Is pregnancy a disease? Should Catholics, purchasing insurance for themselves or their employees be forced against their consciences to subsidize its prevention?
These questions lie at the heart of new regulations just issued by the Department of Health and Human Services (HHS), which will administer President Barack Obama’s new health care law.
Ethics of reproductive health care
The regulations include a list of “preventive services” that all group health plans must provide without any co-pay. The list includes female surgical sterilization, plus all FDA-approved contraceptives, including some (like the prescription drug ella) that can act as abortifacients.
Recently I wrote about how the National Labor Relations Board has set itself to decide (sometimes in opposition to the Church) which universities are Catholic and which are not.
This new development asserts the primacy of the federal government in an equally sensitive area: the ethics of reproductive health care.
Narrow exemptions
Should a government that respects religious freedom require religious institutions to subsidize financially the modern American vision of what counts as “reproductive health”?
The new regulations provide an exemption for “religious employers.” But the exemption is so narrow that it excludes most people who might want to claim it.
First, it applies only to religious employers — institutions that are themselves religious. As such, individuals who own their own businesses and companies that are not church-related get no protection.
Second, it applies only to group health plans run by religious employers. It has no bearing on health plans that universities offer to their students.
Third, even in cases where it applies, the exemption is so narrow that even obviously Catholic institutions that are both religious and employers are not protected. HHS will require such institutions to meet a number of other conditions:
- They must exist for “the purpose” (my emphasis) of “inculcat[ing] religious values.”
At The Catholic University of America, we promote religious values in nearly everything that we do. But we also teach physics, mechanical engineering, finance, and the literature of Francophone Africa. Offering courses in those subjects, it seems, would disqualify us.
- Exempt organizations must also “primarily” employ and serve “persons who share the religious tenets of the organization.”
If this means that a school’s faculty and student body must be 51 percent Catholic, The Catholic University of America would pass the test. But many Catholic colleges and universities, and some elementary and secondary schools would not, nor would organizations such as Catholic hospitals and Catholic Charities that serve poor people without regard to their religious affiliation.
- HHS also says that, even if an employer inculcates religious values, and even if it employs and serves primarily co-religionists, it is still not exempt unless it is excused under the tax law from filing the Internal Revenue Service’s Form 990. That limits the exemption to churches, their integrated auxiliaries, and religious orders.
Safeguarding Catholic teachings
HHS has approached this question with the same narrow view of religion that the NLRB took in deciding to allow collective bargaining at Catholic universities.
Both agencies would reduce religion to prayer and liturgical rituals, activities that occur inside church walls. There is no acknowledgment that faith has a place in the world, that it informs our education, that it performs corporal works of mercy.
I have spent my first year as president of The Catholic University of America talking about how intellect and virtue are central to the idea of a Catholic university, and noting that it is part of our job as Catholic educators to teach our students to grow in both wisdom and grace.
Now the government is telling us that no matter what message we preach about contraception, sterilization, and abortion, we must provide these “preventive services” in our employee and student health plans, and ask the members of our community to subsidize them in the fees we charge.
In a nation where the free exercise of religion is supposedly sacrosanct, we may soon be left without the freedom to practice what we preach.
John Garvey is the president of The Catholic University of America in Washington, D.C.