Requirement balances religious freedom, equity, public health.
The Obama administration has reached a sensible but controversial decision on health insurance coverage for contraceptives. In general, an employer's religious beliefs should not dictate the type of drugs or medical procedures covered by their employees' health insurance plans.
The U.S. Department of Health and Human Services (HHS) recently announced that it will stand firm on requiring many religiously affiliated hospitals, universities and charities to provide coverage for prescription birth control to their covered employees. Under federal health reform, birth control is now part of the preventive services provided at no charge by insurers.
The decision puts the administration at loggerheads with the powerful U.S. Conference of Catholic Bishops. The bishops, noting their institution's long stance against prescription birth control, sought a broader religious exemption from this policy.
Houses of worship are not required to provide birth control in their health coverages, nor should they be. But the Obama administration rebuffed the bishops by declining to exempt religiously affiliated organizations whose primary mission isn't worship.
Critics, such as New York Archbishop Timothy Dolan, blasted the decision as an attack on religious freedom. Yet another constitutional challenge to the federal health reform law is likely -- the last thing this embattled law needs.
The Obama administration nevertheless made the right decision. Birth control access is critical for women and children's health, ensuring that kids are born to parents ready for this responsibility. Lost in all the heated rhetoric over this milestone public health measure are several important points.
This policy does not require anyone to use birth control. In addition, courts have already rejected claims by Catholic organizations that requiring contraceptive coverage in employee health plans violates their religious freedom.
Requiring these religiously affiliated institutions to cover birth control in their plans is nothing new. Twenty-eight states (Minnesota isn't one) already have "contraceptive equity" laws requiring birth control coverage for many plans covering prescription drugs.
In 2004, the California Supreme Court, noting that many of these organizations' employees are not Catholic, soundly rejected a challenge to the state's contraceptive equity law. It concluded that the state can enact employment laws to protect workers, even if these laws conflict with the employers' religious beliefs.
The U.S. Supreme Court declined to hear Catholic Charities' appeal. New York's highest court rejected a similar claim by Catholic Charities on grounds that the law didn't target religious beliefs and that a broad public interest is served by addressing gender disparities in medical costs.
The U.S. Supreme Court has also decided on multiple occasions that religious beliefs do not protect discriminatory practices, such as failing to comply with civil rights laws.
The battle over birth control coverage is likely just beginning. Legislation has been introduced in Congress that would allow employers and insurers to refuse to cover medical services they find objectionable on religious grounds.
Birth control would likely be struck quickly from many plans, but what would be next? HIV testing? Treatment for cancers linked to sexually transmitted diseases? The door would be left wide open for eliminating almost anything.
Religious freedom is one of this nation's most cherished values. The Obama administration's birth control ruling carefully balanced respect for this tradition with concern for equity and public health.
Congress should do the same.
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