Holy Matrimony: Catholic Institutions and The Fight For Birth Control Coverage

Late last month, the U.S. Department of Health and Human Services, backed by the Obama Administration, announced that all health insurance providers were required to include prescription birth control in their preventive health coverage. Kathleen Sebelius, who was still suffering major criticism for her December Plan B decision, decreed that all health insurance providers must give women access to preventive care services, as well as birth control, with the exception of houses of worship. As you can imagine, the decision has not been received easily.

Religious groups and institutions, predominantly Catholic universities, hospitals, and non-profits, decreed the decision as an infringement upon their 1st Amendment rights and an all-out threat to religious freedom, citing reasons from religious oppression to what “true” Catholics do and do not do. The mandate got even more flack as Florida Senator, Marco Rubio, introduced a bill aptly named The Religious Freedom Restoration Act, that is intended to roll back the decision. From Nick Baumann at Mother Jones:

…the bill would allow any institution or corporation to cut off birth control coverage simply by citing religious grounds”¦ It has 26 cosponsors in the Senate; a similar proposal sponsored by Rep. Jeff Fortenberry (R-Neb.) has 148 cosponsors in the House. On Wednesday, Speaker of the House John Boehner (R-Ohio) vowed to repeal Obama’s rule, and Sen. Mitch McConnell (R-Ky.) pointed to Rubio’s bill as a potential model for doing so.

In English, this means that no entity has to cover birth control in a health plan if it can point to a religious reason for not doing so. And the entity itself is not required to have any religious affiliation. It could just be a plain old corporation. That means that if the middle-aged white guy who runs your company is religiously opposed to birth control, he can have it stripped out of your insurance plan–even if his Viagra is still covered. You could wake up the next morning and find you’re paying full price for drugs that you once got for free or at much-reduced prices.

Republican leaders who have already been warned by several GOP members to “back off” the fight on birth control have now found a fresh wound to react off of. House Speaker John Boehner called it “an unambiguous attack on religious freedom,” though to say that it is only GOP members is daft. House Democratic Caucus Chairman John Larson, Senator Robert Casey, and Senator Joe Manchin, all Democrats, have banded together with members of the GOP to reverse the policy.

But the ensuing backlash is not without a fight. It was reported by USA Today that more than “600 physicians and medical students from 49 states” signed a letter to both Obama and Sebelius urging them to protect the recent mandate. Other proponents of the measure (shockingly women) like Rep. Lois Capps were quick to point out that 28 states have similar plans for birth control coverage and Rep. Jan Schakowsky noted that the “religious based exception” would affect staff who are not Catholic yet work within Catholic institutions. “Women’s health care should not depend on who the boss is,” stated Schakowsky. “The idea that birth control could be controversial in 2012 is outrageous.”

What the opponents of the coverage seem to be forgetting is that no one is forcing them to take birth control, but only mandating that they allow access and coverage to what the Health and Human Services Department deems as a “preventative service.” To also assume that all Catholics are the same and therefore do not want birth control under the banner of Catholicism being a “pro-life” based religion is to deny more than half of Catholic identified persons access to a necessary service. According to The Public Religion Research Institute:

  • Roughly 6 in 10 Catholics (58%) believe that employers should be required to provide their employees with health care plans that cover contraception.
  • Among Catholic voters, support for this requirement is slightly lower at 52%.
  • Only half (50%) of white Catholics support this requirement, compared to 47% who oppose it.

From The Guttmacher Institute:

  • Among all women who have had sex, 99% have ever used a contraceptive method other than natural family planning. This figure is virtually the same among Catholic women (98%).
  • Among sexually active women of all denominations who do not want to become pregnant, 69% are using a highly effective method (i.e., sterilization, the pill or another hormonal method, or the IUD).
  • Some 68% of Catholic women use a highly effective method, compared with 73% of Mainline Protestants and 74% of Evangelicals.
  • Only 2% of Catholic women rely on natural family planning; this is true even among Catholic women who attend church once a month or more.
  • More than four in 10 Evangelicals rely on male or female sterilization, a figure that is higher than among the other religious groups.

“We certainly don’t want to abridge anyone’s religious freedoms,” said Obama advisor, David Axelrod on MSNBC. “We’re going to look for a way to move forward that both provides women with the preventative care that they need and respects the prerogatives of religious institutions.” But here’s the thing. No one’s religious freedoms are being impeded. Institutions are only required to give access to the care, not to prescribe it. However, the logical measure is clearly not enough, and earlier this week, Obama announced that a “compromise” would be coming based on the recent push-back from critics. White House spokesman Jay Carney recently said at a press conference “There are ways to approach this that would ensure that the rule is implemented so that women have access to these important healthcare services no matter where they work, but also hopefully would allay some of the concerns.”  What was intended to be a measure in providing accessible reproductive healthcare has now just become as Alternet’s Adele M. Stan’s described “presidential politics of contraception”:

Everywhere you look, birth control is under attack, most notably by all of the candidates competing for the Republican presidential nomination. To advance the cause, the candidates are allied with the United States Conference of Catholic Bishops, which has cleverly framed its war against women as an issue of religious freedom–a talking point that the candidates, especially frontrunner Mitt Romney and the second-place Newt Gingrich, have jumped on”¦ At a deeper level, though, the appropriation of the bishops’ position by the Republican candidates is the full-flower expression of what might be called the Romanizing of the Protestant right–a cross-pollination of convenience between historically opposed factions of Christendom, a phenomenon that has unfolded with little fanfare over the course of the last three decades.

Are we really so surprised, though? How could we be? Even the most basic attempts at providing access to reproductive healthcare are vilified as attacks on personal liberty and belief, many opponents citing that “the government need not be in personal business,” and yet, I can’t help choke on the sheer obtuse, hypocritical audacity of such a woodenhead, simple, and ill-informed statement, when at this very moment, those who use this sentiment are the same people who are lining up to do anything and everything to cut off access to abortion and Plan B. In other words, it’s all a sick joke. Reproductive access and healthcare in this country is a terminal joke, a constant playing chip in the morality as politic as privacy issue that remains almost always in the deciding hands of out of touch, fatuous, straight, white, male power figures who are nothing if not masking their thinly veiled contempt for the dying “good ole days” where reproductive access was something of an anomaly.

So forgive me if I sound “simple” when I believe advice columnist Dear Coke Talk describes it best when she says:

Here in America, only the creepy Jesus freaks think their religious doctrine supersedes a woman’s reproductive rights, and now that they can’t openly legislate their way into your uterus, they’re gonna find whatever bureaucratic back door they can to defund and dismantle the safe and legal family planning services that currently exist.

Because in the end, that’s all it’s really about.

[Update: This morning, The White House announced that  contraceptive coverage is to be offered directly from insurers, issuing this statement: “Under the new policy announced today, women will have free preventive care that includes contraceptive services no matter where she works…If a woman works for religious employers with objections to providing contraceptive services as part of its health plan, the religious employer will not be required to provide contraception coverage but her insurance company will be required to offer contraceptive care free of charge.”]

36 replies on “Holy Matrimony: Catholic Institutions and The Fight For Birth Control Coverage”

Either way would work, so long as they figure out a way to pay for it without cutting more funding to physicians or raising taxes on people who can’t afford them. And figure out a way to take patient compliance into reimbursement funding. That drives me up the wall. But that’s a completely different issue.

Because my brother is not a P-Mag reader but I thought it was a brilliant insight, here is his thought: “I don’t see why religious institutions are so insistent against having to provide contraceptives to their employees, considering that if their employees were truly righteous they wouldn’t even ask for them. Do they have such little faith in their church community?”

Technically, if you are employed by a church or house of worship, they can still deny paying for the birth control. This whole debacle is centered around whether or not Catholic hospitals and other religiously affiliated businesses should be required to provide birth control coverage just like every other secular institution. It’s a debate about whether or not religion should be allowed to override the law (and I think we can all agree that that should not be allowed). These institutions are not allowed to discriminate based on religion in the hiring process, just like every other secular business, and because of that, not everyone working at a religiously affiliated business is of the same religion. So while I like your brother’s logic, it doesn’t entirely apply in this case.

Also, recruit your brother!

No, he was more speaking in general of the whole debate around religious groups and birth control; while it isn’t specifically aimed to the exception being made, I thought it was still a relevant point. I do know the laws re: workplace discrimination (I’m an HR management doc student), and the issue surrounding religious discrimination in religion-based companies is one of the most frustrating debates I have with people. I cannot count how many times people have said to me Chick-Fil-A (for example) should be able to hire Christian staff only, because they’re a Christian organization, and I am just like, “Do you even understand the words coming out of your mouth?” Being atheist does not hinder your ability to work a cash register! I can’t even.

Spot freaking on. You should write an article about that since you probably have way more knowledge about the topic than most. And then I just link people to that article any time I get into that argument (which happens more often than you would think in Canada).

Actually, a general article about hiring and discrimination would be kinda great.

I can’t decide if the compromise is the most brilliant or infuriating thing I’ve ever heard of. Let’s face it, insurance companies don’t give away anything for free. Hell, they barely pay for the stuff they have to pay for. All this means is that the “free” birth control will just be figured into the base price but not actually written into the policy. The religious leaders who are raising hell over this are either so stupid they don’t realize they’re getting played, or they’re such hypocrites that they know and don’t care because now they can crow about how they “won.” It’s a bullshit technicality, but at least people can get the prescriptions they need.

And the whole “people can just work elsewhere if they want their bc covered” argument is bullshit. It reeks of the Ron Paul line about how sexual harassment victims should just quit their jobs. The city I grew up in had two hospitals, one Catholic and one Baptist. If you were a doctor or nurse and wanted to work in a hospital, you had to work for a religious institution. And what about the janitors, groundskeepers, admin staff, etc? Fine, if you get offered a professorship at Notre Dame you can probably afford the full prescription price, but in many towns there are a lot of jobs that are affiliated with churches or religious institutions and that don’t pay any more than the non-church jobs. It’s hard enough to find a job these days without eliminating huge swathes of the available positions because you don’t share the religious beliefs that 98% of American Catholic women don’t even follow!

Thanks to Obama’s compromise, this shouldn’t be an issue – insurance companies are now mandated to cover contraceptives if an institution owned by a religious organization opts out. It sounds as though many women’s health advocates are happy with the compromise. However, I disagree with your contention that the original mandate was unconstitutional. You said that the language of the bill violates the First Amendment; for reference, the ‘religion clause’ of the First Amendment states that “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof.” The definition of ‘religious employer’ used by the Department of Health and Human Services covers that base quite thoroughly (from

Consistent with most States
that have such exemptions, as described
below, the amended regulations specify
that, for purposes of this policy, a
religious employer is one that: (1) Has
the inculcation of religious values as its
purpose; (2) primarily employs persons
who share its religious tenets; (3)
primarily serves persons who share its
religious tenets; and (4) is a non-profit
organization under section 6033(a)(1)
and section 6033(a)(3)(A)(i) or (iii) of the
Code. Section 6033(a)(3)(A)(i) and (iii)
refer to churches, their integrated
auxiliaries, and conventions or
associations of churches, as well as to
the exclusively religious activities of
any religious order. The definition of
religious employer, as set forth in the
amended regulations, is based on
existing definitions used by most States
that exempt certain religious employers
from having to comply with State law
requirements to cover contraceptive

(See also The key point here is that when the employees of a given institution are not there to further a religious cause, it is unfair and arbitrary to restrict their healthcare access based on the employer’s religion. My biggest problem with your argument is that it says that an organization has the right to infringe upon the bodily and reproductive autonomy of individual women. Freedom of religion is impossible without freedom from religion.

I find it utterly bizarre seeing contraception being so … restricted. But I guess that’s the whole outside-looking-in part at play, being in a country where contraception is free and easily available. Very, very interesting article though – thank you!

Honestly, I’ve been following this very closely, and not because of my deep Catholic roots or my belief that all women should be able to get cheap birth control. I’ve been following this because the way this bill is worded and how it is directed (until the change this morning which I’m still researching) greatly effects Constitutional rights.  Freedom of religion is a first amendment right, and if those rights are in order of importance, then it’s one of the most important, right up there with freedom of speech.

So I see a problem with the mandate as a means of limiting rights, and frankly, I’m tired of the government taking away my rights even just a little, and even if it only tangentially effects me. There are other ways of getting birth control without insurance and without your employer having any say in it. So why force religious institutions to do something against their beliefs? And yes, I think it should be worded so that only religious institutions could get away with that because then the person has clearly and knowingly aligned herself with a job that wouldn’t provide birth control.

Because to me both the rights of the woman and the Church are important. Neither more so than the other because I am both very Catholic and a woman. I wouldn’t change either aspect of my life. But they don’t have to conflict, and they don’t have to be mutually exclusive.

I think my other disagreement with your point is that I see this as a protection of rights rather than an infringement upon them.  If I’m hearing you correctly, and please correct me if I’m not, your concern is with the rights of the religious institutions.  My concern is with the individual rights of the women who are employed by them.

I find it highly amusing that the same people who want religious exemptions for providing birth control are also the same people who want to defund groups like Planned Parenthood. So your proposal that women can just go to free clinics to access healthcare? That’s under threat as well.

And I don’t think it should be. Hell, my Catholic church back home has a fundraiser for Planned Parenthood every year, so please don’t just lump all religious groups together because some do support it. I just wish that every group could respect each other’s views and work for a common good without trying smother each other. That’s my ideal.

You have to scream loud to be heard above the stupidity. It’s hard not to lump religious institutions together when, typically, we only hear from the idiots. I feel that lumping all Catholics together to say that they object to the coverage of birth control is exactly what you are doing in saying that they should be exempt. According to recent polls, 58% of Catholics support providing access to birth control through religiously affiliated institutions.

And I personally do not feel every viewpoint is valid. Opinions are not all created equally. The person who believes that people should not be able to control their own bodies does not get the same respect as a person who respects body autonomy. And a group of people that believe that their religious doctrine should be allowed supersede the law of the land does not get respect from me.

I understand where you are coming from on this, Veruna, as I was raised Catholic myself.  However, the way I read the rule, it meant that the businesses affiliated with the Catholic church–like hospitals and schools–would have to abide by this and provide the birth control.  It is a very sticky situation because while religious rights must be respected, these are businesses operating in the United States and they are bound by the same laws as a secular business.  Providing for different levels of care to women and men based on gender is, in my mind, quite discriminatory.  I think the Obama administration came up with a very creative way to get around it, but at the same time, if the Church wants to keep operating businesses in the United States, it needs to understand that it has to follow the laws just like any other business does.

But what happens to people who work at religious institutions who aren’t of that religion and do not have a choice in perhaps switching jobs or even having a limited pool? Especially universities or hospitals. Also, why are the decisions being made by the people who don’t need birth control in the first place? No one is impeding your rights by making you sign a clause in your insurance policy that offers to cover birth control, which many Catholic women use.

No one should be forced to take birth control. But to not offer access to it as a preventative health service seems to me to be just another way to chip away at women’s reproductive care or hell, even health care as many take birth control to alleviate fibroids, high blood pressure, and multiple other ailments.

The Catholic church is too large of an institution with a record of being unfriendly to women and political ties to many organizations that are unfriendly to women. If anything, it pisses off Catholics who use birth control or think people should have access to birth control. Its one thing to believe that you should not make a personal decision, its another to have an institution make that personal decision for you. Do I think this decision reflects on Catholics? No. I think individuals should do whatever they want, believe whatever they want, and take birth control if they want. But to make a decision for all that cuts off access -just access-to affordable birth control reads as nothing but manipulative to me.

My problem isn’t with religious organizations providing birth control. My issue is with the freedoms being removed. My problem is with the precedence this can set for other amendment rights. I think this bill has the best intentions, but I don’t think it is worded properly or has considered possible repercussions for the future.  I don’t want to turn around one day and not be able to carry concealed because of preventative methods. I don’t want to have my games censored to keep them from making kids violent.

In other words, I’d rather have smaller government interference in many realms.


Edit: I don’t mean to be provocative or rude; I just wanted to share how I feel too.

You aren’t being provocative or rude, but I’m just having a hard time following your logic. If you are concerned about freedoms being removed, why concentrate on a mandate that provides access to birth control instead of religious and political institutions trying constantly to take away other forms of reproductive access? It seems a leap to say that a bill that provides access to birth control is the next thing to turning around and having all your freedoms removed, especially when we live in a country that has politicians actively trying to destroy all systems of care. Its not just reproductive care- its taking away head start programs, limiting food stamps, taking away public child care options, firing women for becoming pregnant or demoting them to “lesser labor” when they have children, making child rearing seem like the only option for women, yet devaluing it.

I just cant assume in good faith that offering access to birth control is the path to having my rights taken away. I know my rights are being taken away. But not by this.

Look, I’m sorry I disagree with you all, but I do. And I think a big portion of that comes from the fact that I don’t want to have to give abortions as a physician, and I see this bill as leading towards it. If I could take back my response and hold my tongue, I would. But I can’t undo it. I’m sorry. Please just leave me and my different view alone. I’m going to go hide in my corner now. I just wanted to discuss things, but I feel attacked, whether or not that’s justified I don’t know, but it’s how I feel.

Can you point out where commenters are attacking you or where you feel attacked? We have a strict policy here at P-Mag against personal attacks, but I also don’t necessarily see where it would be happening, especially since criticism has been lodged at your ideas, not you. So if you do feel like its something worth addressing, I would say now is the time and you can PM me or one of the other editors.

BUT- and I say this in the spirit of discussion, because thats what this has been about, if it is something you believe strongly in, why would it not be worth talking about? You haven’t really defended your idea other than its how you feel.Thats fine, I respect that you personally don’t like this, that really is fine. But this was a piece regarding the disappointment in catholic institutions using birth control as a veil for an attack on freedom of religion and how personal feelings, especially ones based in sexism, interfere with rights.


I’m not being personally attacked. You all have been very good about that. What I am is feeling ostracized because of my viewpoint, which I am having super issues properly articulating so that you all can understand my point. Which is why I stopped trying to discuss it yesterday.

And I think the real difference might lie in the fact that I don’t really see this as an attack based in sexism. Now, this might be because I want to see the good in an institution that has done so much for me or just out of a need to think people have the best intentions. And I will do more research and look into this viewpoint (after I take exams on Monday because I don’t have time right now to really give it the attention it deserves). I do, however, feel like the status quo between religious freedom and government rights is being pushed too far. I like it where it is and not an inch more in either direction.

One of the points of preventative measures for pregnancy is to reduce the number of abortions had in this country. I don’t understand how any responsible physician would stand against having birth control available to all women who want it, especially those who are so vehemently against abortion.

I think you might have misunderstood my point. I was trying to say that interfering with religious freedom in this way will open up the door for someone to tell me “hey, you’re a doctor. Get rid of this fetus for me.” (albeit in not quite so blunt terms) and the government will require me to provide this service because it’s for the good of my patient without taking into account what it will do to me. I am happy to provide information on abortion to my patients and recommend another physician I trust to take care of it for them, but I do not want to do it myself. And I think that this bill might open up a can of worms in precedence setting for things like this.

I will say this though, I like how Obama is handling this sticky situation, and I think he may have found a very good compromise to it. And please note that I am not, absolutely Not, against getting birth control for any and all of my patients who want it. I never have been nor will be. I just happen to be more Pro-Life than others (though I like the decision on Roe v Wade because I think women should have access to safe and sterile medical care of all types, regardless of if I would use it personally).

It’s a very tricky issue. In this case, I agree with the decision to insure people have access to birth control under their insurance policies, but I can definitely see the slippery slope aspect to it too.

I’m sorry you feel attacked. It’s obviously something people get very passionate about, and I don’t think anyone is trying to attack you. I think you were simply the only one with a differing opinion who was brave enough to say so, so you are getting ALL THE ARGUMENTS. I promise we still like you, even when we disagree.

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