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February 24, 2012

Religious Conscience Amendment

This week, the United States Senate narrowly defeated an amendment sponsored by Senator Roy Blunt (R-MO) that was designed to overturn the provision in the Department of Health and Human Services' preventive services rule that requires Catholic institutional ministries to cover certain morally objectionable services.  On a vote of 51-48, the Senate tabled (ended debate on) the Blunt amendment.  All but one Republican Senator voted in support the amendment, and three Democrats – Sens. Bob Casey of Pennsylvania, Joe Manchin of West Virginia and Ben Nelson of Nebraska – voted to support it.  Action now moves to the House of Representatives, where the leadership plans to "mark-up" similar legislation (H.R. 1179) in committee and bring it to a floor vote.


 

February 10, 2012

Revision to Preventative Services Mandate

President Barak Obama took the national stage this morning to announce that his Administration is implementing a policy that “accommodates religious liberty while protecting the health of women.”

He explained that when HHS announced that religious organizations had an extra year to comply with the contraceptive services mandate it was because the Administration intended to take that time to work out concerns expressed by Church-affiliated organizations, such as Catholic hospitals.  In light of the brewing controversy generated by the HHS regulations, however, he has directed his Administration to work out the issue in weeks, rather than taking a year during the transition.

Although the final regulation will not be published until later today, reports out of the White House indicate there will be no change to the very narrow definition of “religious employer.”  Rather, the Administration is making an accommodation for “non-exempt religious organizations” through a new insurance scheme, which is described in a White House fact sheet as follows:

♦ The new regulation will require insurance companies to cover contraception if the non-exempted religious organization chooses not to.

♦ Religious organizations will not have to provide contraceptive coverage or refer their employees to organizations that provide contraception.  

♦ Under the policy contraception coverage will be offered to women by their employers’ insurance companies directly and be free of charge.

♦ The new policy does not affect existing state requirements concerning contraception coverage.

Once the final rule has been published, we will provide additional analysis of the implications for the Catholic health care ministry.


January 20, 2012

HHS "Modifies" Preventative Services Mandate

The Obama Administration announced today that it was providing religious employers, who do not currently provide contraceptive coverage in their insurance plans an additional year to comply with theDepartment of Health and Human Services Secretary Kathleen Sebelius stated, “After evaluating comments, we have decided to add an additional element to the final rule.  Nonprofit employers who, based on religious beliefs, do not currently provide contraceptive coverage in their insurance plan, will be provided an additional year, until August 1, 2013, to comply with the new law.  Employers wishing to take advantage of the additional year must certify that they qualify for the delayed implementation.” Moreover, the Administration will require religious employers, exempt from the mandate under the Department’s very narrow definition of religious employer, to refer employees to providers that will provide contraceptive and sterilization services – “[The Department] intend[s] to require employers that do not offer coverage of contraceptive services to provide notice to employees, which will also state that contraceptive services are available at sites such as community health centers, public clinics, and hospitals with income-based support.”

Remarkably, Secretary Sebelius claims that the administration’s proposal “strikes the appropriate balance between respecting religious freedom and increasing access to important preventive services.”   In fact, this is not a modification of the rule, only a delay in the implementation of the mandate.

The Administration did nothing to address the fundamental flaw of the interim rule relative to its very narrow definition of “religious employer.”  Unchanged under the rule, a “religious employer” is exempt from the mandate to provide contraceptive and sterilization services if that religious employer is one that: 1) has the inculcation of religious values as its purpose; 2) primarily employs persons who share its religious tenets; 3) primarily serves persons who share its religious tenets; and 4) is a non-profit organization under Internal Revenue Code section 6033(a)(3)(A)(i) or (iii).  This HHS exemption entirely excludes the Catholic health care ministry, social services and educational institutions.

It is important to note that while California was the first state to enact this definition of “religious employer,” the California law is a more narrowly focused mandate than is the federal rule.  California law requires health care and disability insurance plans to cover FDA approved prescription contraceptive methods only if they also provide coverage for outpatient prescription drug benefits.

The new federal regulation creates an unprecedented mandate for all types of employer-sponsored health plans – including ERISA plans – to cover all FDA-approved contraceptive methods regardless of whether or not they cover outpatient prescription drugs, and broadens the mandated services to include sterilization procedures, as well as patient education and counseling for all women with reproductive capacity.

In a statement on the “revised” HHS regulation, Bill Cox, President/CEO of the Alliance of Catholic Health Care, stated, “The Department of Health and Human Services’ definition of religious employer is an unconstitutional encroachment on the authority of the Church.  For the first time in U.S. history, the rule places the federal government in the untenable position of defining what is or is not a religious employer.   In essence, the Obama Administration is saying, ‘We don’t agree with certain of the Church’s moral beliefs, so we will use state power to simply redefine what we consider a religious employer.’ Thus, religious employers the Administration now essentially views as ‘secular’ will have to comply with the new government mandates, whether or not they conflict with the authentic religious employer's deepest moral convictions.”

Mr. Cox further noted, “Under the First Amendment to the United States Constitution the federal government does not have the authority, nor does it have the competence, to troll through the religious beliefs and practices of the Church and determine which of its elements are religious and which are secular, and then impose on the ones it defines as ‘secular’ mandates that violate the Church’s religious and moral beliefs.  This seriously flawed precedent set by Administration’s definition of religious employer must, at the earliest opportunity, be reversed by the Congress, the federal courts, or both.

September 23, 2011

HHS Comments: Religious Employer Exemption

The Alliance of Catholic Health Care submitted comments to the federal Department of Health and Human Services (HHS) on the interim final rule relating to coverage of preventive services under the Patient Protection and Affordable Care Act. As you may recall, in early August, HHS issued an interim final rule requiring all types of health plans to include coverage of certain preventive services for women, without any cost sharing.  These preventive services were expanded to include, among other services, all FDA-approved contraceptive methods, sterilization procedures, and patient education. The regulation included an exemption for “religious employers” that was so narrowly defined to exclude health care, social services and higher educational ministries of the Catholic Church.  The attached comments address the regulation’s very narrow religious exemption.

capitol-domeThe Alliance has developed bipartisan federal civil rights legislation, The Abortion Non-Discrimination Act of 2011 (HR 361), to better protect the health care ministry in California from state discrimination on the basis that it does not provide, pay for or cover abortions.  The legislation seeks to strengthen existing conscience protections, such as the Weldon Amendment, by making them permanent under statute rather than a rider to an annual appropriations bill.  It also includes a "private right of action" that would strengthen the enforcement of federal conscience-rights statutes.  This effort was done in collaboration with the California Catholic Conference and the United States Conference of Catholic Bishops.

The Alliance has prepared a Bill Fact Sheet on HR 361, which gives backgound information and a summary of the bill.The Alliance's press announcement articulates our strong support for the legislation.
2011 Resources
pdficon_large HR 361 - Why The Federal Hyde/Weldon
Amendment Must Be Strengthened This Year

pdficon_large Alliance of Catholic Health Care
H.R. 3 Press Release - 5/4/11
pdficon_large HR 361 Bill Fact Sheet - February 3, 2011 pdficon_large Alliance of Catholic Health Care
Press Announcement - January 24, 2011
pdficon_large The Abortion Non-Discrimination Act
of 2011 (HR 361) - January 20, 2011
Other Resources
pdficon_largeAlliance Primer on Federal
Conscience Clause Protection
pdficon_largeConscience Clause Protection Q&A
pdficon_largeObey Conscience Clause Letter -July 09 pdficon_largeCatholic Hospitals in California
Obey Fact Sheet
pdficon_largeStatutory Provider Conscience Clause
Protection for Health Care Entities