The birth control battles

Michael Gerson, a former speechwriter for President George W. Bush, has drawn a fair amount of attention for advocating “family planning as a pro-life cause.” His column Tuesday in The Washington Post praised the use of contraceptives in efforts to reduce maternal deaths in Africa.

“Support for contraception does not imply or require support for abortion,” he wrote. “Even in the most stringent Catholic teaching, the prevention of conception is not the moral equivalent of ending a life.”

What’s gotten less notice: an influential group of progressive religious leaders pushing back against insurance coverage for contraceptives in the health reform law.

A bit of background: Beginning next year, the health reform law will require insurance companies to cover preventive health services for women - including contraception - without a co-payment. That regulation also includes a conscience clause. Faith-based nonprofits that oppose contraceptives, and primarily employ and serve those of the same religion, can pursue an exemption.

Progressive, religious leaders contend that’s not enough. They want the conscience clause to be wider-reaching and not hinge on whom a religious institution employs or serves. That would likely allow Catholic universities and hospitals, which tend not to serve primarily Catholic populations, to qualify for the exemption.

Late last week, some of these leaders sent a letter to Health and Human Services Secretary Kathleen Sebelius, asking her to expand the conscience clause. The letter’s signatories included many Catholics who prominently supported the health reform law, including Democrats for Life executive director Kristen Day and former Democratic Rep. Kathy Dahlkemper.

They join the United States Conference of Catholic Bishops and Catholic Hospital Association, who have also been lobbying hard to expand this regulation’s conscience clause.

“I think anybody who works for Catholic institutions understands when they sign up to be part of an institution, there are certain values that’s organized around,” Catholic University of America’s Stephen Schneck, who organized the letter, told me. “They should have used that more expansive language, which would include organizations that are driven by the religious mission.”

Public opinion generally tilts in favor of insurance coverage for birth control -- two-thirds of Americans support that provision of the health reform law, according to a Kaiser Family Foundation poll.

That being said, even among some health reform supporters, contraceptives remain a thorny issue. It’s one that gets at “what counts as health care and what doesn’t count as health care,” Schneck said. “In our view, that definition touches on some religious sensibilities.”