Most Americans can hardly believe we’re having a national debate about birth control in the 21st century — more than 50 years after the Pill became available and decades after condoms became as commonplace as, well, balloons.

The reason for the incredulity is because we’re actually not having a debate about birth control. To repeat: The debate is about freedom of conscience. It ain’t about the Pill.

This particular episode is significant because the Obama administration has provided the narrowest conscience protection in our nation’s history, according to legal experts who are challenging the administration’s rule. We have a long tradition in this country of working around religious differences so that people are not forced to violate their faith to satisfy a secular mandate. This is the essence of the debate.

To women who merely want help paying for birth control, this may seem an obnoxiously silly discussion. Noted. But the larger issue is worth paying attention to even at personal inconvenience. That inconvenience, by the way, needn’t be permanent. The immediate problem of providing birth control to those who can’t afford it can be massaged — for instance, the government can hand out contraceptives to the poor, as is already the case in some states. But the issue of religious liberty is one of those foundational principles that isn’t really up for revision.

As to the separation of church and state argument that church critics keep raising, keep in mind that this separation was also intended to protect religious believers from state interference. When the state insists that one’s religious beliefs be supplanted by another’s, in this case by secularism, then might one argue that the state is establishing a religion in contravention of the Constitution’s intent?

The new health-care reform act’s mandate that Catholic institutions pay for insurance to cover birth control and even abortifacient drugs (a.k.a. “morning-after” pills) 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.

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 have to pay $10 million in annual fines. That’s some expensive birth control, baby.

And we’re talking billions of dollars’ worth of lost services to the poor if Catholic charities shut down, as well as educational chaos, especially in inner cities where Catholic schools often provide the only stability in poor children’s lives.

Whatever the odds are that the church may change its position on contraception someday, it won’t be soon. For now the bishops are promising a fight to the end. It’s that important to them, a fact of which Obama was well aware. Catholic leaders are justified in their outrage, especially those who helped Obama with health-care reform and now feel betrayed.

Exhibit A: Sister Carol Keehan, CEO of the Catholic Health Association, who supported the health-care act with assurances from Obama that Catholics’ rights of conscience would be protected, despite criticism from many other Catholic leaders. She has now met the crowded underside of Obama’s bus.

Exhibit B: Archbishop Timothy Dolan, who had a private meeting with Obama in November, after which he said he was hopeful about the final rule. Headlines to that effect unleashed Planned Parenthood’s public relations whirlwind, prompting blog headlines such as “Will Obama cave to Catholic bishops?” Apparently not.

Obama’s calculation must have been that there are more women who want insurance coverage for birth control than there are obedient Catholics. Although Obama won with 54 percent of the Catholic vote last time, he may have miscalculated. Women are not a monolithic vote, and even though some Catholic women may disagree with the church, they still love and respect it and how it serves the poor. They may like Obama, birth control and Democrats, but they don’t want to see their church beaten up.

These are tough, emotional issues, to be sure. But consider that we allow even Nazis to march because we believe so fervently in freedom of expression. We should believe at least as strongly in freedom of conscience, not only for Catholics’ sake but also for our own.