

  • crowepps

    Tell you what, why don’t you define what you mean by ‘conscience’, because as you’re using it, it seems to exceed “I won’t do what I think is wrong” and expand through “I don’t think I should be penalized in any way for refusing to do things I find morally troubling” into “I should have the right to assess penalties on other people who do anything of which I disapprove”.  As a matter of fact, you seem to be slipping over into an almost Libertarian attitude of “I’m RELIGIOUS and that means I get an exemption from ANY laws that I don’t want to follow.”

     

    I don’t think people can be compelled to violate their conscience, because those people can refuse to do things that they find immoral.  In some instances that may mean that they will pay a penalty for their standing on principle, like having their employer reassign them to a different position, or not being eligible for federal grants, or being unable to hire employees.  The cost of their standing on principle should ALWAYS properly be paid by the person doing so, and should not be shifted to their employer or their coworkers or their employees or their neighbors.

     

    I’m not much impressed by a  person or organization which claims a so-called *conscience right* to uphold a principle and at the same time insists they shouldn’t be penalized for it in any way and that all the cost, inconvenience and anguish that results can properly be inflicted on someone else.  It’s pretty easy to believe martyrdom is the moral choice if you know you’re not the person who’s going to die.

  • plume-assassine

    This is an excellent post, crowepps. You’ve identified exactly why it sounds hollow when people like waterjoe talk about defending their conscience. It is one thing to want to be exempt from anything they disagree with, but it becomes another matter entirely when they also want to penalize other people who may or may not participate in what they disagree with.

     

    I liked this especially:

    The cost of their standing on principle should ALWAYS properly be paid by the person doing so, and should not be shifted to their employer or their coworkers or their employees or their neighbors.

  • colleen

    Whether a person works for a particular organization is a choice.

    So when your current Pope joined the Hitler Youth and worked ‘supervising’ in a slave labor camp during WW2, that was a choice? I’ve always thought so. Apparently when the ‘conscience rights’ of social conservatives are expressed it’s always other people who need to suffer.

  • goatini

    and their Prez had a “revelation” that maybe the blacks weren’t all evil Lamanites.