At this university, most debates about reproductive morality center on abortion, so the furor last week regarding whether Catholic universities and hospitals needed to cover contraception in employee heath care plans may seem a more foreign concern. However, the debate illustrates an important clash between liberal and religious ethics over the scope of the state’s power.
Briefly, the Obama administration at first refused Catholic universities and hospitals an exemption from the policy that requires health care providers to include access to reproductive planning services including contraception, sterilization, and the emergency contraceptive Plan B. As the president of the University of Notre Dame, John I. Jenkins, pointed out this September, the Catholic Church opposes contraception, and thus the policy compels Catholic organizations “to either pay for contraception and sterilization in violation of the Church’s moral teaching, or to discontinue our employee and student health care plans.” Jenkins asked that exemptions be provided beyond those organizations “that primarily serve persons who share its religious tenets” to include ones like Notre Dame, which “shares common religious bonds and convictions with a church.” In doing so, Jenkins suggested that such an exception would “protect the conscience” of those who work for universities like Notre Dame and believe contraception use is wrong. Yet this discussion of conscience versus government regulation ignored the reason that the government issued the contraception mandate in the first place—the rights of the women whose contraception is on the line.
These women have rights and liberties that the government must defend. Those affected by Notre Dame’s health care policy range from professors to students to dining hall workers, and although many of them are Catholic like the university that educates and employs them, many are not. Furthermore, despite the Catholic Church’s ban on contraception, 98 percent of American Catholic women use some form of contraception—about the same rate as other women. Many women who work for Notre Dame thus use or will wish to use birth control, which is often prohibitively expensive. As one Harvard student told me recently, “My father is a deacon of an evangelical Christian church, and I knew that if anything ever showed up on insurance for contraception, I would be disowned. I decided to go to Planned Parenthood and was absolutely surprised when the nurse told me that my bill for a fifteen-minute appointment and thirty pills was $130. With $145 to my name, I had to choose two of the three: have sex, not get pregnant, or have more than $15 to your name. I chose not getting pregnant.” Birth control can at times be so expensive that allowing anti-contraceptive modification of a health plan would prevent some women from receiving birth control.
The women who work for Notre Dame have the right to the full health care plan afforded to women elsewhere in the United States—to equal access to the same benefits regardless of the views of their employer. This right necessarily begins beyond those organizations “that primarily serve persons who share its religious tenets” because only organizations with such specific membership criteria can presume that their members will agree to renounce contraceptives. The difference between organizations that primarily serve those with the same religious beliefs and those that are simply affiliated with a church is that it can be reasonably inferred that members of the former kind (for example, nuns or missionaries, as the language of the government decision suggests) personally reject contraceptives. Institutions that are simply affiliated with a church cannot ensure the same. Nuns may reasonably be expected to not need contraception because of the conditions under which they join their sisterhood, but college students and janitorial staff are not implicitly held to reproductive choices because of their membership in a religious university, nor should they be.
The Obama administration’s efforts to ensure women’s access to contraceptives originally forced some health care holders to pay for contraceptives they deemed immoral. Obama’s eventual concession, which gives women access to contraception at the insurance companies’ cost rather than the cost of the insurance pool, protects the freedom of conscience of Americans who believe that contraception is wrong by exempting religious organizations from paying for contraceptives. The recent concession does as much as possible to protect individuals from financing what they consider immoral while defending the right of all women to the same health insurance regardless of their employer’s religious views. Ultimately, the contraception mandate is not so much government interference with religious values as it is a legitimate protection of workers and students who would otherwise face discrimination based on the views of others members of their insurance pool. Individuals should at times have a “conscience clause” that exempts them from participation in government programs, but not at the price of denying access to others who have not committed to the same religious conscience.
Sarah C. Stein Lubrano ’13, a social studies concentrator in Kirkland House, is spending spring 2012 in Cambridge, United Kingdom. Her column appears on alternate Wednesdays.