President Obama’s announcement of a modified policy on insurance and birth control satisfied some critics, like the Catholic Health Association, which said it was “very pleased” with the new arrangement. But other critics remain angry. The Conference of Catholic Bishops called the arrangement unacceptable. And Republicans were in high dudgeon all weekend, with Senate Minority Leader Mitch McConnell predicting on CBS “Face the Nation” that “the issue will not go away until the administration simply backs down.”
I have no idea whether the issue is about to go away but I don’t think the administration will back down. More important, I don’t think the administration should back down, because this isn't about religious freedom anymore.
From the get-go, I have supported making birth control coverage a mandatory part of insurance, with exemptions only for plans provided by churches. But, as readers of this space know, I also thought the critics speaking out against that policy last week made some reasonable points. Improving access to birth control is important, but so is respecting the wishes of religious leaders who felt that paying for birth control would violate the tenets of their faith.
The scheme Obama outlined on Friday should accomplish that. Because providing birth control saves money, insurers who administer plans should be able to cover the upfront costs without drawing on funds directly from employers. Yes, the arrangements will be complicated. (I still believe the simplest method would be to pay the upfront costs of contraception with funds taken only from employee contributions.) But it’s doable and I’m convinced the insurers will find a way to do it.
In addition, Obama and his advisers have said that employers won’t even be responsible for notifying employees of the option of contraception coverage. Insurers will do that on their own. This is different from the Hawaii system, as I understand it, and should satisfy religious organizations whose objections are to paying directly for contraception coverage or taking an affirmative step so that employees could get it.
But some critics are still not satisfied. They say the only solution is to eliminate the requirement altogether, so that birth control coverage is no longer mandatory for any private insurance policy. Already, two senators, Roy Blunt and Marco Rubio, have introduced bills to accomplish that legislatively. And it’s consistent with the Bishops’ position, which opposes any contraception requirement because “all the other mandated 'preventive services' prevent disease, and pregnancy is not a disease.”
No, pregnancy is not a disease. But pregnancy is a medical condition, one with profound and pervasive effects on health. (Any woman who has been pregnant will surely attest to that.) What’s more, effectively planning the timing of pregnancy is possible only with use of birth control. And the most reliable forms of birth control are the ones that physicians provide, sometimes at considerable expense.
That is one big reason why the Obama Administration, acting on the recommendation of the Institute of Medicine, has decided to include birth control on the list of preventative treatments that insurers must cover without cost-sharing in the nation's new universal health care scheme. The Bishops’ position, which the Republicans have now adopted as their own, is that religious leaders have the right to override that decision, even though it will affect employees who have no moral or religious qualms about birth control. Writing in Newsweek, Andrew Sullivan captured the Bishops' thinking perfectly: "Catholic doctrine should, according to the bishops’ spokesman, also apply to non-Catholics."
Again, I have no idea how this plays politically – although, like Ed Kilgore and Greg Sargent, I think the Bishops may be isolating themselves by taking up a position that, according to the polls, even most Catholics oppose. But the principle seems pretty clear to me.
The Bishops want a veto over public policy. And the Republicans want to give it to them.
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