The latest proposals for the Affordable Care Act's contraceptive mandate were released a few days ago. From what I gather, there are two major adjustments:
Fact sheet from the federal Center for Consumer Information & Insurance Oversight (CCIIO), describing proposed changes to the contraceptive mandate: Women's Preventive Services Coverage and Religious Organizations
PDF version of the Notice of Proposed Rulemaking (NPRM) covering the contraceptive mandate, from the Office of the Federal Register (January 30, 2013)
Fact sheet from HealthCare.gov web site, explaining in general the benefits of the ACA for women (updated February 1, 2013): Affordable Care Act Rules on Expanding Access to Preventive Services for Women
Post by David Firestone on the Taking Note blog at The New York Times (February 1, 2013): Contraception Compromise
Assistant Secretary for Planning and Evaluation (ASPE) Issue Brief on the U.S. Department of Health and Human Services web site (February 2012): The Cost of Covering Contraceptives through Health Insurance
Article in The New York Times (February 1, 2013): Birth Control Rule Altered to Allay Religious Objections
Editorial in The New York Times (February 2, 2013): A Good Compromise on Contraception
Article in LifeNews.com (February 1, 2013): Pro-Life Groups Blast Revisions to Obama Abortion-HHs Mandate
Article in LifeSiteNews.com (February 1, 2013): Obama admin releases revised rules for HHS mandate: met with skepticism
Article in LifeSiteNews.com (February 1, 2013): Catholic and pro-life leaders slam White House 'compromise' on birth control mandate
- The types of groups that are exempt from having to provide free birth control in their health plans expanded slightly.
- More importantly, of the groups that are still required to provide a health care plan with free contraceptive services, those with religious objections to contraception are further insulated from funding those services. Insurers, not the organizations who contract with them, pay for contraceptive services themselves (so that no employer money pays for birth control). For employers that self-insure, a separate government entity will provide the contraceptive services, again at no cost to the employer.
At this point, for employers with religious objections to contraceptives, I think it is inaccurate to even say that they will be 'providing' contraceptive services to their employees. It is more accurate to say that a) insurance companies and b) the government are providing birth control coverage to employees of religiously-affiliated organizations.
Pro-life activists and employers that still complain after these adjustments enter dangerous territory.
If religious employers complain that indirect connections remain between their insurance premiums and contraceptive services, they are getting into the realm of something like the 'taxpayer' objection. The taxpayer objection goes something like this: I refuse to pay taxes because a) my money will go directly to something I don't like (unpopular war, dirty energy subsidy, etc.), or b) my money will pay for X (which I'm okay with), which in turn allows other government money to pay for Y (to which I object), thus indirectly subsidizing activity Y.
The main problem with the taxpayer objection is that government would fail to work at all, because everyone's tax dollars directly or indirectly subsidize government decisions and actions that violate their moral and religious beliefs. Religious pacifists, for example, would pay no taxes whenever the American government was at war (so they would never pay taxes). Religious vegans would not pay taxes because of their resulting indirect subsidization of the meat and dairy industry. Non-Catholics would object to paying their taxes because of the millions of dollars governments provide to Catholic organizations each year in grants and subsidies.
In my reading of American culture, Americans deal with the taxpayer objection in the following ways. First, we note that we have no idea whose tax dollars are paying for X, Y, or Z, because most tax money goes into one big pot and gets stirred up. So it is usually impossible to say that any one person's tax dollars directly pay for any particular government activity.
Second, where the use of a given person's tax money can be directly linked to a particular government program, and that is the subject of conscience objections, we make it so that the government program is no longer directly subsidizing that activity. And then we leave it at that. We generally reject the 'indirect' funding objection as asking too much and making the work of government impossible.
This is the Obama Administration position, and it is correct.
Not only are pro-life activists and employers wrong to push their objection to indirect funding of birth control, they are also hypocritical, because, as noted, religious organizations in the United States are being 'indirectly' funded by millions of taxpayers who object to the tenets of their specific religion.
For these reasons, I think the reaction to the new proposals, with their firewalls, has been relatively muted. What I am not seeing are precise objections-- in other words, I have not seen an explanation why the firewalls constructed by the new regulations are insufficient. Instead, the initial response seems to be to repeat platitudes about freedom of religious conscience.
A commentator for The New York Times, David Firestone, suggests that nothing the Obama Administration does will mollify those fighting the contraceptive mandate. Statements made by pro-life activists (see the pro-life media links, below) appear to confirm his suspicion. If pro-life and religious organizations don't move toward the Administration at least a little in the coming days, they will undermine their own credibility. Americans share their concerns about government regulations undermining freedom of religious conscience. Americans do not share their concerns about contraception itself. If it starts to look like their primary concern is to keep other Americans away from birth control, they have lost.
Links:A commentator for The New York Times, David Firestone, suggests that nothing the Obama Administration does will mollify those fighting the contraceptive mandate. Statements made by pro-life activists (see the pro-life media links, below) appear to confirm his suspicion. If pro-life and religious organizations don't move toward the Administration at least a little in the coming days, they will undermine their own credibility. Americans share their concerns about government regulations undermining freedom of religious conscience. Americans do not share their concerns about contraception itself. If it starts to look like their primary concern is to keep other Americans away from birth control, they have lost.
Fact sheet from the federal Center for Consumer Information & Insurance Oversight (CCIIO), describing proposed changes to the contraceptive mandate: Women's Preventive Services Coverage and Religious Organizations
PDF version of the Notice of Proposed Rulemaking (NPRM) covering the contraceptive mandate, from the Office of the Federal Register (January 30, 2013)
Fact sheet from HealthCare.gov web site, explaining in general the benefits of the ACA for women (updated February 1, 2013): Affordable Care Act Rules on Expanding Access to Preventive Services for Women
Post by David Firestone on the Taking Note blog at The New York Times (February 1, 2013): Contraception Compromise
Assistant Secretary for Planning and Evaluation (ASPE) Issue Brief on the U.S. Department of Health and Human Services web site (February 2012): The Cost of Covering Contraceptives through Health Insurance
Article in The New York Times (February 1, 2013): Birth Control Rule Altered to Allay Religious Objections
Editorial in The New York Times (February 2, 2013): A Good Compromise on Contraception
Article in LifeNews.com (February 1, 2013): Pro-Life Groups Blast Revisions to Obama Abortion-HHs Mandate
Article in LifeSiteNews.com (February 1, 2013): Obama admin releases revised rules for HHS mandate: met with skepticism
Article in LifeSiteNews.com (February 1, 2013): Catholic and pro-life leaders slam White House 'compromise' on birth control mandate
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