The U.S. Senate urgently needs to support legislation that would apply longstanding federal law on conscience protection to the Patient Protection and Affordable Care Act (PPACA), said the chairman of the Committee on Pro-Life Activities of the U.S. Conference of Catholic Bishops (USCCB).

In a February 15 letter to all Senators, Cardinal Daniel DiNardo of Galveston-Houston explained how the “Respect for Rights of Conscience Act” (S. 1476) is especially needed since a new mandate by the Department of Health and Human Services (HHS) will force almost all health insurance plans to cover all FDA-approved contraceptives, including drugs that can cause an early abortion, and sterilizations. Even many religious organizations will not be exempt from the mandate.

This rule, Cardinal DiNardo noted, was finalized on February 10. On the same day the White House announced it would develop a mechanism for applying the rule to non-exempt religious employers, claiming it would shift costs for contraceptive coverage to insurers.

“It is little or no comfort that, rather than being forced to propose such coverage, religious organizations will simply have it imposed on them,” Cardinal DiNardo said. “The argument that they will not really have to subsidize the coverage, because insurers will offer it ‘free of charge,’ runs up against the reality that this coverage will be integrated into their overall health plan, and subsidized with the premiums paid by employer and employee for that plan.”

He added: “The Administration’s rule makes no provision for the rights of insurers, even religiously affiliated insurers, but places responsibility for enforcing the mandate more squarely than ever on their shoulders. This is a radical departure from current law, under which a health plan that excludes contraception can be sold even to federal employees if the carrier has any religious objection to such coverage.”

Cardinal DiNardo outlined the scope of the proposed Senate bill, noting that it does not support discriminatory decisions to withhold basic coverage, does not free anyone from responsibilities under other state or federal laws, and does not allow anyone to deny coverage for high-cost treatments using morality and religion as a pretext.

Cardinal DiNardo explained what the bill does achieve: “It states that the new lists of mandated benefits for private health plans created under PPACA will not forbid those who provide, sponsor and purchase health coverage to negotiate a health plan that is consistent with the religious beliefs and moral convictions of those involved.”  Thus, he said, “it simply ensures that new requirements under PPACA are not used to take away a freedom of conscience that Americans have enjoyed under federal law until now.”

“If the needless dispute over this issue were resolved through this legislation, Congress and the Administration could return to the most pressing of all the real problems – the fact that many millions of Americans still lack basic coverage for health care that supports and sustains life,” Cardinal DiNardo said. “Let us begin the task by respecting each other’s values that call so many of us to work for life-affirming health care for all in the first place.”

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The United States Conference of Catholic Bishops (USCCB) have issued the following statement: The Catholic bishops have long supported access to life-affirming healthcare for all, and the conscience rights of everyone involved in the complex process of providing that healthcare.

That is why we raised two serious objections to the “preventive services” regulation issued by the U.S. Department of Health and Human Services (HHS) in August 2011.

First, we objected to the rule forcing private health plans—nationwide, by the stroke of a bureaucrat’s pen—to cover sterilization and contraception, including drugs that may cause abortion. All the other mandated “preventive services” prevent disease, and pregnancy is not a disease.Moreover, forcing plans to cover abortifacients violates existing federal conscience laws. Therefore, we called for the rescission of the mandate altogether.

Second, we explained that the mandate would impose a burden of unprecedented reach and severity on the consciences of those who consider such “services” immoral: insurers forced to write policies including this coverage; employers and schools forced to sponsor and subsidize the coverage; and individual employees and students forced to pay premiums for the coverage.

We therefore urged HHS, if it insisted on keeping the mandate, to provide a conscience exemption for all of these stakeholders—not just the extremely small subset of “religious employers” that HHS proposed to exempt initially.

The President has done two things.

First, he has decided to retain HHS’s nationwide mandate of insurance coverage of sterilization and contraception, including some abortifacients. This is both unsupported in the law and remains a grave moral concern. We cannot fail to reiterate this, even as so many would focus exclusively on the question of religious liberty.

Second, the President has announced some changes in how that mandate will be administered, which is still unclear in its details. As far as we can tell at this point, the change appears to have the following basic contours:

• It would still mandate that all insurers must include coverage for the objectionable services in all the policies they would write. At this point, it would appear that self-insuring religious employers, and religious insurance companies, are not exempt from this mandate.
• It would allow non-profit, religious employers to declare that they do not offer such coverage. But the employee and insurer may separately agree to add that coverage. The employee would not have to pay any additional amount to obtain this coverage, and the coverage would be provided as a part of the employer’s policy, not as a separate rider.
• Finally, we are told that the one-year extension on the effective date (from August 1, 2012 to August 1, 2013) is available to any non-profit religious employer who desires it, without any government application or approval process.

These changes require careful moral analysis, and moreover, appear subject to some measure of change. But we note at the outset that the lack of clear protection for key stakeholders—for self-insured religious employers; for religious and secular for-profit employers; for secular non-profit employers; for religious insurers; and for individuals—is unacceptable and must be corrected.

And in the case where the employee and insurer agree to add the objectionable coverage, that coverage is still provided as a part of the objecting employer’s plan, financed in the same way as the rest of the coverage offered by the objecting employer. This, too, raises serious moral concerns.

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