The contraception mandate, a growing point of contention between Catholics and the Obama administration, suffered a blow last Friday when the Catholic Health Association walked back on its earlier support for the White House's birth control compromise.
The dissension removes a key ally from Pres. Obama's court in the debate over the administration's rule stating that most health insurance plans must cover contraceptives for women free of charge. The rule includes coverage for sterilization, contraception and some abortion-causing drugs, which some Catholics have charged is a violation of their fundamental right to religious freedom.
Certain religious employers are exempted from the requirement, but "religious employer" is defined so as to exclude Catholic hospitals and health organizations as well as other religious institutional employers.
"The administration has cast aside the First Amendment of the Constitution of the United States, denying to Catholics and people of other faiths our nation's first and most fundamental freedom, the free exercise of religion," Bishop Robert J. McManus said in a February letter. "As a result, unless the rule is overturned, we Catholics will be compelled either to violate our consciences or to drop health coverage for our employees and suffer the penalties for doing so."
In February, the administration offered a compromise, saying that Catholic institutions would not have to pay for the birth control coverage or refer their employees to it, but that it would all be covered directly by the insurance companies.
Timothy Dolan, archbishop of New York and president of the U.S. Conference of Catholic Bishops, said the rule forces insurance companies to provide services without a co-pay, wrongfully suggesting the services are "free."
"There is no free lunch, and you can be sure there's no free abortion, sterilization or contraception," he wrote in The Wall Street Journal. "There will be a source of funding: you."
On May 21, 43 Catholic institutions filed lawsuits asking federal judges to declare that the rules violate free exercise of religion and the Religious Freedom Restoration Act.
In its five-page letter Friday, the Catholic Health Association, which represents about 600 hospitals and hundreds of nursing homes and other health-related organizations, said that while the government's insurance compromise seemed to be a good first step at the time, further examination of the proposal did not alleviate the group's concerns.
"The more we learn, the more it appears that the (Advanced Notice of Proposed Rulemaking) approaches for both insured and self-insured plans would be unduly cumbersome and would be unlikely to adequately meet the religious liberty concerns of all of our members and other church ministries," the letter stated.
The letter was signed by Daughter of Charity Sister Carol Keehan, who originally supported the compromise.
The letter also suggested changes to the rule to make it more acceptable. The changes included broadening the exemptions for employers in order to address "serious constitutional questions created by the Department's current approach," which separates religious organizations into secular and religious components.
"To make this distinction is to create a false dichotomy between the Catholic Church and the ministries through which the Church lives out the teachings of Jesus Christ," the letter said. "Catholic health care providers are participants in the healing ministry of Jesus Christ. Our mission and our ethical standards in health care are rooted in and inseparable from the Catholic Church and its teachings about the dignity of the human person and the sanctity of human life from conception to natural death."
Critics who say the Catholic Church is fighting to restrict access to birth control are missing the mark, Notre Dame Law Professor Richard Garnett said in May, when the lawsuits against the government were filed.
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