Saturday, February 02, 2013
Descriptions of the latest iteration of regulations under the Affordable Care Act that define how women will have free access to contraception services didn't clarify much for me. But some digging, including a smart Catholic source, has helped me make some sense out of this which I'll share here.
I knew the back story: Catholic bishops were enraged last year that the government mandated that the insurance they provide to their employees -- Catholic or not -- must include contraception. Contraception is part of healthcare in the secular thinking of this democracy. The government said "okay -- if you are a church that doesn't allow women to control when they get pregnant, your insurance company will do the job for you, no charge." The bishops and some lay Catholics (mostly ones who didn't like Obama anyway) remained outraged because the compromise would leave institutions that proudly announce their Catholic connections -- universities, hospitals, social service agencies -- but operate in a secular context, without a fig leaf when they obeyed the law.
Since Catholic individuals are about as likely to approve of contraception as anyone else in this country, the brouhaha over the contraception mandate had no electoral effect. Bishops fumed and the majority of Catholics voted their consciences -- for Obama.
The latest go-round brings the historically Catholic institutions that operate in the secular world into compliance with the law by putting the burden for providing free contraception on insurance companies that write policies for the institutions. Presumably they'd recoup because contraception is good preventative medicine, saving money later -- and the Department of Health and Human Services also gives cooperating insurance companies a break when they also participate in the market portion of "reform," the exchanges.
That is, this rule makes an insurance companies act like a Shabbos goy -- a person not bound by religious prohibitions who performs an act that would be forbidden to a Jewish household that observes the sabbath in the full traditional manner. In the modern context, this concept, a concept that has analogues in many religions, seems like a strange concession to tribal gobbledy-gook -- we are mostly ethical universalists: if it is good for me, it is good for thee. The HHS rule allows some institutions to say "it is not good for me and perhaps thee -- but you'll be covered and the matter is subject to your individual conscience." In a pluralist system, that's what we should expect.
But hey -- this Obamacare compromise preserves the central win for women in the new system: contraceptive and reproductive care is simply healthcare.
The new rule doesn't cover private businesses that provide insurance. If your boss is some kind of fundamentalist with idiosyncratic medical ideas and the company offers insurance, he can't impose his medical prejudices on you.
Will the Catholic bishops and other fundamentalist objectors be smart enough to recognize this is probably the best deal they can get in a country that largely thinks they've jumped the shark in their struggle to control women's bodies? I hope so.