Obama Administration Must Clarify Contraception Rules

In an ideal world, reforming America's broken health care system would have produced a single-payer system — a Medicare-like program for people of all ages.

In the real world, however, the political and financial forces opposed to a single-payer system were too strong. What emerged, instead, was the Patient Protection and Affordable Care Act of 2010, a major advance over the current system, but dauntingly complex and vulnerable to attack every time a new provision kicks in.

The Obama administration now finds itself under assault, for example, over provisions requiring insurance companies to broaden coverage of women's preventive health services — with no co-pay or deductible charges — starting in August. Among services that insurers will have to cover are contraception methods and procedures.

But the use of birth control pills, IUDs, tubal ligations, implants and condoms runs counter to Roman Catholic teaching that forbids artificial means of birth control. The U.S. Conference of Catholic Bishops and some religious orders officially have condemned the new insurance requirement. So have secular conservative groups and, not surprisingly, the Republicans competing for their party's presidential nomination.

From the perspectives of women's health and public policy, the administration is on sound footing. The new requirements make sense, and White House officials said the president intends to stand by them, as he should.

But President Barack Obama must directly address genuine concerns that the requirements seem to infringe on the First Amendment's freedom of religion guarantee. It doesn't matter that some of that concern has been stoked by misinformation spread by political opponents and conservative media. It doesn't matter that American Catholics essentially disregard church teaching on contraception — like all American women, 83 percent of Catholic women at risk of unintended pregnancy currently use the pill, IUDs, sterilization procedures or condoms to prevent unplanned pregnancies.

That fact is that Americans don't want the government interfering with religion, and the administration has done a terrible job of explaining that it's not.

The insured women themselves make the decision to use or not to use contraception.

For example, the new requirements exclude any religious organization whose principal activity is conveying religious values to people of the same faith and whose employees also are members of that faith. In other words, churches, synagogues, mosques and other institutions of worship are exempt, as are schools of religious instruction.

Health officials also need to categorically refute false claims that the new rules cover medications that cause abortions. The rules explicitly exclude abortifacients.

Moreover, group or individual health insurance plans that were operating prior to March 2010 are exempt; the new requirements do not apply to them. Besides, no business, religious or not, will be required under the law to offer health insurance to its employees. No health insurance, no requirements.

The tricky part of this dispute involves religiously aligned or sponsored organizations that may employ people of all faiths and provide services to people of all faiths. They include social service groups, charities, hospitals and universities offering broad educational curricula.

These organizations offer employment and services to all in our shared community. They function side by side with other groups and businesses in a secular context. If they choose to compete for employees by offering a health insurance benefit, as comparable organizations do, then fairness requires that the law treat the groups equally, even if one has arisen from a religious tradition.

The administration must make that clear.

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