resident Barack Obama went a long way this month to proving conservative critics correct when they paint the president as aloof and arrogant. In a long-anticipated decision, Obama and HHS Secretary Kathleen Sebelius mandated that employers provide coverage for contraception, sterilization, and abortifacients at no charge — not even copays — as part of the ObamaCare regulation of health insurance. That mandate exempts "places of worship," but not religiously affiliated organizations such as schools, charities, and hospitals. When an eruption of outrage followed the announcement of this new rule, Obama announced an "accommodation" — without once bothering to consult the religious organizations impacted by the rule, nor changing the impact of the rule one whit through the supposed "compromise."
Obama's diktat to Catholics demonstrates just how arrogant the president can be.
First, let's take a look at the differences between the original rule published in late January and the supposed accommodation offered last Friday, as economist Greg Mankiw helpfully explains it. The original rule (A) required employers to buy health insurance that covers contraception and abortifacients for its employees. The compromise (B) requires employers to buy health insurance for its employees, and have the health insurer communicate its coverage for contraception and abortifacients to the employees. As Mankiw notes, the employer still bears the cost of the health insurance, which will cover the costs of those products and services, so it's impossible to support B but not A, or A but not B. There is no substantive difference between the two positions.
Employers still have to provide coverage — at no cost, not even copays — for contraception and abortifacients such as "ella" and Plan B, as well as IUDs. Here's a question few are asking: Why? Obama and his administration insist that women need better access to contraception and abortifacients, but few women have problems accessing them. The CDC reported in 2009 that contraception use wasn't exactly lacking: "Contraceptive use in the United States is virtually universal among women of reproductive age: 99 percent of all women who had ever had intercourse had used at least one contraceptive method in their lifetime." Of all the reasons for non-use of contraception in cases of unwanted pregnancy, lack of access doesn't even make the CDC's list; almost half of women assumed they couldn't get pregnant (44 percent), didn't mind getting pregnant (23 percent), didn't plan to have sex (14 percent), or worried about the side effects of birth control (16 percent). In fact, the word access appears only once in this study of contraceptive use, and only in the context of health insurance, not contraception.
The mandate for no-cost insurance coverage makes no business sense, either. Insurers operate risk pools, and the more risks one group creates, the more they are expected to contribute to balance the risk for the other participants. For instance, when a driver buys insurance, his rates depend on a number of factors, including age, vehicle type, area of residence, driving record, and the number of miles driven in a year. If a driver chooses to drive more than 7,500 miles in a year, the risk increases, and so do premiums for that driver. If the insurer spread the cost of this one driver's increased risk across the whole pool of drivers, it would disincentivize risk minimization. Adults can choose to be sexually active. They might require contraception. But if the government mandates coverage of those products, shouldn't the people choosing that riskier behavior be expected to contribute more rather than less, to keep the rest of the risk pool from paying for their increased access?
The White House and HHS insist that this is immaterial, because it's cheaper to provide the contraceptive coverage than to exclude it. This is based on a cost-benefit analysis that claims that the use of contraception and abortifacients lower health-care costs for women. If that's true, however, health insurers wouldn't need a mandate to add such coverage to existing plans. The problem with this analysis is that it ignores the fact that insurers have to cover the up-front cost of such products and services, while any possible savings (by preventing more expensive pregnancy and childbirth costs) would occur over a much longer period of time. Those up-front costs will be borne by those paying the premiums — in this case, the employers (and sometimes, partially, by employees.)
The insistence on enforcing a mandate on private employers to cover contraception use at no additional cost to the employee is arrogant. When has the U.S. ever mandated to private employers that they had to give away products and services for free? But in relation to religious organizations, it's more than arrogant. It flies in the face of religious freedom, and not just for Catholics (although we provide a clear example for the purposes of this debate).
The Catholic Church has opposed artificial birth control and abortion for two millennia. That opposition springs from the same core doctrine that animates the church's efforts in charitable outreach, education, and health care: The sanctity of human life and the meaning of sexual relations between men and women. The Obama mandate and its subsequent "accommodation" attempt to divorce the Church from the schools, hospitals, clinics, and charities it runs by declaring that only houses of worship deserve the protection of the First Amendment ban on government interference with the practice of religion. However, those hospitals, schools, and charities are the way in which the Catholic Church puts their religious principles into action, and the same is true for any number of other religious denominations. Those organizations are indeed the "free exercise thereof" in a very real sense, the very activity that the First Amendment protects.
Now the Obama administration wants to force these organizations to violate the very doctrine that motivates their outreach to the communities they serve. By being forced to carry insurance that funds contraceptive and abortifacients, the U.S. would force religious organizations to facilitate activities that they see as immoral or evil, and that contradict their faith.
Some may well disagree with the Catholic Church's teachings on contraception and abortion, including more than a few Catholics. Those who disagree have no compulsion to attend Mass or to work for Catholic organizations. Opponents of Catholic doctrine can work to get the church to change its position, however unlikely that might be. However, no one elected Barack Obama to be pope, and his diktat to Catholics and other Christians to accept his doctrine at the expense of their own violates our cherished freedom of religion — and demonstrates better than any of his critics might have done just how arrogant Obama can be.
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