The Affordable Care Act Turns Two — What’s in it for you?

March 20, 2012, 10:18 am | Posted by

This week marks the two-year anniversary of the Affordable Care Act, which passed thanks in part to the faith community’s remarkable efforts. Millions of Americans are already benefiting from the law’s new cost-savings and protections, and more is on the way.

Here’s a helpful interactive flowchart to help you figure out how the law benefits you:

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Reading the USCCB’s New Religious Liberty Letter

March 16, 2012, 3:00 pm | Posted by

USCCB Building - CNSAt the conclusion of their administrative committee meeting about religious liberty and the religious accommodation on contraception coverage Wednesday, the U.S. Conference of Catholic Bishops released a statement detailing their position on the issue.

Fr. Thomas J. Reese, S.J., Senior Fellow at Georgeown University’s Woodstock Theological Center, passed along some helpful analysis for interpreting the document.

While pointing out that the bishops remain united in their opposition to the rule and distrust the Obama administration’s accommodation, Reese highlights some of what’s not in the document:

There is no talk of the Obama administration waging a war on religion or being anti-Catholic. While the language is strong and uncompromising, it is not inflammatory.

There is no mention of the fact that Republican politicians have abandoned them and that a legislative solution (like the Blunt-Rubio proposal) is unlikely even in the House.

There is no talk of civil disobedience or cancelling health insurance for their employees if they do not get their way.

But Reese also notes something we’ve talked about extensively before. In a rush to prove that this debate is “not about contraception” and all about religious liberty, the bishops have still failed to answer the $64,000 question — what are the limits to that principle?

Reese again:

The statement infers that religious liberty is an absolute right that cannot be restricted. If this were true, Mormons and Muslims could practice polygamy and those who believe God demands the separation of the races should be exempted from civil rights legislation.

Michael Sean Winters notices the same thing. Responding to the bishops’ call for conscience protection for any individual who has a moral objection to a law, he says:

This is frankly shocking. Were the drafters of this task unaware that these words could be used — actually such arguments were used! -– by segregationists? They cited the biblical story of Ham to justify their stance, and I suppose a biblical citation counts as a religious claim.

Bishop Lori has vaguely outlined his own view that freedom is limited by a compelling government interest (seemingly rejecting exemptions for Christian Scientists and Jehovah’s Witnesses), but that seems to have been the bishops’ only attempt to answer this essential question. Until they address it more specifically, it’s extremely difficult to engage with their overall arguments on religious liberty.

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Will Arizona Women Have to Petition Their Bosses for Birth Control?

March 15, 2012, 8:00 am | Posted by

Arizona FlagLast month, we covered the testimony of Sandra Fluke, the Georgetown University Law student who testified in favor of the HHS regulation requiring all insurance plans to include birth control and other preventive services without co-pay. In particular, she highlighted the consequences of letting employers deny women these services, relaying the story of a friend who lost her ovary after she could no longer afford to pay out of pocket for contraceptive pills to treat her ovarian cysts.

Since Fluke’s testimony and the subsequent backlash from the far Right, the media has been saturated with coverage of the debate between religious liberty and reproductive freedom. However, as Nicole Neroulias’ recent Huffington Post piece rightly points out, framing the story in these terms misses this part of Fluke’s actual testimony.

“[A]s Fluke tried to explain in her opening statement, both frames miss the big picture: Women take the pill to address myriad health issues, from ovarian cancer, menstrual problems, hormone imbalances and fertility treatments to cystic acne, et al. This is the angle I’ve been waiting in vain for religious and mainstream journalists to acknowledge and investigate.

And logically, even when clergy approve of contraceptives for unrelated medical reasons, how would they have their institutions apply these directives? Should women who work at Catholic hospitals and schools get a doctor’s note for their bosses before requesting insurance reimbursement for the birth control pill? Would ovarian cysts and infertility make the cut, but acne and bad cramps be more along the lines of God’s will?”

This logistical problem is currently playing out in Arizona, where proposed Blunt Amendment-style legislation that would allow employers with moral objections to opt out of contraceptive coverage includes an exemption for employees who need it for health reasons, but only if they get permission from their employer.

I presume this measure is meant to prevent employees from lying about health problems to exploit this as a “loophole” to gain coverage for contraception. The law even makes it easier for employers to fire women for doing so.

But what about the 44% of women who use contraception for both health and birth control reasons? Do they have to convince their boss they’ve renounced the latter? Will people’s job security hinge on their bosses’ interpretations of their sincerity?

Further, does this principle apply to other drugs that can be used in multiple ways as well? Do single men with Viagra prescriptions need to prove they suffer from pulmonary arterial hypertension? Do employees need to convince their boss they aren’t abusing their painkiller prescriptions for recreational purposes? Is it practical to try to enforce legal lines that are based on the intention a person has when he or she uses a drug?

Turning bosses into moral and medical authorities over their employees seems to go far beyond bill proponents’ ostensible goal of limiting an employer’s involvement in practices they disagree with and clearly into the realm of directly controlling the behavior of their workers.

Tara Culp-Ressler contributed to this post.

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Cardinal Dolan Claims Bishops are Only Appropriate Catholic Legal Experts

March 7, 2012, 4:48 pm | Posted by

Cardinal Timothy DolanCardinal Timothy Dolan, president of the United States Conference of Catholic Bishops, gave a speech this weekend on the role of Catholics in public life, responding to recent debates about contraception and religious liberty.

In a news conference after the speech, Dolan addressed the fact that Catholic organizations and experts aren’t united around the Bishops’ policy analysis of the HHS mandate on contraception coverage and the subsequent accommodation that allowed Catholic institutions like hospitals and universities an exemption from covering contraception if it violates their beliefs. Groups like the Catholic Health Association and the Association of Jesuit Colleges and Universities who will be directly affected by the law have accepted the updated policy as addressing their religious liberty concerns while the Bishops remain unsatisfied.

Dolan has some choice words for anyone who asserts the validity of Catholic institutions besides the Bishops to weigh in on matters concerning church:

“We kind of got our Irish up when leaders in government seemed to be assigning an authoritative voice to Catholic groups that are not the bishops.”

He added: “If you want an authoritative voice, go to the bishops. They’re the ones that speak for the truths of the faith.”

Eduardo Penalver at dotCommonweal makes an important observation:

This understanding of the role of Catholic laypeople in public life would leave ample room for independent thought if Dolan’s conception of “the truths of the faith” were sufficiently general.  But he seems to view “the truths of the faith” as an extremely capacious category.

It includes not only determinations of high-level principles, but also the bishops’ views on very specific and fact-intensive moral conclusions, like the determination that Ella is an abortifacent or the conclusion that (under traditional Catholic views about cooperation with evil) Catholic institutions not only cannot provide health insurance that covers contraception that an employee is free to choose not to use but that those institutions must be empowered to preclude their own insurance carriers from separately contracting with employees to provide contraception coverage for no extra cost (or even, presumably, for some nominal extra cost).

This dynamic is exactly the same as the health care debate, in which the Bishops declared that their analysis, finding the complex structures preventing federal funding of abortion in the law inadequate (unlike the vast majority of experts and fact-checkers, who found that the law did prevent abortion funding), was the only acceptable Catholic position.

Blurring the lines of their teaching authority on moral principles by discrediting the expertise and judgment of Catholics they disagree with does a real disservice to the wider Catholic community.

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Health Care Expert’s Accommodation Explanation in Politico

March 6, 2012, 1:00 pm | Posted by

Professor Tim Jost’s explanation of why the Obama administration accommodation on contraception in healthcare is not an “accounting gimmick” has now been published in Politico.

A review of Jost’s analysis:

[T]he federal agencies are to propose a permanent rule that will require insurers to offer insurance to these religious employers without contraceptive coverage.

But insurers will also have to offer free coverage of contraceptives without cost sharing directly to any employees of these religious employers who want it. Objecting employers will thus not be required to provide coverage of nor referrals for coverage.

Insurers will be able to offer contraceptive coverage for free because, according to studies, contraceptives cost substantially less than pregnancies. The free coverage is not, therefore, an “accounting gimmick” — under which employers in fact pay for coverage against their beliefs. Instead, coverage will be paid for by the insurers — out of savings that they realize by offering contraceptive coverage.

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