Dear President Obama,
I see that your Administration has just issued new rules in an attempt to appease me and all the other Americans who have concerns about your mandatory-contraception coverage. The formal fact sheet describing these rules says that you are accepting feedback through April 5. Perhaps something new will come up within the next two months, but I already have plenty of “feedback” for your consideration.
Your HHS Mandate, so called because the Department of Health and Human Services is implementing your “Patient Protection and Affordable Care” Act, rested on your conclusion that it was a matter of public health for women to be rendered chemically or surgically sterile for most of their reproductive years. This was so important to you, in fact, that you approved calling such practices “preventive” and making them available with no co-pay.
You cited advisors at the “Institute of Medicine” who concluded that it is much cheaper for women to be chemically altered than to have babies. Sterilization and abortion-inducing drugs made it into the Mandate as well. No corresponding concern for the cost savings attendant upon male contraception and sterilization made it into your guidelines for “preventive” services.
So, here’s my first concern as I contemplate your new rules: Your contempt for my religion still permeates your health care plan. It is a matter of deep religious belief for me that fertility is a gift, to be regulated by means consistent with human dignity, and at no point considered to be a public health problem. And if you call contraception “preventive,” then you are calling fertility a problem.
Second concern: Women aren’t broken and they don’t need fixing. If only you hadn’t called contraception for women a “preventive” service, we wouldn’t need to have this conversation. How ironic that an Administration that has claimed “being a woman shouldn’t be a pre-existing condition” has codified precisely the opposite.
Since contraception is a direct violation of Catholic teaching, the Mandate hit home for all the Catholic bishops in the United States. They spoke out with one voice. This is no small matter, since many people depend on Catholic churches and schools for employment and insurance coverage. Soon after the bishops cast a glaring light on the religious-liberty violation inherent in the Mandate, representatives of other faiths spoke up with the same concerns.
It took you several months, but your Administration started carving out exemptions. At first, your Mandate restricted the definition of exempt religious institutions to those that primarily serve people of that particular faith. Hospitals and schools that didn’t screen users for religious conformity didn’t count. You were quite justly criticized for attempting to tell the American people what a “religious institution” looked like.
Today’s new regulations appear to address that, sorta kinda. Instead of one executive agency (HHS) deciding what’s religious, you are turning the matter over to another executive agency, the IRS, that has been making that determination for years. The new regs also exempt non-profit religious organizations that meet four criteria, or jump through four hoops, to the satisfaction of whatever agency is going to implement this whole policy. Seldom do the American people have cause to be glad the IRS is going to define religion, but at least by bringing the tax people into it, you are making an effort at consistency.
But what about individuals? What about groups that do not hold themselves out to be “religious” but are nonetheless animated by a respect for life that makes the Mandate abhorrent to them? What about a business owner – someone who owns a hobby store, as an example – who has religious objections to providing contraception and abortion-inducing drugs by way of employee health insurance?
Third concern: Individuals have religious liberty AND conscience protection under our Constitution, and those protections are not forfeited when individuals form groups or run businesses.
Mr. President, maybe your own conscience dictates that contracepted women are good for public health, quite apart from what the Institute of Medicine tells you. Even so, your Mandate fails as valid public policy. Today’s rules might render moot some of the court challenges to the Mandate, but not all. It appears that your Administration will have to defend the proposition that in the name of public health, the First Amendment does not apply to individuals. That’s a tall order.
You could have avoided all this simply by declining to classify women’s induced infertility as a “preventive service.” You could have left alone the co-payments for contraception. Since you acted as you did, and since you are sticking to that, there is no way I can support the Mandate. I will do everything in my power to support legal efforts to overturn it.
With all due respect,
Ellen Kolb
This post first appeared in leavenfortheloaf.com.
Photo: Official White House Photo by Pete Sousa (Public Domain)