There has been lots of brouhaha about the ACA mandate to provide contraception coverage. There are now two cases pending in the Supreme Court related to the mandate. One is Sebelius v Hobby Lobby Stores, Inc.; the other is Conestoga Wood Specialties Corp. v Sebelius. What are the issues here?
An unusual editorial in the January 2, 2014 issue of the New England Journal of Medicine written by “The Editors,” dissects the issues in the case from a medical point of view. Both plaintiffs are claiming that the mandate violates their Companys’ religious freedom.
Are corporations people?
We now know the consequences that have plagued our political system since Corporate personhood was recognized. It seems to me that the arguments these companies are making are along the same vein: A corporation has religious rights, the same as a person. Really? According to the editorial, this is one of the issues that the Supreme Court will weigh in on.
The other issue at stake is whether protection of women’s health is a compelling state interest that should supersede the corporation’s religious preferences—in this case, to not provide coverage for contraception.
The public health value of contraception
The Editors make a compelling case for the public health value of contraception:
- Contraception prevents unintended pregnancies and does not promote promiscuity (as feared by some).
- It prevents unplanned pregnancies, half of which end up being terminated with all its attendant costs/risks.
- Planned pregnancies give women and children a chance for a better life—one in which the mothers can finish their education, establish stable relationships, get better jobs, and better provide for their children.
- It saves money for the state
I am not a religious person, so I find it difficult to swallow the reasoning of the Catholic Church’s stance against contraception. It goes like this: The Catechism of the Catholic Church specifies that “all sex acts must be both unitive and procreative.” But then it goes on to say that it is ok to regulate births, but only by using the rhythm method (which really doesn’t work all that well, and…by the way, how does employing the rhythm method meet the requirement that every sex act is procreative??).
From the Catechism:
2399: The regulation of births represents one of the aspects of responsible fatherhood and motherhood. Legitimate intentions on the part of the spouses do not justify recourse to morally unacceptable means (for example, direct sterilization or contraception).
2370: Periodic continence, that is, the methods of birth regulation based on self-observation and the use of infertile periods, is in conformity with the objective criteria of morality. These methods respect the bodies of the spouses, encourage tenderness between them, and favor the education of an authentic freedom. In contrast, “every action which, whether in anticipation of the conjugal act, or in its accomplishment, or in the development of its natural consequences, proposes, whether as an end or as a means, to render procreation impossible” is intrinsically evil: Thus the innate language that expresses the total reciprocal self-giving of husband and wife is overlaid, through contraception, by an objectively contradictory language, namely, that of not giving oneself totally to the other. This leads not only to a positive refusal to be open to life but also to a falsification of the inner truth of conjugal love, which is called upon to give itself in personal totality. …The difference, both anthropological and moral, between contraception and recourse to the rhythm of the cycle…involves, in the final analysis, two irreconcilable concepts of the human person and of human sexuality.
But we all know that you can’t dig too deeply into religious teachings or you will get lost in a jungle of contradictions or pronouncements that just don’t make sense. They must, we are told, be taken “on faith”.
Beyond pelvic politics
But, I digress…let’s get back to the editorial. The NEJM Editors point out that there are many other cases where coverage decisions appear to violate dearly held religious beliefs. For example, coverage for blood transfusions, vaccinations, or mental health services. The feminist writer, Nick Kristof, put it this way in an editorial gloriously titled, “Beyond Pelvic Politics“:
“I wondered what other religiously affiliated organizations do in this situation. Christian Science traditionally opposed medical care. Does The Christian Science Monitor deny health insurance to employees?
‘We offer a standard health insurance package,’ John Yemma, the editor, told me.
That makes sense. After all, do we really want to make accommodations across the range of faith? What if organizations affiliated with Jehovah’s Witnesses insisted on health insurance that did not cover blood transfusions? What if ultraconservative Muslim or Jewish organizations objected to health care except at sex-segregated clinics?”
If the employees are in synch with their Corporation’s “religious beliefs”, then they will not access contraception regardless of whether it is covered or not. If they are do not share the Corporation’s beliefs, shouldn’t they have access to these drugs in the same manner that millions of other folks with employer-sponsored insurance do?
The NEJM editorial closes by stating that “we do not believe that a for-profit corporation should be able to decide what kinds of health care are available to its employees.” I agree. The overwhelming medical evidence is that contraception is an essential health benefit that ought to be available to anyone who wants it—not just to those who can afford it.
As Kristof sums up,
” …let’s remember that there are also other interests at stake. If we have to choose between bishops’ sensibilities and women’s health, our national priority must be the female half of our population.”