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GOP-supported provision would cut support for victims of domestic violence

The Washington Post A “Take Back the Night” rally in Portland, Maine. (Tim Greenway – AP)

Just days before the federal government would shut down for lack of funding, Republican members of the House tossed in an amendment to the spending bill that would not only delay implementation of the new health law known as Obamacare but also allow certain employers and insurers to opt out of specific provisions of the law based on moral or religious grounds.

Specifically, the continuing resolution says:

Section 2713(a)(4) of the Public Health Service Act (42 U.S.C. 300gg-13(a)(4)) shall not be effective for any period before January 1, 2015, with respect to the requirement for specific coverage for any sponsor of a group health plan (or, in the case of student health plans, the institution of higher education offering such plans), health insurance issuer, or individual opposing such requirement for coverage based on religious or moral objections.

In explaining his vote, Rep. Tim Huelskamp of Kansas said, “Also, I am excited that conscience protections have been added to the CR [the continuing resolution]. This provision is a victory for our religious liberty as guaranteed by the First Amendment. Unfortunately, under the guise of ObamaCare, the Obama Administration has consistently trampled on this fundamental constitutional right.”

(The Obama administration has made it clear that large employers that provide insurance coverage must include contraceptive coverage for free in their insurance plan or else pay a penalty. The administration has already granted an exemption for nonprofit religious organizations, churches, hospitals, and universities that object to the birth control provision.)

The ability to object to a provision on moral or religious grounds has many supporters.  The Catholic Church, for example, has been a vocal opponent of the requirement that people pay for birth control as part of their insurance plan. An order of Roman Catholic nuns, for example, is part of a class-action lawsuit filed last week challenging the requirement that contraceptives be included in their insurance plans. 

Not everyone supports the broad application of the so-called “conscience clause.” Also last week, the Obama administration asked the Supreme Court to review a 10th Circuit Court of Appeals ruling that a for-profit corporation can refuse to implement the birth control mandate on religious grounds.

While the provision that has garnered the greatest attention is the ability to drop coverage for birth control, an equally important provision would also allow insurance providers to drop coverage for a host of preventative services — including counselling and screening services for domestic violence — on religious or moral grounds. The timing of this ban on coverage for domestic violence counseling is particularly ironic given that October 1 is the first day of Domestic Violence Awareness Month.

In fact, it’s the catch-all nature of the ban on a whole host of preventative services — coverage for an annual wellness visit, services for pregnant women, screening for HIV and cervical cancer, as well as for domestic violence — that may be the most objectionable feature of the “conscience clause.” 

If coverage for birth control can be denied on religious or moral grounds, what’s to stop coverage from being denied for domestic violence counseling? What impact will that have on women who may be afraid to seek counseling?

As Carla Barnauckas wrote for She the People last week, “Silence allows sexual assault to thrive.” 

While the outcome is certainly unintended, allowing insurers to opt out from providing counseling and screening for domestic violence may be yet another way to keep victims of domestic violence silent.

Joann Weiner teaches economics at George Washington University. She has written for Bloomberg, Politics Daily, and Tax Analysts and worked as an economist at the U.S. Treasury Department. Follow her on Twitter @DCEcon.



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Casey Capachi · September 30, 2013

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