Contraception Uproar Precedes Bigger Health Care Debate

On Friday, President Barack Obama wisely quelled a political uproar that might never have erupted had he acted more wisely in the first place. It involved new preventive health rules requiring insurance policies to cover birth control medications, procedures and devices without co-pays or deductible fees to the user.

Under changes Obama announced last week, non-profit organizations such as hospitals, universities and social service charities will not have to buy employee insurance policies with those provisions if they are aligned with or sponsored by religions that regard artificial means of birth control as immoral.

Instead, the insurance companies will have to deal directly with the organizations' employees, who typically are of many different faiths, and inform them that birth control coverage is available at no cost if they want it.

The insurance companies are obliged to absorb the full cost of birth control pills, IUDs, condoms and such surgical sterilization procedures as tubal ligations and tubal implants, not pass them on to religiously affiliated employers.

The president might not have created this controversy if he had taken the advice of some White House advisers, most of them men, who warned that conservative religious groups and political opponents would gleefully club him with the birth control insurance requirement. The exemption provided for churches, synagogues, mosques and other houses of worship and for schools of religious instruction would not defuse the attacks, they said.

Other advisers, however, most of them women, pointed to the 99 percent of American women who use artificial birth control methods at some point in their lives to prevent unplanned pregnancies.

That includes 98 percent of American Catholic women, who disregard the official position of their church forbidding members of the faith from using such methods.

Twenty-eight states already require insurance coverage of birth control — eight of which allow no exemption for churches — and religious groups in those states seem to be complying well enough.

Obama was persuaded by the latter arguments and announced the new rules on Jan. 20. The U.S. Conference of Catholic Bishops denounced them immediately, and the Republican leadership in Congress and Republican presidential aspirants on the campaign trail were not far behind.

By last week, some liberal media commentators who are Catholic had started criticizing the rule, as had Sister Carol Keehan, chief executive of the Catholic Health Association of the United States. Despite the objections of the U.S. Catholic hierarchy, Sister Keehan has been a key supporter of the president's signature health care reform, the Patient Protection and Affordable Care Act.

Both Sister Keehan and the Rev. Larry Snyder, president of Catholic Charities USA, expressed support for the changes announced by Obama on Friday.

Not so the Republican leadership and the bishops conference. The bishops' group continues to argue that even secular and for-profit employers also should receive morality-based exemptions to birth control insurance coverage. That would be impractical and improper, requiring the federal government to sit in judgment of individual and organizational claims of religious conscience in health care coverage.

Obama's decision demonstrates restraint and reasonable accommodation to reasonable concerns. That might well reassure at least some members of the nation's most exclusive Catholic club: six justices of the U.S. Supreme Court. The court now is weighing the validity of the ACA, and its rejection would inflict far more damage to American health care than any presidential compromise on contraceptive coverage.

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