Catholic Institutions, Health Insurance, and Contraception

The Catholic Church takes as a matter of principle that the use of condoms, the Pill, and "abortifacients" such as the "morning-after" pill violates its fundamental religious beliefs. A ruling recently handed down by the Obama Administration says schools, hospitals, and charities run by the Catholic Church must provide health insurance to their employees which covers birth control — not to mention morning-after pills that some say can induce abortions, along with voluntary forms of sterilization such as vasectomies. Catholic bishops and other leaders of the faith have accordingly cried foul.

Secretary of Health and Human Services
Kathleen Sebelius

I must confess to originally having a tin ear for the bishops' complaints — yet the amount of opposition to the ruling by Secretary of Health and Human Services Kathleen Sebelius (herself a Catholic) has caused me to rethink.

I am not, I need to say here, a "cradle Catholic," but a convert from a culturally Protestant, but mostly secular, orientation. I know many Catholic converts are among the strongest supporters of official Church teachings, but I'm not necessarily one of them. When it comes to teachings concerning sexuality, marriage, and procreation, I'm usually on the other side of the fence from the Church hierarchy.

My ordinary tendency is to say that the Church-run institutions ought not to deny the affordable availability of commonly used contraceptive devices and pharmaceuticals to their employees. Many of their employees, after all, are not Catholic, and among those who are Catholic, the majority (according to widely known statistics) do use birth control. So what business do the bishops have insisting that the health insurance they provide to these employees must lack the relevant coverage?

As a "cultural Protestant" whose upbringing turned out to be much more secular that religious — I virtually never was taken to church during my childhood — I find myself initially more prone than many Catholics to agree with what Secretary Sebelius said in "Contraception rule respects religion" in USA Today:

Today, virtually all American women use contraception at some point in their lives. And we have a large body of medical evidence showing it has significant benefits for their health, as well as the health of their children. But birth control can also be quite expensive, costing an average of $600 a year, which puts it out of reach for many women whose health plans don't cover it.

Therefore, Secretary Sebelius is saying, all health plans — including those paid for by the Catholic Church for employees of its quasi-secular subsidiaries, such as schools, hospitals, and charities — need to cover contraception.

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But wait!

One of my best friends, a cradle Catholic and a Democrat who is a liberal on most religious and secular issues, tells me he thinks the Administration's ruling was a dumb move politically. Alienating a hefty slice of the Catholic vote in several crucial swing states could lose him the November election.

Mark Shields
on the NewsHour

Liberal political analyst Mark Shields, "speaking as a Catholic," said the same thing more forcefully on the PBS NewsHour last week, characterizing the potential "fallout" from the ruling as "cataclysmic."

Washington Post columnist Kathleen Parker — whose religion is unknown to me — writes in today's column, "Obama runs roughshod over religious freedom," that:

The new health-care reform act’s mandate that Catholic institutions pay for insurance to cover birth control and even abortifacient drugs ... runs deeply contrary to fundamental Catholic teaching. The argument that many Catholic women ignore this particular church commandment is a non sequitur. The church has consistently stood by this teaching. Catholics commit adultery and lie, too, but they don’t want or expect the church to condone those actions.

Post columnist Michael Gerson — again, I don't know if he's Catholic — has written, in "The poor pay the price for Obama’s politics":

... religious liberty is also popular, given the Constitution and all that. Even those who have no objection to contraception — the category in which I have repeatedly placed myself — can be offended when arrogant government officials compel religious institutions to violate the dictates of their consciences.

After making that point, Gerson adds that the real victims of the contretemps will be poor people, given that the Church may wind up with no option but to shut down schools, hospitals, and charities:

Take the case of one city: Philadelphia. There are about 2,000 such faith-based institutions, many of them Catholic. Replacing them [with secular initiatives] would require about a quarter of a billion dollars every year. Catholic Social Services helps more than 250,000 people a year in soup kitchens, shelters and centers for the disabled. Its Community-Based Services division runs adoption and foster-care programs, staffs senior community centers and supports immigration services. The Catholic Nutritional Development Services, working in partnership with public agencies, delivers nearly 10 million meals a year — accounting for about half of all meals delivered to poor children in Philadelphia in the summer months when school is out.

That's a practical argument that has to be accorded great weight, given that (per Parker):

Although Catholic churches and their direct employees are exempt from the new rule, all those other Catholic-sponsored entities, from schools to hospitals to charities that employ non-Catholics, have to comply or pay prohibitive fines. Estimates are that Notre Dame University, which hosted President Obama as commencement speaker in 2009 against howls of protest, would [alone] have to pay $10 million in annual fines [if it doesn't accede to the rule]. That’s some expensive birth control, baby.

But it's the abstract question of religious liberty in America, under the Constitution, that, I think, has to carry the day. The Church's stands against contraception and abortion are bedrock beliefs. They lie at the core of Catholic teaching. Under the Constitution, I think it an abuse of secular governmental authority to mandate that the Church violate its own beliefs.

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Why should we take the anti-contraception position of the Church as its bedrock belief? Ultimately, because the Church says it is.

I may disagree with what the Church says about contraception, but at the end of the day I have to uphold its fundamental "right to be wrong" on the matter.

I came into the Catholic Church after having made a temporary home a Protestant faith (I will be kind enough not to name it) that is very close to Catholicism from a liturgical perspective but whose teachings (especially about such hot-button issues as female priests and homosexual unions) seemed to be to increasingly built on quicksand. Never mind that I agreed with the liberals within the faith; I was at the same time appalled that the faith seemed to have no ironclad teaching authority, no magisterium, such that any liberalization of belief today couldn't be wiped out in a generation, or a century.

I decided I wanted to know absolutely what my faith's teaching was. I could then speak out against it, if I felt that to be necessary. Someday, there might be a formal process of change. If and when it came, it would be permanent, not built on quicksand.

So I gladly became a Catholic.

I joined a Church that treats its stand on birth control as bedrock belief. Paying for insurance coverage for contraception is accordingly forbidden to Church agencies, even though employees whose religious scruples oppose contraception would be free not to avail themselves of it.

By the way, I have not seen it mentioned, but what about the fact that Church employees likewise contribute their healthcare paycheck deductions into the same insurance pool? They themselves may decline to use condoms or the Pill, but others in the pool can draw their money for purposes of employing contraceptives. Not just the Church but to a certain extent religiously scrupulous employees of its quasi-secular agencies would thus be bankrolling a practice that is officially called sinful.

* * * * *

We have here a matter of grave principle. I am, I confess, very bad at matters of grave principle. I am a longtime proponent of "situation ethics." As such, I tend to feel nonplussed by appeals to moral and ethical absolutes.

Put more precisely, I want to know what the absolute no-no's are said to be ... then I want to be at liberty to break them and speak out against them, according to my personal conscience.

Right or wrong, mine is a complicated view that inherently demands balance. There must be an equipoise struck between absolute authority and personal conscience.

The ruling of Secretary Sebelius and the Obama administration, I now think, tips the balance too far in the direction of personal conscience. Yes, insured employees whose religious scruples oppose it remain free not to use contraception, even though it's covered under health plans they and their employer, the Church, pay for.

But, no, this ruling does not leave the absolute teaching authority of the Church in matters of faith and morals sufficiently unscathed. The Church says no to contraception in a way that does not permit it to accept the Sebelius ruling, period. If it caves in, it loses a crucial piece of its fundamental identity. That can't be right.

And so my initial reaction to the controversy, I now see, was wrong. I think President Obama and Secretary Sebelius need to reconsider, and sooner rather than later.