As president of Heartbeat International, Peggy Hartshorn could face a moral dilemma if a provision of the new federal health-care law remains unchanged.
Under mandates adopted Aug. 1 for private insurance plans – and hailed by Planned Parenthood, which lobbied for them as “preventive services” – Heartbeat and other faith-based organizations with employee health-insurance plans will be required to provide full coverage for surgical sterilization and prescription contraceptives, including drugs that can cause abortions.
The mandates also affect hospitals, charitable institutions, universities, and schools with employee health programs — many of them religiously affiliated. Some plans initially will be grandfathered in, but eventually they’re expected to lose their exemption as changes are made to them.
Richard Doerflinger, associate director of the U.S. Conference of Catholic Bishops’ Secretariat of Pro-Life Activities, said the bishops’ employee plan, for example, can continue as is until significant changes are made. Ultimately, however, the intent is that every plan in the country must comply with the mandates, he said.
Furthermore, organizations that object to the requirements on religious or moral grounds can only be exempted if they are nonprofit organizations having as their purpose the inculcation of religious values — and only if they employ and serve primarily those who share their beliefs.
That would leave out an organization like Heartbeat, which provides pregnant women with alternatives to abortion, regardless of their religious beliefs.
“It’s almost no exemption at all,” said Matt Bowman, legal counsel with the Alliance Defense Fund (ADF). “It’s unprecedented in federal law to claim that almost no one is a religious entity. I think a lot of religious entities would be surprised to find that the Obama administration doesn’t think they are religious because they serve people who don’t have the same faith.”
Doerflinger agreed. “Only if you stop helping people are you considered religious enough to be exempt. It’s just the opposite of our notion of our faith.”
“What’s bothersome to me is this puts people in a Catch 22,” added Catholic League president Bill Donohue. “According to the wisdom of the Obama administration, because you’re not serving almost exclusively Catholic clientele, it’s a problem.”
Cardinal Daniel DiNardo, chairman of the bishops’ Secretariat of Pro-Life Activities, has called the mandates “a new threat to conscience,” adding that without sufficient legal protection for conscience rights, all Americans will be forced to carry health coverage that violates the moral and religious convictions of many.
Cardinal DiNardo is encouraging legislators to support the Respect for Rights of Conscience Act, introduced in the House by Rep. Jeff Fortenberry (R-Neb.) and in the Senate by Sen. Roy Blunt (R-Mo.). The bill would amend the Patient Protection and Affordable Care Act (aka ObamaCare) to protect conscience rights regarding mandates for coverage of specific items and services.
Doerflinger said the legislation provides that no mandates under the health-care act can be used to prevent insurers, purchasers or sponsors of insurance from negotiating a plan in accord with their moral or religious convictions. Currently, he said, any organization has the right to ask a private insurer to exclude certain things from coverage.
“All we’re doing is trying to maintain the status quo,” he said.
Heartbeat’s Hartshorn, a member of Legatus’ board of governors, said the mandates should have been expected given the views of President Barack Obama and Kathleen Sebelius, secretary of Health and Human Services.
“It’s very clear how strongly in the camp of Planned Parenthood and abortion providers Sebelius has always been,” Hartshorn said. “She is a major proponent of birth control and abortion. When she became head of Health and Human Services we expected the worst, so I shouldn’t have been surprised, but [the mandates] did take me aback.”
In announcing the new guidelines, Sebelius, who says she’s Catholic, called them “historic.” The mandates, she said, “are based on science and existing literature and will help ensure women get the preventive health benefits they need.”
However, Bowman countered, “Pregnancy is not a disease and these things are not preventive health care in the first place.”
Meanwhile, those who oppose the mandates have submitted comments to the Department of Health and Human Services (HHS) arguing for an expansion of the religious exemption. The department accepted comments on the definition of a religious employer in the new rules for a 60-day period that ended on Sept. 30.
Chuck Donovan, a member of Heartbeat International’s board and senior research fellow at the Heritage Foundation, said the HHS invitation for comment doesn’t necessarily suggest the department is willing to make changes.
“In fact,” he said, “the administration is doing other things to suggest that narrowing religious exemptions is their intent.”
ADF’s Bowman believes that forcing Christians and pro-life organizations to cover abortifacient drugs and devices over their objections would violate the Religious Freedom Restoration Act of 1993. In addition, he said, some of the contraceptives covered by the mandate, particularly ella, can cause very early first trimester abortions.
“Those were not supposed to be part of the health insurance overhaul,” he said.
Doerflinger said the USCCB contends that the mandates represent a violation of religious freedom as well as the Religious Freedom Restoration Act. Barring Congressional action, he expects Catholic organizations will challenge the mandates in court.
If the religious exemption is not changed, Doerflinger said an employer who objects to the mandates would find that all available health-care plans provide full coverage for contraception and sterilization. “So his choice would be between buying a plan that violates his values and no plan at all,” he said.
If he chose the latter, Doerflinger said, a fine would be imposed and employees would be directed to health-care exchanges where their only choice would be to buy a plan with contraceptive coverage. In that case, the employer who objected to such coverage on moral grounds would end up subsidizing the very same care through his penalty.
“At a time when tens of millions of Americans still don’t have basic health coverage, to be mandating that all plans have to cover these controversial elective procedures is a very skewed sense of priorities,” Doerflinger said. “Our position has always been that everyone must have access to basic health coverage. Nothing should take precedence over everyone getting access to basic life-affirming services. This certainly does not qualify.”
Judy Roberts is a Legatus Magazine staff writer.