Filed Under:Your Practice, Regulatory

Recognizing a good deal

The Millennial

The Catholic Health Association's pragmatism when contrasted with the United Conference of Catholic Bishops' up turned noses
The Catholic Health Association's pragmatism when contrasted with the United Conference of Catholic Bishops' up turned noses

Like a wily politician, I, as they say, became enlightened and changed my position regarding the perceived infringement on religious liberties the Patient Protection and Affordable Care Act (PPACA) contained in regards to the contraception mandate.

I managed to avoid tossing the hackneyed and weighted John Maynard Keynes line: “When the facts change, I change my mind, what do you do, sir?” into my previous columns on the topic, but I have thought about using it. (And I guess now, I have.)

In its second public fissure with the United States Conference of Catholic Bishops, the Catholic trade group announced that it could accept the Obama administration’s original compromise on the contraception mandate albeit with a few "accommodations." And it should, for two reasons: Because it is a good deal and because it is the right thing to do.

Allow me address the latter reason first. Back in late January of 2012, I wrote my first column on the issue and slapped the incendiary title Let the Bishops have their bottle on it. I was hit with waves of angry emails by people who apparently did not read the actual column. If they would have read it they would have realized I was arguing, as was the United States Conference of Catholic Bishops, that faith-based groups (hospitals and educational institutions, amongst others), with no direct affiliation with a specific house of worship, be offered the same exemption from the contraception mandate that churches, other houses of worship and their affiliated organizations are afforded.

My reasoning at the time was that the non-Catholic individual who was, say, employed as a janitor in a Catholic hospital should not expect steak to be served in the cafeteria on Fridays. Bottom line: If you decide to work for a faith-based organization and you are not a member of that specific faith, you should expect the mores of that faith to permeate your work environment. Therefore, women who work at a Catholic charitable organization should not expect that organization to provide them with contraception, sterilization and drugs that can cause early abortions.

Then, 12 months later I changed my mind. In my second column on the topic, entitled One year later, I assailed my original position as being narrow-minded and ignorant. You see, the fact is that 99 percent of women use contraceptives at some point in their lives for myriad of things besides actual birth control. Adolescent girls and young women are often prescribed birth control for irregular menstruation cycles, menstrual cramps, endometriosis and Polycystic Ovary Syndrome, an endocrine disorder. No one should be denied access to drugs for these conditions because of their employer’s religious values.

The Obama Administration felt the same way, and I have a sneaking suspicion the CHA did too, but it was still not reason enough for the Catholic organization to get on board. A compromise needed to be struck and, alas, at a time when digging in one’s heels is so fashionable that no one ever gets a full glimpse of anyone else’s shoes. 

In a canny move, the administration found a way for faith-based organizations to deflect direct responsibility for providing contraception coverage to their employees by shifting those costs to insurers. This was by all means a good deal. However, for many involved it was not enough. While the general public balked that Catholic groups were turning their nose up at a fair compromise that comprehensively addressed their concerns, there was more tweaking needed.

The CHA felt that there were two sticking points that needed to be hammered out: the four-part definition of what constituted a "religious employer" and, according to the CHA memo, “A federal precedent that mandated our members would have to include in their health plans [those] services they had well-established moral objections to.”

HHS’s most recent accommodations, issued on June 28, satisfied those concerns for the CHA. And on July 8, the CHA announced that the final rules issued governing the Health and Human Services mandate were acceptable. Cardinal Timothy Dolan, President of the United Conference of Catholic Bishops did not agree and had indeed proclaimed, five days after accommodations were announced, that they were unacceptable.

A good deal is hard to come by these days. And, to employ another hackneyed statement: Perfection should not be the enemy of good.

Let us be thankful that the United Conference of Catholic Bishops does not represent the 600 hospitals and 1,400 other health facilities that the CHA does. 

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