The National Catholic Review

For a century and a half the Catholic Church in the United States has served the American people with health care, education and social services. Even a few months ago it would have seemed preposterous to suggest that the U.S. government would place the future of those good works at risk. That seems to be what has happened, however, with a decision by the Department of Health and Human Services to allow only a narrow conscientious exemption to the employer health care insurance mandate of the Affordable Care Act, the administration’s signature health care reform law.

For U.S. Catholics as citizens, the administration’s failure to offer a broader exemption presents a grave test of the “free exercise” of religion protected by the Bill of Rights. For the narrow definition of religion in the new H.H.S. guideline is at odds with the millennia-old Catholic understanding of the church as a community of believers in service to the world. The H.H.S. definition would force the church to function as a sect, restricted to celebrating its own devotions on the margins of society. The ruling is a threat to our living as a church in the Catholic manner.

The controversial guidelines, announced on Jan. 20 by Kathleen Sibelius, secretary of H.H.S., restricts religious exemptions to those persons and institutions the administration defines as religious—namely, those that serve clear religious functions, employing primarily co-religionists and serving a largely denominational clientele. The administration rejected appeals from the U.S. Conference of Catholic Bishops and the Catholic Health Association for a broader conscience clause. Religiously sponsored institutions, like all other employers, will be explicitly required to provide coverage for contraception, sterilization and two potential abortifacients, services that are in violation of Catholic teaching. The administration has thus pushed the U.S. bishops into a destructive showdown over the future of Catholic health care, social services and higher educational institutions. It is a confrontation both sides should seek to avert.

The exemption devised by H.H.S. places Catholic institutional employers in an untenable position. The guidelines force them to cooperate, though indirectly, in grave wrongs by facilitating acts the church considers sinful. They also place dissenting institutions in the position of withdrawing health insurance benefits from their employees and from students at their colleges and universities. Employees of such institutions will have to seek out inferior and more expensive health plans on the open market, and their employers will face annual fines from the federal government for refusing to comply with the employers’ mandate.

A misunderstanding of the Catholic mission in the United States lies at the heart of this unexpected conflict. The Obama administration’s religious exemption covers only entities that serve patently religious functions, including parishes and parochial schools. But serving the broader community through hospitals, clinics, service agencies and institutions of higher learning is not an extraneous activity for the Catholic Church. It is a civic manifestation of the church’s deep beliefs in human dignity, solidarity with the suffering and forgotten, the importance of learning and commitment to the common good. Even as the church remains true to its moral teaching, it is called to remain open and engaged with the wider society. The administration must be led to understand that defining away the church’s service to the world infringes upon Catholics’ free exercise of religion.

Less, but equally real, is the threat to Catholic ecclesial identity created by exasperated responses from some church leaders, who unwittingly would acquiesce to the sectarian temptation presented by the state, jettisoning the church’s public institutions in the name of conscience, apparently without sober attention to the church’s historic teaching on remote material cooperation. By complying with similar state-level regulations, however, the practice of Catholic employers in a number of states without conscience exemptions (a full list is at suggests many have until now held a different reading of that tradition. In any case, the Catholic conscience needs to remain engaged in the public forum out of our faith in the church as a “sacrament” for the world.

Catholics have resisted authoritarian governments that attempted to confine religion to the altar and sacristy. What has distinguished Western democracies from authoritarian regimes has been not just the freedom of individual believers but especially the institutional freedom of the church. While Catholics should be prepared, if necessary, to resist such a policy in our own country, both sides should leave no stone unturned to find a workable solution without unnecessary confrontation. Practically, in an election year, a solution needs to be found as early as possible. Miscalculations from either side could prove devastating.

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David Schmitt | 2/1/2012 - 10:03pm
I find it interesting that most of the comments regarding the president are focused on the political calculus of trading one voting block for another. But has anyone considered that perhaps it wasn't a political calculation but a straightforward move based on a core belief?
C Walter Mattingly | 2/1/2012 - 6:19pm
Note that this does not go into effect for a year, or until after the election. Perhaps this is just President Obama the Opportunist manipulating the system's calendar past the November elections to avoid losing votes, as it appears to be in the Keystone case and the delay of so many of the costly parts of Obamacare until after 2012. So we can hope.
David Smith | 2/1/2012 - 6:22am
Any accommodation will have to be on the part of the Obama administration, not on the part of the Church, which cannot compromise a principle.

It's my sense that the government has not acted primarily on principle, though, but on political expediency, forming its policy in reaction to pressure from secular left, which is a core constituency.  If the government were to give in - say with a more reasonable position like that decided on in Hawaii - it would risk alienating its political base in an election year.
David Pasinski | 1/31/2012 - 5:52pm
How about seeing the episcopacy work itself up for a statemnt or letter from all pulpits on the use of the drones and the targeting of civilians - even Americans. Doesn'yseem to catch their attention...
David Pasinski | 1/31/2012 - 3:17pm

I appeciate the first parts of Marie's argument that it is not a question of freedom of religious practice. I believe that simiilar blogs at Commonweal and The National Catholic Reporter flesh out the many dimensions of this argument. This may be a Griswold or Roe or Bolton moment or even a Brown one. I see this reaching the Supreme Court in some form or - if Obama loses - such a rollback in the whole reform of health care that we won't know what the scene will be in three years. But I'd bet we have even more skyrocketing costs and many less getting insured.

In the "misssion of the Church" argument, nearly all Catholic related institutions could be included in this exempton.. and so would the myriad institutions of many other faiths with whatever carve-outs they propose, as Marie points out. Check the situation in other countries and realize that they have dealt with this in many other creative ways without raising the "material cooperation" flag.

And why can't anybody official be honest and say that Catholic women utilize birth control at the same or greater percentages as any other group? I know that is not a direct argument against such a mandate, but too often it sounds like, "Oh no, we can't fund that... It's against our religion" - when so many have decided that they would handle that question privately long ago. I do believe the bishops are less concerned with doctrinal purity than they are some financial considerations and they are peeved about decsions and trends regarding respect for gay unions and have latched onto this as a "cause celebre."

Marie Rehbein | 1/31/2012 - 2:44pm

This is not a freedom of religion question, given that freedom of religion equates to freedom to worship, rather than being told by the government that one must be a Catholic or a Lutheran or an Anglican.  This is a claim to a new right, which is a right of religious organizations to be exempted from government oversight even while they participate in the business life of the nation.  For example, a Church or religion could exist or come into existence that advocated homosexual relationships to the exclusion of heterosexual relationships.  It could build hospitals but refuse to hire heterosexuals.  It could refuse to pay for insurance policies that cover prenatal care. 

Claiming that the Catholic position on contraception is morally right plus claiming that the Catholic Church's holding this position does not equate to the morally questionable practices of other religions is not an argument.  The editors know this, because they claim that the Catholic position on contraception could be equated to the beliefs of sects.  Such sects might include those who practice polygymy.  That it is God's will that people not use artificial contraception is a simple assertion that does not convince those who believe otherwise.

The situation is thus, all insurance plans must offer contraception coverage and all employers should offer to pay for insurance.  However, employers are not required to pay for insurance, and while it is unfortunate that the Catholic Church would feel morally compromised under both scenarios; paying for policies that cover contraception and not providing insurance coverage, this is not really such a serious problem as we would have in our country if religions were exempt from all government authority.


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