When Congress enacted health-care reform, it left to the Department of Health and Human Services (HHS) the job of determining which preventive services for women insurance plans would be required to include. In August, the administration announced interim rules requiring coverage for contraceptive services without co-pays or deductibles. It provided an exemption from this requirement to “religious employers,” but the exemption was so narrow that it largely left out Catholic hospitals, universities and other church-affiliated institutions.
Although this was only an interim rule, the U.S. Conference of Catholic Bishops immediately denounced it, and Catholics who had supported the health-care law were taken by surprise. It’s astonishing that the administration acted without closely consulting Sister Carol Keehan, the brave president of the Catholic Health Association who backed the health-care bill despite the opposition it drew from the bishops’ conference. Her support — along with help from other social-justice Catholics such as Sen. Robert P. Casey Jr. (D-Pa.) — was crucial to getting the law through.
If HHS had offered a broader religious exemption from the outset, President Obama could still have boasted of having achieved the largest expansion of contraception coverage in the nation’s history. Yet in moving now toward correcting its initial mistake, the administration has set off an uprising among reproductive-rights groups who accuse it of caving in to the Catholic bishops. They demand that the original rule stand.
Right-wing bishops aren’t helping the cause of compromise with their incessant charges that the Obama team harbors an anti-Catholic animus. This view gained ground when the administration ended a grant to the bishops for a program assisting the victims of human trafficking because it did not provide contraception and abortion referrals. Stopping that funding was a mistake, but the White House has reason to bridle at allegations of anti-Catholicism, given how much it has actually increased financing for many leading Catholic groups.
Administration calculations show, for example, that federal funding for Catholic Relief Services went from roughly $198 million in 2007 to $362 million in 2010. Catholic Charities affiliates have seen an increase in federal help of more than $100 million since 2008. The polemical overkill on the right end of the bishops’ conference is not justified and only feeds a belief among Democrats that compromise with the church is pointless because the most conservative bishops will continue their attacks no matter what Obama does.
But the question of what a fair and principled compromise would look like on contraception and the health-care law should not be lost in the political maelstrom. Even an expanded exemption covering Catholic hospitals and universities would still go far beyond what the bishops have called for, as Cardinal Daniel N. DiNardo, chairman of their Committee on Pro-Life Activities, made clear in a September statement opposing mandated contraception coverage altogether.
Far from constituting a “cave-in” to the bishops, in other words, a broader exemption would be a modest concession, honoring the rights of religious institutions that liberals and Obama have long respected. And as Sister Carol noted in an interview, “we’re not talking about taking away from women anything they have,” since Catholic institutions that don’t cover contraception now wouldn’t cover it in any event.
Catholic bishops need to lower the rhetorical temperature — as the head of the conference, Archbishop Timothy Dolan of New York, seems to be trying to do. Advocates of reproductive rights need to do the same.
If the administration is pressured into refusing any accommodation on the contraception rules, the people who will be undercut most are progressive Catholics who went out on a limb to support the health-care law and those bishops holding the line against the Catholic right by standing up for the church’s commitment to social justice. This will only strengthen the most conservative forces inside the Catholic Church. That can’t be what advocates of reproductive rights really want.