The HHS Mandate: Why the Cost Issue Is Irrelevant

One issue that mainstream and even some Catholic commentators seem to be bungling to my mind is the relevance of costs. According to the Obama Administration, under the new rule insurance companies will provide sterilization and contraception free to employees of Catholic institutions like hospitals and universities. Further, the Administration has claimed that insurance companies are happy to do this because the costs of contraceptives and sterilization are lower than the costs of pregnancy and all of the associated doctors visits. This certainly seems plausible. Pregnancy and the associated doctors visits cost a lot of money. I’ve heard it claimed that policies without contraceptives typically cost more than their counterparts that include them, and so it’s possible that the new policies will be even cheaper than the prior policies (absent all of the costs imposed by other new regulations, but that’s another story).

But this just brings into starker relief the fact that no compromise has been offered at all. Let’s assume for a moment that it is actually cheaper for an insurance company to offer sterilization and contraceptives without charge than to not offer them at all. In that case, Catholic hospitals and universities have historically been able to purchase plans at a higher cost that enables them to avoid providing coverage that violates their consciences. The original rule said that they could no longer purchase such plans, and most right thinking people recognized this as an infringement on religious liberty. The new rule says: “good news, you won’t have to pay more than you currently do!” Which, of course, is completely non responsive.

Insurance companies will continue to price the plans based on the services provided and the levels of risk posed by the participants, so Catholic institutions will have to start paying for plans with contraception and sterilization priced in. I am not quite sure how anyone views the scenario above as an “accommodation,” much less an accommodation to religious liberty.  And the evidence suggests that the Obama Administration did not expect the USCCB to either. That’s why they did not inform the Bishops of the proposed policy prior to the morning of the release, but had statements from NARAL, Planned Parenthood, and Sister Keehan supporting this “accommodation” lined up. All of the relevant legal and moral objections to the original rule apply to the current rule. I expect the new rule – if it remains in place – to be strongly and successfully challenged in the courts.

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John Henry

Don't call me Nueman.


  1. Fri. noon, he served the people who want free contraception in whatever affiliation with embarassingly ‘all on the same side of the scale’ approval. Spoke to voters whose minds are concerned with maintaining things ‘below the belt’. Pretty insulting to the rest of their lives in progress with possibilities of growth and development.

    For the nation as a whole, an unspoken mandate to comply with yet deeper disturbance of any higher minded spiritual beliefs, sort of enabling another form of disease of schizophrenia. Insulting and dismissing the concerns of healthy spiritual life found in the Catholic Church and other religions, he pandered for the votes that will strengthen his culture of death. The cost won’t be counted in $.

  2. “The cost won’t be counted in $.”

    First will come loss of jobs for employees or loss of businesses for business owners. Then will come denial of purchasing food and other necessities for life. Then will come imprisonment. And final the ultimate solution. The people in the 1790s who cried “Liberty, Equality and Fraternity” followed this route and employed Dr. Guillotine’s “merciful machine” to ensure their liberty, equality and fraternity.

  3. Arguments for a “religious employer” exemption have gone from wrong to ridiculous.

    Questions about the government requiring or prohibiting something that conflicts with someone’s faith are entirely real, but not new. The courts have occasionally confronted such issues and have generally ruled that under the Constitution the government cannot enact laws specifically aimed at a particular religion (which would be regarded a constraint on religious liberty contrary to the First Amendment), but can enact laws generally applicable to everyone or at least broad classes of people (e.g., laws concerning pollution, contracts, fraud, negligence, crimes, discrimination, employment, etc.) and can require everyone, including those who may object on religious grounds, to abide by them. (E.g., http://supreme.justia.com/cases/federal/us/494/872/case.html http://www.aafcp.org/cplm/files/12.pdf.) Were it otherwise and people could opt out of this or that law with the excuse that their religion requires or allows it, the government and the rule of law could hardly operate.

    When moral binds for individuals can be anticipated, the legislature may, as a matter of grace, add provisions to laws affording some relief to conscientious objectors.

    The real question here then is whether there is any need for such an exemption in order to avoid forcing some employers to act contrary to their consciences. Those demanding such an exemption initially worked themselves into a lather with the false claim that the law forced employers to provide their employees with health care plans offering services the employers considered immoral. The fact is that employers have the option of not providing any such plans and instead simply paying assessments to the government. Unless one supposes that the employers’ religion forbids payments of money to the government (all of us should enjoy such a religion), then the law’s requirement to pay assessments does not compel those employers to act contrary to their beliefs. Problem solved–except perhaps for an employer who really desires not just to avoid a moral bind, but rather wants to retain control of his employees’ health plans, limit their choices to conform to the employer’s religious beliefs, and avoid paying the assessments that otherwise would be owed. For that, an employer would need an exemption from the law.

    Indeed, some continued clamoring for just such an exemption, complaining that by paying assessments they would be paying for the very things they opposed. They seemingly missed that that is not a moral dilemma justifying an exemption to avoid being forced to act contrary to one’s beliefs, but rather is a gripe common to most taxpayers–who don’t much like paying taxes and who object to this or that action the government may take with the benefit of their tax dollars. Should each of us be exempted from paying our taxes so we aren’t thereby “forced” to pay for a war, health care, or whatever else each of us may consider wrong or even immoral?

    In any event, they put up enough of a stink that the government relented and announced that religious employers would be free to provide health plans with provisions to their liking and not be required to pay the assessments otherwise required. Problem solved–again, even more.

    Nonetheless, some continue to complain. They fret that somehow religious employers ultimately will pay for the services they oppose. They argue that if insurers (or, by the same logic, anyone, e.g., employees) pay for such services, those costs will somehow, someday be passed on to the employers in the form of demands for higher insurance premiums or higher wages. They counter what they call the government’s “accounting gimmick” with one of their own: the “Catholic dollar.” These dollars remain true to an employer’s religious beliefs, it seems, even after paid by the employer to others, e.g., insurers or employees, in that they can be used only for things the religious employer would approve. The religious employers’ aim, we are assured, is not to thereby control the actions of others, oh no, but rather is merely to assure that the employers themselves do not somehow act contrary to their own beliefs by loosing “their” dollars into hands that would use them for things no self-respecting religious employer would himself buy. Their religious liberty, they say, requires not only that they be exempted from the law, but further that anyone to whom they pay money also be exempted and thus “free” to act according to their desires.

    I wonder what they would think of their follow-the-dollar theory if they realized they had some of my “atheist dollars” in their wallets that can be used only for ungodly purposes, lest I suffer the indignity of paying for things I disbelieve.

  4. @DougIndeap: The mission of the Catholic Church is to present the dignity of the human person, the common good, the subsidiarity of the government. The destruction of the human being, the obliteration of human existence, class warfare, tyranny, denying the act of creation to the will of God, none of these Is true.

  5. Mr. Indeap is parachuting into various religious blogs, attempting to hit us with some knowledge.

    It’d be nice if he’d explain why he thinks everyone has a right to no-cost abortifacients and birth control first, but hey–he gets his licks in on the religious types he despises.

    And that’s what’s really important.

  6. I believe Mr. Indeap’s arguments deserve a response. They are plausible and reasoned, and that’s a refreshing rarity. If he does indeed despise religious people, I see no evidence of such in his post. The comparison to taxation is especially interesting.

    1) The paying of an “assessment” is not a worthy alternative. You’re correct that it would let us off the hook as far as violating our consciences, but it is flatly unjust. Would you attempt to make the case that the government is justified in levying such a fine? Why not a fine against Mormon employers who fail to serve real coffee in the break room?

    2) On whether the employer in question is wishing to “limit their [employees’] choices to conform to the employer’s religious beliefs”: this stands out among your plausible arguments as flatly silly. Failing to buy your employees condoms impinges on their choices about contraception no more than failing to buy them parachutes impinges on their choice to skydive. Your freedom does not mean other people have the obligation to buy you things.

    3) Is the situation analogous to paying taxes for a war one doesn’t want? Certainly, to some extent. I’ve been trying to think that through myself. How could our society function if every socialized expenditure/service were optional? This question can’t be blithely dismissed. And yet, surely it does not follow that governments may therefore compel their citizens to pay for anything at all, and that citizens are never justified in rebelling against said coercion. I suggest that the burden of proof falls on the side of the government. In the matter at hand, it’s hard to imagine anyone even attempting to make such a case. The White House’s statements, riddled as they are with red herrings, misrepresentations, misdirection, and bizarre assumptions, serve to illustrate the futility of the project.

    4) Are we inventing an irrational notion of a “Catholic dollar?” No… and your analogy about your own “atheist dollar” fails. A Catholic institution would be guilty of such an invention if, for example, they claimed authority to stop employees from spending their wages for contraception. The money has changed hands: it isn’t theirs anymore, end of story. But that is not analogous to the matter at hand. The reason is that it is still the employer who is buying the controversial product. It’s a shell game to claim that “no, now it’s the insurance company providing it.” Everything the insurance company does, is done with money from the employer. The contraceptives etc. will not come out of executive’s paychecks, nor will they be delivered by the Progesterone Fairy. Even if it is true that money will be saved – and this is indeed a plausible claim – it remains true that the Catholic institution is being forced to pay for contraception. That’s the problem. The “accommodation” fails to address it.

    As much subtlety as may arise from tangential questions, the core issue is really very simple. The HHS policy makes precisely as much sense as forcing synagogues to pay their employees in bacon. None. And if you, an atheist, are ever forced by the government to buy Bibles for people you may employ, I will oppose it just as fiercely.

  7. A telling illustration of the main point of the post:
    Would the Catholic employer be held accountable if there was a rider on the insurance contract hiring an assassin to kill someone? Would anyone accept the excuse that since it was an action of the insurance company, the Church was not complicit? If that’s true, then I will also accept the President’s “accommodation.”

  8. I am glad the Steven Beatty took the time to give Doug Indeap’s atheist objections a thorough response. When a sincere objection like Doug’s is raised (however many times he may have parachutted onto Catholic blogs to voice his objections), then a serious response is warranted.

    On a different note, if an atheist like Doug does believe in rule of law, then what pray tell ought that law be based on if not God’s? The whim and fancy of whatever atheist makes the law? I fear we would have Maximillien Robespierre all over again. Oh wait, we do have him: Barack Hussein Obama. The cry of “liberty, equality and fraternity” never fails to result in the death of the innocent, this time to the tune of 54 million unborn babies.

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