House asked to extend conscience provision to HHS mandate

The chairman of the U.S. bishops' Ad Hoc Committee for Religious Liberty has urged the House of Representatives to extend long-standing federal conscience protections to the Affordable Care Act's new coverage mandates for private health plans.Archbishop William Lori of Baltimore made the request in a Feb. 15 letter to members of the House.Saying the tradition of conscience rights in health care "has long enjoyed bipartisan consensus, but is now under greatly increased pressure," Archbishop Lori asked in his letter to attach the conscience provision to upcoming appropriation bills for the departments of Labor and Health and Human Services."I urge Congress to address this problem when it considers proposals for continued funding of the federal government in the weeks to come," he said."While the mandate for coverage of abortion-causing drugs, contraceptives and sterilization is hailed by some as a victory for women's freedom, it permits no free choice by a female employee to decline such coverage for herself or her minor children, even if it violates her moral and religious convictions," Archbishop Lori added.He detailed precedents dating back 40 years on conscience rights in health care:— The Church amendment of 1973 to shield individual and institutional health care providers from forced involvement in abortion or sterilization.— A 1974 alteration to protect conscientious objection to other health services.— An opt-out from coverage of "abortion or other services" for those with a moral or religious objection in former Sen. Daniel Moynihan's failed 1994 health care reform bill.— A congressional exemption in 1999 for both insurers and federal employees with religious objections to contraceptive coverage in health benefits.— A 2000 appropriations provision instructing the District of Columbia to exempt those with moral or religious objections if it wished to approve a contraceptive mandate for its citizens.The 1999 and 2000 provisions have been renewed annually since."It can hardly be said that all these presidents and Congresses, of both parties, had been waging a war on women," Archbishop Lori said."I have seen no evidence that such laws, showing respect for Americans' conscientious beliefs, have done any harm to women or to their advancement in society. What seems to be at issue instead is a new, more grudging attitude in recent years toward citizens whose faith or moral principles are not in accord with the views of the current governing power."Archbishop Lori also asked for a protection in current appropriations talks that clarifies current nondiscrimination laws to improve protection of individuals and institutions that decline involvement in abortion, allowing the victims of discrimination to vindicate their rights in court.The amendment "places the Hyde/Weldon amendment, approved every year since 2004 as part of the Labor-HHS (Health and Human Services) appropriations bill, on a firmer legal basis by merging it with an older law against forced involvement in abortion training, the Coats-Snowe amendment of 1996," he said."The Obama administration has said it supports both these laws and President Obama has signed Hyde-Weldon into law several times since 2008," Archbishop Lori added. "We assume no one in Congress opposes the idea that people whose civil rights have been violated have a right to go to court. So this provision should be accepted without serious controversy."In his letter, Archbishop Lori also noted that in the new proposed rules issued by HHS Feb. 1 on the contraceptive mandate, the administration's definition of an exempt "religious employer" is briefer than its original four-part definition, "but the administration itself says it does not 'expand the universe' of those who are exempt."He noted that under the new proposal, insurers, individuals and families, nonprofit or for-profit organizations that are not explicitly religious, and third-party administrators who object to the contraceptive mandate on moral grounds will have it "imposed on them without any recourse.""I fear that the federal government's respect for believers and people of conscience no longer measures up to the treatment Americans have a right to expect from their elected representatives," he said. "It is most discouraging that this coercive element remains unchanged in the new notice of proposed rulemaking.”Catholic groups, bishops weigh in on proposed rulesOther Catholic leaders and institutions offered their comments on new proposed rules governing the contraceptive mandate. Issued Feb. 1, the new proposal attempts to accommodate objections raised by Catholic institutions, among others, that the exemption for religious employers was too narrow and that most would be forced to stop providing employee health insurance because they object on moral grounds to the requirement they cover contraception, sterilization and abortion-inducing drugs.The Catholic Health Association said the changes "are substantial progress" but it will continue to study them and work with its member hospitals, the leadership of the U.S. Conference of Catholic Bishops and the Obama administration "to complete this process."The Feb. 13 statement, issued by Sister Carol Keehan, a Daughter of Charity and CHA's president and CEO, said the group was pleased that HHS removed "three objectionable conditions" in defining religious employers — as groups whose purpose is the inculcation of religious values, who primarily employ persons of the same faith and who serve those of the same faith.The fourth criterion remains — what is a nonprofit organization under specific sections of the Internal Revenue Code. Employees of nonprofit religious organizations — such as many Catholic hospitals and universities — would have those services covered through separate insurance plans, and HHS says employers would not fund or administer these separate plans.No exemption, however, will be given to "for-profit, secular employers" whose owners have moral objections to providing the coverage.In an unsigned editorial in the Feb. 24 issue, Our Sunday Visitor acknowledged the clarification of what defines religious organizations but at the same time, it said, the "government has replaced these (criteria) with a very technical and very narrow definition of what is considered an exempt religious organization.""The bottom line is that instead of recognizing that this is a coercive and unnecessary overreach by the government to force Catholic organizations to violate their consciences or go out of business, the government appears to have doubled down," it said.In a Feb. 11 letter to diocesan employees, Bishop Blase Cupich of Spokane, Wash., said he was pleased HHS removed three of the four criteria for defining religious organizations and for providing "an alternative pathway of accommodation," which could provide religious organizations with the ability to "fully exercise their moral objections to providing contraceptives, sterilizations and abortifacients, while not breaking the law."He said in "many ways this is a positive development, but with documents of such complexity we need to give more and careful study to the details outlined in it."Bishop Robert Lynch of St. Petersburg, Fla., said in a Feb. 9 posting on his blog that the Obama administration has been "desirous of listening to and accommodating the concerns of Catholics" referring in particular to the changes in how religious organizations are defined."We still have time to work to smooth out some of the rough waters which lie ahead," he wrote, stressing that the bishops should collaborate with others on this issue.In its Feb. 13 statement, CHA said it welcomed "HHS' intent to protect eligible organizations from having to contract, arrange, pay, or refer for contraceptive coverage to which they object on religious grounds. HHS also proposes that these organizations will incur no liability for the failure of others such as insurance companies to provide such services. We are grateful for the simplicity of the self-certification process."It also said it is studying the proposed accommodation for "eligible organizations" that would apply "to our ministries" and emphasized its issues "as a ministry are narrower than the broader concerns" of the USCCB.Bishop Cupich in his letter to Catholics said the HHS's removal of the four-part definition of religious groups "has the potential of being a breakthrough moment" but he also said church leaders have to "better understand what is involved in granting some church institutions the exemption outright or by way of accommodation.""The critical issue is that we find a moral way forward so that health care coverage can be offered to our employees," he added."It will be important in the days ahead for lawyers and staffers of dioceses and the USCCB, of Catholic Charities USA, of the Association of Catholic Colleges and Universities, and of the Catholic Health Association to work together. Whether it is in terms of medicine or law, it is always prudent to seek unbiased second and even third opinions," Bishop Cupich said.All must "press forward to a solution, in a way that is respectful and forthright, but which is also aware that the lives and security of those who work for the church are at stake," he said.Bishop Lynch in his blog said the end result "is likely to be imperfect regulations drawn from imperfect legislation," but he is "grateful that more universal health care coverage will be the first fruit of the Affordable Care Act." He also added that he is "beginning to feel" that he can say to his diocesan self-insured employees "that their moral right to health care coverage will survive this moment."HHS is accepting comment on the new proposed rules until April. Final rules are expected by summer.—CNS{gallery width=100 height=100}gallery/2013/0222/mandate/{/gallery}