Contraception Controversy @ HHS

Following up on recommendations issued last month by the Institute of Medicine, the Department of Health and Human Services issued new guidelines today on mandatory care for women. Beginning August 2012, new health insurance plans will be required to include women’s preventive services such as well-woman visits, breastfeeding support, domestic violence screening, and, most controversially "contraception without charging a co-payment, co-insurance or a deductible."

H.H.S. Secretary Kathleen Sebelius said, “These historic guidelines are based on science and existing literature and will help ensure women get the preventive health benefits they need.” The guidelines are part of a broader effort undertaken as part of health care reform to get more people into preventive services, which, according to the H.H.S., Americans use at half the recommended rate.

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H.H.S. argues, "Family planning services are an essential preventive service for women and critical to appropriately spacing and ensuring intended pregnancies, which results in improved maternal health and better birth outcomes." 

Sebelius' office also released an amendment to the new regs that "allows religious institutions that offer insurance to their employees the choice of whether or not to cover contraception services. This regulation is modeled on the most common accommodation for churches available in the majority of the 28 states that already require insurance companies to cover contraception." According to the statement: "H.H.S. welcomes comment on this policy."

They will likely get some comment soon. The U.S. bishops, which had been opposed to including contraception as a mandatory component of women's "preventive care," also sought explicit conscience exemptions from the policy. The U.S.C.C.B. is preparing a response to the new guidelines that should be issued sometime today.

UPDATE: The U.S. Conference of Catholic Bishops (USCCB) sharply criticized a new HHS “preventive services” mandate requiring private health plans to cover female surgical sterilization and all drugs and devices approved by the FDA as contraceptives, "including drugs which can attack a developing unborn child before and after implantation in the mother’s womb."

“Although this new rule gives the agency the discretion to authorize a ‘religious’ exemption, it is so narrow as to exclude most Catholic social service agencies and healthcare providers,” said Cardinal Daniel N. DiNardo, Archbishop of Galveston-Houston and chairman of the USCCB Committee on Pro-Life Activities. “For example, under the new rule our institutions would be free to act in accord with Catholic teaching on life and procreation only if they were to stop hiring and serving non-Catholics,” Cardinal DiNardo continued. “Could the federal government possibly intend to pressure Catholic institutions to cease providing health care, education and charitable services to the general public? Health care reform should expand access to basic health care for all, not undermine that goal.”

“The Administration’s failure to create a meaningful conscience exemption to the preventive services mandate underscores the need for Congress to approve the Respect for Rights of Conscience Act,” the Cardinal said. That bill (H.R. 1179), introduced by Reps. Jeff Fortenberry (R-NE) and Dan Boren (D-OK), would prevent mandates under the new health reform law from undermining rights of conscience.

Contraceptive services that will be covered under the new standards include "All Food and Drug Administration approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity." That means the so-called abortion pill RU-486 and similar drugs are not covered, but that prohibition has not been enough to satisfy pro-lifers who are already attacking the new guidelines since the FDA recognizes the so-called morning-after pill, "Plan B" and Ella, as birth control.

Cardinal DiNardo added: “Catholics are not alone in conscientiously objecting to this mandate. The drugs that Americans would be forced to subsidize under the new rule include Ella, which was approved by the FDA as an ‘emergency contraceptive’ but can act like the abortion drug RU-486. It can abort an established pregnancy weeks after conception. The pro-life majority of Americans – Catholics and others – would be outraged to learn that their premiums must be used for this purpose.”

“HHS says the intent of its ‘preventive services’ mandate is to help ‘stop health problems before they start,’” said Cardinal DiNardo. “But pregnancy is not a disease, and children are not a ‘health problem’ – they are the next generation of Americans.

“It’s now more vital than ever that Congress pass the Respect for Rights of Conscience Act to close the gaps in conscience protection in the new health care reform act, so employers and employees alike will have the freedom to choose health plans in accordance with their deeply held moral and religious beliefs.

In addition to no-cost contraception, some of the less controversial new standards will allow women to have access to a full range of IOM recommended preventive services without cost sharing, including: well-woman visits; screening for gestational diabetes; human papillomavirus (HPV) DNA testing for women 30 years and older; sexually-transmitted infection counseling; human immunodeficiency virus (HIV) screening and counseling; breastfeeding support, supplies, and counseling; and domestic violence screening and counseling. H.H.S. projects that these changes will result in significant improvements in health outcomes for low-income women who may have been discouraged to seek out preventive services, even when they had health insurance, because of co-pays.

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Crystal Watson
6 years 4 months ago
David, where exactly does the idea that using contraception is immoral  come from?  At Vatican II, most of those there were in favor of it, and the pope's own commission on birth control advised allowing contraception. It's a failed theory based, I fear, on little more than a desire to keep women under the church's thumb.
Anne Chapman
6 years 4 months ago
David, your response to Crystal was quite interesting and raises a question.

  Since you did not choose to give any reasons for your conclusion that using contraception is immoral, simply said ''I don't know, but there it is', could one conclude from your response that you are among those who simply accept all church teachings without analysis or question or independent study simply because  the hierarchical church (not THE church) said so?
Anne Chapman
6 years 4 months ago
Well, David, as most educated Catholics who have studied church history even in a cursory manner know, the church has changed its teachings on many occasions, and it has even canonized some who were silenced/suppressed, and even executed for heresy (Joan of Arc comes to mind).  Even Thomas Aquinas, on whom the church currently bases some of its more wrong-headed teachings about women, was silenced at one time, and some of his writings condemned. 

We also know that more than 90% of practicing Roman Catholics use various forms of modern family planning (barrier, oral contraceptives, and permanent sterilization).  THE church has rejected the hierarchical teaching on this issue - and John Cardinal Newman once noted that a teaching that is rejected by THE church cannnot be ''infallible.''  Of course, the church has been smart enough (so far) not to declare that this teaching is ''infallible.''  Perhaps someday the hierarchical church will gain the wisdom of John Cardinal Newman and understand that the Holy Spirit speaks through THE church also, not simply through a relative handful of celibate old men in Rome. who have been wrong many times in history, and have especially demonstrated many times that they are totally clueless when it comes to marriage, married sexuality, and sexuality in general. Those who live the sacrament of marriage have an understanding and wisdom that totally escapes these celibate males who are so unbelievably arrogant and presume that they can tell those who actually live the sacrament what marriage means.  So, do you follow your own conscience, presumably well-formed through study, prayer, and reflection, or do you simply follow what the church teaches without thinking too much about it on your own?   Even Joseph Ratzinger understood (before climbing too high in the ecclesial power structure) that conscience must be obeyed - even above the Pope's statements.

Over the pope as expression of the binding claim of ecclesiastical authority, there stands one’s own conscience which must be obeyed before all else, even if necessary against the requirement of ecclesiastical authority. This emphasis on the individual, whose conscience confronts him with a supreme and ultimate tribunal, and one which in the last resort is beyond the claim of external social groups, even the official church, also establishes a principle in opposition to increasing totalitarianism”.
Joseph Ratzinger, 1967
(in: Commentary on the Documents of Vatican II )


Crystal Watson
6 years 4 months ago
This seems like a really good thing for women.  The religious exemption - "under the new rule our institutions would be free to act in accord with Catholic teaching on life and procreation only if they were to stop hiring and serving non-Catholics" - also seems fair to me.  The fact that these services will be available doesn't mean everyone will use them - maybe the church can allow women to be moral agents and make choices.
6 years 4 months ago
As expected, partusan arguments along the uusal lines from posters here.
Probably why the Church's message is drowned out by many.
Vince Killoran
6 years 4 months ago
Cardinal DiNardo's claim that the majority of Americans are pro-life is not supported by the polling data.  See http://www.pollingreport.com/abortion.htm.
Crystal Watson
6 years 4 months ago
Contraception is good for women - one example is that using BC pills lowers the risk for ovarian cancer - and I'd take the time to list all the reasons why, but I doubt anyone here really cares.
Kay Satterfield
6 years 4 months ago
The bottom line of this health care plan it seems is to help women who need health care services who are below the poverty line;that being primarily women with children.  The Life of these women are at risk. Being Pro-Life shouldn't just be to protect the unborn.  Though the bishops have the right to seek protect the conscious of those who could not support this health plan; the big picture needs to be taken into account.  It is my opinion that abortion and contraception are two very different issues and need to be addressed as such.  It also seems in my opinion that more women need to be involved in this debate as it is women who are affected.
Anne Chapman
6 years 4 months ago
For women, access to reliable methods of family planning, including the pill, is indeed a form of preventative medicine. There is no need to take the pill if it is dangerous for any particular individual. But the question raised concerns the use of the birth control pill as a form of preventative health care. Even though maternal death rates are low in the United States, for most women in the US, the risk of dying from using birth control pills is still dramatically lower than the risk of dying from pregnancy or childbirth.  The risk of death from use of the pill in the US is 1 in 200,000 per year in non-smoking women under the age of 35.  According to the National Center for Health Statistics, the maternal mortality rate in the US is 12.1/100,000 live births - a significantly higher risk than is taking the pill.  However, women who smoke, especially women who are older than 35 who smoke, would be advised to use a different form of birth control as the mortality rate is dramatically higher for women older than 35 who smoke.  According to the CDC, the most popular form of birth control after 35 is surgical for either the man or the woman (tubal ligation and vasectomy).  The most popular non-surgical form of birth control in use in the United States is the condom.

Pregnancy/childbirth risks are much higher in the developing world than in the rich nations, due to lack of access to decent health care, including reliable methods of family planning. According to the World Health Organization, ''...the maternal mortality ratio in developing countries is 290 per 100 000 births versus 14 per 100 000 in developed countries. There are large disparities between countries, with some countries having extremely high maternal mortality ratios of 1000 or more per 100 000 live births. There are also large disparities within countries, between people with high and low income and between people living in rural and urban areas.....Women in developing countries have on average many more pregnancies than women in developed countries, and their lifetime risk of death due to pregnancy is higher. A woman’s lifetime risk of maternal death – the probability that a 15-year-old woman will eventually die from a maternal cause – is 1 in 4300 in developed countries, versus 1 in 120 in developing countries.''

The male death rate from pregnancy and childbirth is an enviable 0/100,000, even in the poorest countries of the world. Perhaps the celibate males in Rome and currently those in the USCCB should have the humility to realize that they simply don't understand and bow out of the discussion - as long as their ''consciences'' are protected and they can refuse to pay for access to the pill for women employees/spouses of the church. 

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