January 29, 2012

Maine Diocese pushes back on birth control rule

Requiring nonprofits to cover staffers' contraception violates the Constitution, officials say.

By Kelley Bouchard kbouchard@pressherald.com
Staff Writer

The Roman Catholic Diocese of Maine is taking a leading role in a national protest against an impending federal rule that will require nonprofit employers with religious affiliations to cover birth control as part of health insurance benefits.

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Bishop Malone

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Bishop Richard Malone and clergy across the state are asking parishioners this weekend to speak out and take action against the requirement -- part of wide-ranging federal health care reforms that became law in 2010 -- as a violation of the First Amendment right to freedom of religious practice.

"With the stroke of a pen, the (Obama) administration has violated our right to act in keeping with our conscience," Malone wrote in a letter to church members. "As a community of faith, we must act on this matter courageously, decisively and promptly."

Exactly what action will be taken remains to be seen.

Marc Mutty, the diocesan public affairs director who led the campaign that defeated a statewide referendum on same-sex marriage in 2009, said he was one of the first to mobilize national opposition to the contraception requirement. He has scheduled a conference call early this week with church leaders across the country to develop a plan to try to overturn the rule, which is part of the Patient Protection and Affordable Care Act.

"We understand that a lot of people don't see eye to eye with us on the issue of contraception, but that's not really the point," Mutty said. "The Catholic Church would have to violate its tenets to pay for and provide that service."

The U.S. Department of Health and Human Services announced Jan. 20 that nonprofit employers who, based on religious beliefs, currently don't provide contraceptive coverage in their insurance plans will have an additional year, until Aug. 1, 2013, to comply with the law.

While churches are exempt from the law, it applies to thousands of people across Maine, and millions across the country, who work for hospitals, nursing homes, schools, social service organizations and other nonprofits with religious affiliations.

The Maine diocese had no estimate of its cost to provide contraceptive coverage or the number of employees who would qualify; the diocese oversees 15 schools, three hospitals, four nursing homes, two day-care centers and numerous social service programs, including Catholic Charities Maine.

Health and Human Services Secretary Kathleen Sebelius responded after the United States Conference of Catholic Bishops, led by Cardinal-designate Timothy Dolan, archbishop of New York, lobbied the Obama administration for full exemption of religious nonprofits. The rule was supposed to take effect Aug. 1 of this year, but Sebelius gave religious nonprofits an additional year to comply.

"This decision was made after very careful consideration, including the important concerns some have raised about religious liberty," Sebelius wrote in a Jan. 20 statement. "I believe the proposal strikes the appropriate balance between respecting religious freedom and increasing access to important preventive services."

LAWMAKERS OFFER SUPPORT

Sebelius and President Obama received strong backing from Democratic lawmakers, who urged the administration to stand its ground against the bishops and others opposed to the law.

"The conscience of an employer or an insurance company should not impede a woman's access to birth control," the lawmakers wrote in a Nov. 18 letter to Obama. "We oppose any efforts to further exempt employers from following the law."

U.S. Rep. Chellie Pingree, D-1st District, signed the letter and lauded the Obama administration last week for refusing to expand the exemption.

"This is a good compromise between the interests of religious freedom and the interests of public health," Pingree said. "It prevents discrimination and it's more fair. This is an essential service to women. To deny it on religious grounds is to make it more expensive and discriminatory."

Pingree noted that 99 percent of sexually active women in the United States, including 98 percent of Catholic women, have used contraceptive medications or devices, according to the Guttmacher Institute and the National Survey of Family Growth by the Centers for Disease Control and Prevention.

In addition, 77 percent of Catholic women voters said birth control should be covered as preventive health care without any out-of-pocket costs, according to a survey by Hart Research Associates for Planned Parenthood.

The compliance delay failed to appease the nation's Catholic bishops, who criticized the decision Monday during the National Prayer Vigil for Life in Washington, D.C. Dolan also recorded a video message, posted on the conference's website.

"I am afraid the administration is on the wrong side of the Constitution again," Dolan said. "Let your elected leaders know that you want religious liberty and rights of conscience restored and that you want the administration's contraceptive mandate rescinded."

Catholic health care organizations and other affiliated groups are prohibited from providing or supporting services that prevent or substitute for fertilization by sexual intercourse, according to the Ethical and Religious Directives for Catholic Health Care Services.

Banned services include contraception (including so-called morning-after drugs), sterilization (such as fallopian tubectomy or vasectomy), artificial insemination, surrogate motherhood and abortion (under any circumstances).

Most Catholics contacted for this story were unaware of the pending federal rule or unwilling to comment on the record. One woman said she believes all health care plans should cover birth control if they cover medications for erectile dysfunction.

Mike Nappi, on his way to Mass at the Cathedral of the Immaculate Conception in Portland, said he's conflicted about the requirement.

"I really don't think it should be happening because I think the government tries to control too much," Nappi said. "But if that's the way society is going, with most people using birth control, I don't know if you can fight it."

IMPROVING WOMEN'S HEALTH

Obama signed the health care reform act into law in March 2010. It requires all health insurance plans to cover a comprehensive set of preventive services for women, including federally approved methods of birth control, sterilization procedures and counseling.

It doesn't recommend or require coverage of abortion-inducing drugs, according to a federal fact sheet on the law.

Nonprofit employers with religious affiliations who plan to delay implementation until 2013 must certify that they qualify.

Religious employers who are exempt from the law are those whose primary purpose is to teach religious beliefs and who primarily employ and serve people who share those beliefs.

Under such strict limits, Mutty said, Catholic and other churches throughout Maine are exempt from the law, but the umbrella organization of the diocese and its affiliated operations are not, according to diocesan lawyers.

If a qualifying religious employer doesn't provide birth-control coverage, it must notify employees and direct them to other community resources that provide low-cost contraceptive services, such as health clinics and hospitals with income-based support.

At this point, Mutty said, the diocese has no plan to launch a fundraising and public-relations campaign to fight the requirement, as it did in 2009 to help defeat the referendum on same-sex marriage.

Neither is the diocese drumming up opposition to Obama's re-election, Mutty said, though language in response to the requirement has been strong and squarely blames the president. A news release from Mutty called the president's decision "a blatant and capricious affront to conscience rights and religious liberty" that will have "dramatic and devastating consequences."

The diocese has reached out to Maine's congressional delegation, seeking support and advice on ways to overturn the requirement. If church-affiliated nonprofits aren't exempted, the challenge facing the diocese and organizations like it is daunting.

"We either comply with the law and violate our conscience, or we don't comply and we don't provide our employees with health insurance," Mutty said. "Either is unconscionable."

Staff Writer Kelley Bouchard can be contacted at 791-6328 or at:

kbouchard@pressherald.com

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