There has been some talk lately—though not nearly enough—about the new healthcare mandate authored by the Institute of Medicine (IOM) and promulgated by the U.S. Department of Health and Human Services (HHS). This mandate, with the deceptively benign title “Guidelines for Women’s Preventive Services,” is set to go into effect in August 2012 as part of the Affordable Care Act. That means it will become law without going before the legislature. And if it does, starting a year from now, all healthcare plans will be required to cover a variety of “treatments” that many Americans find objectionable, and Catholics particularly find morally unacceptable.
For example, under the heading of “contraceptive care and counseling,” the guidelines will require healthcare plans to cover all FDA approved contraceptives. This list includes extremely controversial drugs like Plan B and “Ella,” which can act as abortifacients, as well as voluntary sterilization—not to mention counseling in favor of such “treatments.” Neither the IOM, which allegedly provides “unbiased and authoritative advice,” nor the HHS specifies exactly which “illnesses” are being treated, leaving one to assume that pregnancy and fertility are now considered threats to women’s health—but don’t worry: the HHS assures us that the guidelines “are based on scientific evidence.”
However, most Americans are overwhelming opposed to the federal government requiring them to pay for such services. This is perhaps because they understand that these so-called “health services” are elective and that pregnancy and fertility are not diseases that must be prevented or cured.
The main criticism of the mandate is that it offers a conscience exemption that excludes Catholic institutions from participating in and serving the larger culture. Specifically, the mandate exempts religious employers, which it defines as follows: “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 section 6033(a)(1) and section 6033(a)(3)(A)(i) or (iii) of the Code.”
This definition is so narrow that it excludes almost all Catholic institutions as they now operate. The conjunction, “and” before the fourth article ensures that almost no religious organization satisfies the criteria; “or” would have been limiting, but “and” is crippling. Catholic hospitals, schools, and charities do not serve primarily Catholics, they serve everyone; there is no baptismal requirement to receive services from Catholics. We do not serve people because they are Catholic; we serve people because we are Catholic. And the same goes for members of other religious groups.
The IOM, HHS, and the president fundamentally misunderstand the aim of religious institutions and the role they play in our society: at its core, this mandate is an assault on the First Amendment’s “free exercise” clause. Catholic employers would no longer be free to serve or employ non-Catholics, except at the cost of violating deeply held and reasoned moral and religious convictions about human life and dignity. But then, not serving our neighbors also violates deeply held and reasoned moral and religious convictions about our mission to serve others. Thus, by providing only two equally unacceptable and offensive options to Catholic teaching, the mandate de facto prohibits the free exercise of the Catholic religion.
The HHS, led by the pro-abortion Kathleen Sebelius, and heavily supported by Planned Parenthood and NARAL, is putting the Catholic Church between a rock and a hard-place. Indeed, this mandate directly and unabashedly lays the groundwork for the creation of a Catholic ghetto. It would force Catholics to serve primarily other Catholics, thus removing the overwhelmingly positive influence of Catholic charities, social services, hospitals, and schools on the broader culture.
The impact of Catholic institutions currently far exceeds the number of Catholics in America; Catholic hospitals, for instance, took well over 100 million visits and admissions in 2009, while there are just over 68 million Catholics in America. The doctors, nurses, and staff at Catholic hospitals are not primarily Catholic, and most importantly, the patients are not primarily Catholic. Catholic Charities USA, one of many Catholic charities, alone served almost 10 million people in 2009; the US Conference of Catholic Bishops oversees the federal program to serve victims of human trafficking and sex slavery; the list goes on—and none of these services “has the inculcation of religious values as its purpose.”
The actions of the administration would drastically reduce the number of people receiving aid from Catholic institutions, effectively forcing more people to go without aid, or to seek aid from state subsidy, thus increasing the tax burden on those who pay for such subsidies, and effectively reducing the role of faith in our communities, while denying many people basic services.
The actions of the administration are in keeping with the prevailing secularist ideology: religious beliefs, practices, and institutions are seen as essentially private matters, best kept out of public discourse and away from the public sphere. While I have focused here on the Catholic Church, this mandate would affect not only the Catholic Church, but every church, every religious community, every individual believer. It must be opposed.
Christopher T. Haley is a Research Fellow at the Dietrich von Hildebrand Legacy Project.
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