Contraceptives, Catholics & Controversy: What's the Real Deal?

If you’ve caught the news in recent days, you’re probably wondering what’s going on with the issue of contraceptives and the Catholic Church. 

Here’s the deal:

One of the biggest goals of the Affordable Care Act -- aside from making coverage accessible to those who are currently shut out of the system now -- was putting a bigger focus on wellness and preventive care by giving everyone better tools to keep themselves healthy. 

That’s why the law made sure that all new insurance plans would cover preventive services for free -- with no cost-sharing or co-pays.

What qualifies as a preventive service? Who makes that call? 

The Affordable Care Act let doctors answer this question -- doctors from the national Institute of Medicine. The IOM recommended a full range of services they deemed to be essential preventive health benefits, including contraception and other services specifically for women. Those benefits included: screening for gestational diabetes in pregnant women for all women between 24-28 weeks of gestation, and for women at risk of diabetes at the first pre-natal visit, annual counseling and screening for HIV for sexually active women, comprehensive lactation support and counseling, and costs of renting breastfeeding equipment, screening and counseling for domestic violence for all women and adolescent girls,  and at least one well-woman preventive care visit annually for adult women. Read the IOM’s full report on recommended services for women, here. 

Other recommended preventive services, available to everyone with no cost-sharing under the Affordable Care Act include: 

Blood pressure and cholesterol screening, colon cancer screenings for adults over 50, depression screening, diet counseling for adults at risk for chronic diseases, and annual vaccinations like flu shots. For a complete list of covered preventive services for all adults, and children, see here. 

The Affordable Care Act protects women by making sure that they don’t have to give up important preventive care benefits over expensive co-pays or deductibles, or because an insurance plan doesn’t include contraceptive services. On average, birth control costs $600/year, putting it out of reach for women whose employers don’t cover it. 

Scientists have long documented the significant health benefits of contraceptives for women, which (for me, personally to treat polycystic ovarian disease) included preventing ovarian cysts and ensuring a healthy menstrual cycle. In fact, birth control is the most common medication in the country taken by middle-aged and young women. And polls show that a majority of Americans (55% -- it’s even higher among Catholics, 58%) agree that “employers should be required to provide their employees with health care plans that cover contraception and birth control at no cost.” 

In announcing the policy--and an exemption for churches and houses of worship--HHS Secretary Kathleen Sebelius noted that the rule is “consistent with the laws in a majority of states which already require contraception coverage in health plans, and includes the exemption allowing certain religious organizations not to provide contraception coverage.” The policy takes effect on August 1, 2012, when most new and renewed health plans will be required to cover these services for all women, with no cost-sharing. 

Unfortunately however, in our polarizing political climate, a policy that ensures all women are treated fairly and have access to important medical care -- and that a majority of Americans believe is the right thing to do -- is used as a wedge and a weapon to attack health care supporters and the Affordable Care Act. That’s what we’re seeing now. 

So let’s separate the overheated rhetoric from the commonsense reality:

1) Contraception is an important preventive benefit for women. Prevention saves money, it makes wellness a priority and it gives people the tools they need to stay healthy. Women are people, with different health needs, and those needs deserve equal attention. 

2) Churches and other houses of worship are exempt from the requirement to cover contraception in their insurance plans. Religiously-affiliated hospitals and universities -- which rely heavily on government funding, hire people from other faiths, and are subject to follow the same laws as other employers (i.e. child labor, workers compensation, etc) -- who choose to become employers, are treated the same as other employers who will have to cover the full range of recommended preventive services with no cost-sharing or co-pays under the Affordable Care Act.  

Here’s the exact definition of a “religious employer” used by HHS: An organization that meets all of the following criteria:

• The inculcation of religious values is the purpose of the organization.
• The organization primarily employs persons who share the religious tenets of the organization.
• The organization serves primarily persons who share the religious tenets of the organization.
• The organization is a nonprofit organization. 

Using that definition, you can see why a Catholic hospital or university, that both employs and serves people from lots of other faiths is rightly thought of as an employer, for legal and practical purposes -- just like other hospitals and universities. 

3) Half of all Americans live in the 28 states that already require insurance plans to cover contraception. Several of those states, including North Carolina and New York have an exemption for religious employers that is exactly the same as the one laid out by HHS earlier this year, while others, including Georgia and Wisconsin, have no exemption for religious institutions at all.

4) The Catholic Church has already allowed its own institutions to cover contraceptives in employees’ insurance plans -- most notably, the largest Catholic University, DePaul University in Chicago which offers contraceptive coverage to employees. 

Constitutional expert David Boies addressed this issue yesterday -- explaining it more clearly and simply than I could ever hope to, saying:

“You don't exempt religious employers just because of their religion. You are not asking anybody in the Catholic Church or any other church to do anything other than simply comply with a normal law that every employer has to comply with.”

Just like employees at Catholic hospitals and universities have to follow the rules of their workplace set by their employers, so too do their employers have to follow the laws that govern employment. This is one of them.

The First Amendment gives us the freedom to choose and practice our own religion, and to be free from someone else imposing their religious beliefs on us or forcing us to exercise their religious practices. This policy recognizes that fundamental American freedom, and makes sure that employees who work for religious institutions whose religious beliefs and practices may differ from theirs, can enjoy the same rights and protections as employees who work for other institutions. That’s what this is all about. 

This policy protects women, and it protects the conscience of religious employers who choose not to offer contraceptive coverage. It strikes an important balance between protecting the health of all women, regardless of their religious beliefs and the religious liberty of institutions. And it should not be used as a divisive wedge to advance a political agenda at the expense of our health.  

Do your part to shed some light on this issue. Share this information with your friends, and sign the petition showing your support for women’s health.