It is clear that the Obama administration is not backing down from its anti-conscience mandate but hopes to bury the controversy with bureaucratic delay. In its “Advanced Notice of Proposed Rulemaking,” the government now officially promises to take action at some time in the future to address the conflict.
The notice, issued on Friday, takes 32 pages to explain that the president still doesn’t have a clue how to balance the demands of the Left, which insists that all women should have free access to drugs that cause early abortion, sterilization procedures, and contraceptives, and the Catholic Church, which believes the mandate is a government violation of conscience and religious liberty.
The March “notice” about February’s “accommodation” to January’s “final rule” also is an admission that the administration still has no idea who should be forced to pay for its mandate.
You will recall that on February 10, President Obama announced he would require health insurance companies to pay for the offending services so Catholic institutions didn’t have to.
That was widely derided as a shell game because the insurers would simply pass the costs along indirectly to religious organizations through higher premiums. And it left no escape for self-insured religious organizations that pay health costs directly for their employees.
In an admission that the original idea had failed, Friday’s notice lists several ways that health plans could get money to pay for the mandate without dipping directly into premiums: through rebates the plans get from prescription drug companies, service fees, savings from disease management programs, or private non-profit contributions. It also proposes having the Office of Personnel Management in Washington require health plans to provide the mandated services for free as a price for participating in ObamaCare’s coming multi-state health-insurance plans.
But the religious organizations would still be required to make sure all of their employees have access to the offending coverage. So nothing has changed.
Friday’s announcement falls apart in another key way. The administration’s notice repeatedly refers to the mandate as only covering contraceptives, not the full contingent of “All Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity” which are actually covered by the mandate, as defined by the Health Resources and Services Administration.
Friday’s notice refers only to contraceptives, which it repeatedly says save money: “Actuaries and experts have found that coverage of contraceptives is at least cost neutral, and may save money, when taking into account all costs and benefits for the issuer.” (It then proceeds to cite a study done Feb. 9, the day before the president’s original accommodation announcement, by two of his senior administration appointees.)
But the administration is, once again, completely out of touch with the reality of the cost of its mandate. It’s not just contraceptives, which can be obtained for as little as $9 a month.
Sterilization is expensive surgery. According to Planned Parenthood website, “Sterilization for Women at a Glance,” this “surgery that prevents pregnancy” is “safe and highly effective” and “costs between $1,500 and $6,000.”
There is simply no way that these costs can be hidden in fees and rebates. When this administration can’t tax or deficit spend, it has no idea where to get the money to carry out its directives.
So Friday’s announcement changes nothing. The administration clearly is not backing down from its original plan:
- Virtually all private health plans nationwide still will be required to provide their employees with access to sterilization, contraception, and drugs that cause abortion.
- All women will have to have access to the mandated services at no charge, even if they work for a religious organization such as a Catholic hospital, university or charity whose teachings are violated by the directive.
- Private employers who are not religious organizations are given short shrift and clearly have no hope of being able to exercise their own right of conscience if they do not want to pay for the morally-offensive services.
Friday’s notice even admits that the government is trying to figure out how to define religious ministries when it asks: “What entities should be eligible for the new accommodation (that is, what is a ‘religious organization’)?”
George Weigel warns of just this danger when “an overweening and arrogant government tries, through the use of coercive power, to make the Church a subsidiary of the state, [and when] the state claims the authority to define religious ministries and services on its own narrow and secularist terms.”
Weigel says that with the anti-conscience mandate, “the state is attempting to co-opt as much of society as it can, while the Church is defending the prerogatives of civil society.”
The bishops have been and continue to be strong and unwavering in explaining that this debate is about the core American value of religious liberty. The administration’s latest notice does nothing to change the risk to Catholic institutions. They still would be forced by government to violate their own teachings within their very own institutions.
The bishops will not be fooled by this obfuscation. The administration is doing nothing to protect their religious liberty and is only trying to buy time so it can try, once the election is over, to bend the Church to the will of the state.
Posted on National Review Online: The Corner, March 17, 2012.