Rachel Evans
The HHS mandate, enforced by the Department of Health and Human Services, has been a contentious issue for Catholics, as it requires employers to provide and pay for coverage of abortifacients, contraceptives, and sterilization in their employee healthcare plans. This mandate forces Catholic institutions to go against their religious beliefs and has sparked opposition from Catholics and other religious groups who see it as an assault on religious liberty. The Catholic Church's theological tradition has spoken out against the mandate, and Catholic employers have struggled to balance following Church teachings while operating their businesses. The Supreme Court has not yet ruled on whether this accommodation violates the Religious Freedom Restoration Act when applied to religious organizations.
| Characteristics | Values |
|---|---|
| Institutions impacted | Charities, schools, universities, hospitals |
| Mandate forces institutions to | Pay for things they consider immoral |
| Religious employers | Must write policies that violate their beliefs |
| Religious employees and students | Must purchase coverage that violates their beliefs |
| Catholic stance | Unified in opposition to the mandate |
| Other religious groups | Also oppose the mandate |
| Federal mandate vs state mandate | Federal mandate is stricter than existing state mandates |
| Religious exemption | HHS chose the narrowest state-level exemption as the model |
| Religious Freedom Restoration Act (RFRA) | Passed in 1993 with bipartisan support |
| Supreme Court decision | In favor of Hobby Lobby and its owners, upholding religious rights |
| HHS Secretary Kathleen Sebelius | Defended the mandate, stating it respects religion |
| Obama administration | Accused of targeting religious liberty |
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What You'll Learn
The HHS mandate is a substantial burden on the practice of faith
The HHS mandate, enforced by the Department of Health and Human Services, is a provision of the Patient Protection and Affordable Care Act. It requires employers to provide and pay for their employees' health insurance coverage for abortifacients, contraceptives, and sterilization. This mandate includes Catholic employers, such as charities, schools, universities, and hospitals, which are considered to have a primarily non-Catholic workforce.
The HHS mandate has been deemed a "substantial burden" on the practice of the Catholic faith by some. This is because it forces Catholic employers to pay for products and services that are considered immoral by the Catholic Church. These include abortifacients, contraceptives, and sterilization procedures. By providing this coverage, Catholic employers are knowingly facilitating actions that go against their religious beliefs, making them morally complicit.
The Catholic Church has consistently taught that the use of contraceptives is immoral and has spoken out against the HHS mandate. Catholic bishops have objected to the mandated involvement in coverage of these practices, and Catholic theologians and employers have concluded that the mandate is unacceptable due to its direct conflict with Catholic teachings. The mandate forces Catholic employers to either change their beliefs or violate them, which is seen as a coercive pressure imposed by the government.
Additionally, the HHS mandate has been criticized for not providing a religious exemption for Catholic organizations. While HHS Secretary Kathleen Sebelius stated that the policy respected religious organizations that primarily employ people of their own faith, Catholic agencies have a history of serving and hiring non-Catholics. As a result, they do not qualify for this exemption and are forced to either turn away non-Catholics or comply with the mandate, which they consider immoral.
The HHS mandate has faced opposition from Catholics and people of other religious faiths, who see it as an assault on religious liberty. The mandate has been challenged in court, with over 190 individuals from various Catholic institutions filing 59 lawsuits. The Supreme Court has not yet ruled on whether the mandate violates the Religious Freedom Restoration Act when applied to religious non-profit entities, but the debate continues between those who prioritize reproductive freedom and those who prioritize religious freedom.
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The Catholic Church's stance on contraceptives
The Church's position is based on the belief that contraception is a deliberate violation of the design God built into the human race, often referred to as "natural law". The natural-law purpose of sex is procreation, and the pleasure that sexual intercourse provides is seen as an additional blessing from God, intended to offer the possibility of new life while strengthening the bond of intimacy, respect, and love between husband and wife.
The Church also teaches that the sexual union of husband and wife is meant to express their committed love and their openness to new life. Contraception is seen as a failure to respect married love's power to help create new life, which has led to a lack of respect for life and the sanctity of marriage.
In addition to these theological arguments, some Catholics also point to the health risks associated with contraceptive use, such as an increased risk of blood clots, tumors, strokes, and certain cancers. However, the Church does not oppose the use of hormonal medications for legitimate medical purposes, as long as there is no contraceptive intent.
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The Obama administration's stance
A key aspect of the administration's position was its understanding of religious liberty. The Obama administration believed that religious freedom entailed more than just the right to hold and practise one's faith; it also included the ability to act upon those beliefs. This meant that religious institutions should be exempt from certain laws that substantially burdened their religious exercise, as long as granting such exemptions did not impinge on the rights of others.
In the specific case of the HHS Mandate, the administration recognised the sincere religious objection that many Catholics and other religious groups had to providing or facilitating access to contraceptive services. As such, the initial rule included an exemption for certain religious employers, defined as those organisations primarily dedicated to inculcating religious values and primarily employing and serving individuals of their own faith.
However, the administration also believed that access to contraceptive services was an important matter of public health and gender equality. As a result, they sought to ensure that employees of non-exempt religious organisations, as well as those working for secular companies, would still have access to contraceptive coverage, without cost sharing. This led to the creation of an accommodation for non-exempt religious organisations, whereby these groups could notify the government of their religious objection. The government would then ensure that employees received separate coverage for contraceptive services directly from insurers.
The Obama administration defended this approach as a reasonable balance between religious liberty and women's access to healthcare. They emphasised that the accommodation meant that religious organisations were not required to provide, pay for, or facilitate access to contraceptive services. Instead, a separate mechanism was created to provide this coverage directly from insurers, thus removing any substantial burden on religious exercise.
While the administration's stance aimed to navigate the complex intersection of religious liberty and access to healthcare, it nonetheless provoked significant controversy and legal challenges from Catholic and other religious groups who felt that their religious freedom was still being infringed upon. The issue became a flashpoint in the debate over the role of government, the scope of religious liberty, and the place of religion in American public life.
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The Supreme Court's ruling
The Supreme Court appeared to side with the federal government, upholding the legality of the HHS preventive care task force. Justices questioned the government's interpretation of the task force's independence, as members can be removed at any time. The court also considered the power of the HHS secretary to appoint task force members.
In a separate case, the Supreme Court ruled 7-2 in favor of the Department of Health and Human Services (HHS) regarding the calculation of Medicare Disproportionate Share Hospital (DSH) payments. The court upheld HHS's position that patients ineligible for monthly cash benefits under Supplemental Security Income (SSI) cannot be counted towards the SSI portion of the DSH formula.
The Supreme Court also upheld the CMS vaccine mandate, requiring COVID-19 vaccination for staff in Medicare and Medicaid facilities, with exemptions for medical and religious reasons. The court recognized the core mission of CMS to protect patient health and safety and characterized the mandate as consistent with the Hippocratic principle of "first, do no harm."
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Religious liberty and the First Amendment
The First Amendment's first two clauses enshrine freedom of religion into the framework of the American legal system. The Establishment Clause states that "Congress shall make no law respecting an establishment of religion", while the Free Exercise Clause adds that Congress shall also not prohibit "the free exercise [of religion]". This right, as Catholics recognize, comes from God and not any man or government. The existence of this right is often taken for granted today, but in the 1700s, the idea was revolutionary.
Early American Catholics played a crucial role in convincing the Founding Fathers to guarantee religious liberty in the Bill of Rights. One prominent Catholic advocate for religious liberty was the Irish-born writer and publisher, Matthew Carey, a good friend and protege of Benjamin Franklin. During the early Revolution, Carey wrote a popular pamphlet titled "The Urgent Necessity of the Repeal of the Penal Code against Roman Catholics", which brought attention to anti-Catholicism in the English-speaking world. Through his pamphlets and newspaper, Carey actively petitioned for strong religious freedom protections in the Constitution of his home state of Pennsylvania, as well as the federal Constitution.
In 1784, Father John Carroll, who would later become the first Catholic bishop in the newly independent United States, penned a defence of the Catholic faith. He observed that the new country was "blessed with civil and religious liberty" and stated that if the United States continued to recognize this freedom, it would prove to the world that "general and equal toleration, by giving free circulation to fair argument, is the most effectual method to bring all denominations of Christians to a unity of faith".
In more recent times, the HHS (Department of Health and Human Services) mandate has been a source of controversy for Catholics. The HHS mandate does not exempt Catholic charities, schools, universities, or hospitals, as these institutions are not deemed "religious employers" worthy of conscience protection. The mandate forces these institutions to pay for things they consider immoral, such as abortifacients, contraceptives, and sterilization. Catholics of all political persuasions are unified in their opposition to the mandate, seeing it as an assault on the broader principle of religious liberty.
Archbishop Joseph Kurtz of Louisville, KY, has spoken out in defence of religious liberty, citing the Religious Freedom Restoration Act (RFRA): "The Religious Freedom Restoration Act (RFRA) guarantees this protection. Thank God for RFRA." The USCCB has also called for continued protection of RFRA and other laws that safeguard religious freedom. They encourage Catholics to contact Congress to include conscience provisions in legislation.
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Frequently asked questions
The HHS mandate is a federal mandate from the Department of Health and Human Services (HHS) that requires employers to provide and pay for coverage of abortifacients, contraceptives, and sterilization in their employee healthcare plans.
Catholics oppose the HHS mandate because it forces them to pay for and provide products and services that are considered immoral by the Catholic Church, such as contraception, abortion, and sterilization. The mandate also does not exempt Catholic charities, schools, universities, or hospitals, which are vital to the mission of the Church.
The HHS mandate is part of the Patient Protection and Affordable Care Act, also known as Obamacare. The Obama administration argued that it was necessary to balance religious beliefs and convictions with the need to provide women with preventative care.
The Catholic Church has strongly opposed the HHS mandate, with Catholic bishops, theologians, and employers concluding that it is unacceptable and a violation of religious freedom. More than 190 individuals representing Catholic institutions have filed lawsuits against the mandate.
