March 30, 2012

Be Our Guest / Dr. Richard Feldman

Mandate infringes on religious rights

The Obama administration’s mandate that religious-sponsored institutions provide contraceptive benefits in their employee insurance plans has created a confrontation between religious leaders and the U.S. Department of Health and Human Services (HHS).

The decision further defines the Affordable Care Act provision that insurance companies must provide certain preventative services at no cost.

HHS followed the Institute of Medicine’s recommendation that contraception, including sterilization and emergency contraception—considered by many to be an abortifacient and identified as such in HHS informational releases—should be included in those free preventative services.

The ruling exempted religious institutions, such as houses of worship and those that employ and serve members of their own faith. But the exemption excluded other religious entities, including religious-affiliated universities and hospitals.

Outraged religious institutions, primarily Catholic, passionately object to the requirement of providing these insurance benefits. For them, it would be a compromise of their religious beliefs, and immoral and unconscionable to be involved in their provision. (Learn more about religious freedoms here)

The Catholic Church and many institutions consider this a direct assault on religious freedom and a violation of the First Amendment.

Conservatives agree and relish the opportunity to use this against the Obama administration in an election year, although outrageous comments by some may impair any potential benefit of influencing independent voters.

Meanwhile, liberals and women’s health advocates believe the Church should not be allowed to compel their beliefs on others, and hail the decision as a victory for wider access for health and preventative services.

What a mess. An already deeply politically divided country has one more issue to fight about. State attorneys general are filing suit, and states and Congress are considering legislation in attempts to block the implementation of the rule.

The Obama administration really stepped in it. I was surprised that President Barack Obama would alienate such a large segment of employers, especially more than 600 Catholic hospitals.

The administration actually thought it could soothe the pain by giving religious institutions an extra year before implementation to figure out how to violate their consciences.

And then it tried to calm the storm by requiring the insurance carrier to provide these services by separate contract with the employees, thus keeping the religious employer completely out of it. Sound like a solution? Probably not.

Most Catholic institutions continue to object. They believe they will still be at least indirectly involved and paying the insurance company for contraception even though the insurance company is supposed to cover this “separately” at their own cost.

The insurance empire will recoup their costs one way or another from these objecting employers. And many large religious organizations are self-insured, and are thus guaranteed to pay for it.

The administration must re-evaluate its position. A totally employer-independent solution must be created. Otherwise, hundreds of religious employers will drop their health insurance plans and pay the significant, but much less expensive penalty for not providing their employees insurance.

In the end, more working people will end up uninsured or pay more for health insurance. Another reason why health insurance should not be employer sponsored.

Is the regulation lawful or constitutional? Relevant federal laws and court rulings are conflicting. A Supreme Court decision on the parameters of religious liberty would be important if the administration cannot fix this.

This column is concerned exclusively about the rightness of government to impose its position on those who would be forced to violate their religious beliefs, ethics and values by fiat.

Some will be surprised by my opinion, but I agree, as do a number of Jewish and Protestant groups, with the position expressed by the Catholic Church that feels so violated.

President Obama’s decision would have disappointed James Madison and Thomas Jefferson.

(Dr. Richard Feldman is director of Medical Education and Residency Training at Franciscan St. Francis Health in Indianapolis.)

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