Wednesday, February 15, 2012


February 16, 2012


Just when things were looking brighter for Barack Obama, just when the economy was edging up and unemployment was edging down, just when the Republican candidates (save one) were scrambling to find another three issues besides jobs, jobs, and jobs, here comes a special-interest group that in one narrow respect is more powerful than even the Big Banks: the U.S. Catholic bishops.

The bishops, coached by a crafty team of advisers, have learned a lot about politics in recent years. In the 1980's, their sweeping, book-length pastoral letters decrying military buildups and promoting economic justice were incisive and edifying but largely ineffectual. Policy-makers listened politely to the prelates, then ignored them.

Now they've wised up. They've determined, as all good politicians do, that hammering at one issue, backed by one principle, can yield impressive results.

The issue at hand is birth control, and the principle is religious freedom.

Oddly, the issue itself is a non-issue to most Americans, Catholics included. Contraceptive services are regarded by governments in general and by most people at large as an integral component of public health. Even many who are strongly opposed to abortion support contraception as the best preventative. Surveys indicate that 98 percent of Catholic women have used some form of artificial contraception sometime in their life. In the Catholic Church, the topic has rarely been mentioned from the pulpit for years, and in marriage counseling and confession, many priests treat the use of contraceptives as a matter of individual conscience based on the circumstances. Why then would the bishops take this on?

Because, objectively speaking, they had no choice.

The Catholic doctrine that sexual intercourse must always be open to procreation — paradoxically, even among the sterile — was unilaterally promulgated over 40 years ago by Pope Paul VI, overriding recommendations to the contrary by his own scholarly commission on the subject. Theologians have long debated the moral gravity of this teaching, but grave or less grave, it's on the books. Bishops by their office are compelled not only to teach it but also to ensure that Catholic institutions do not facilitate the use of contraceptives, either directly or through their insurance plans.

It is true that up until now, the U.S. bishops' policy on contraceptive coverage has not been unambiguous. Some states like New York require insurers to provide such coverage without exception, a regulation that individual Catholic dioceses and agencies have contested in the courts (and generally failed). Large dioceses have gotten around these mandates by insuring themselves, and have allowed standalone Catholic institutions like hospitals and colleges to deal with the problem in their own ways. Fordham University here in the Bronx, for example, prohibits prescribing contraceptives in its student health clinics but reimburses students for obtaining them elsewhere, and covers them for its emploees.

Once the mandate went national through the Affordable Care Act, however, the body of bishops had to act. The principle at stake was the free exercise of religion, a centerpiece of the Bill of Rights, and now this was a federal issue, not a state or local one.

Attempting to beat back the firestorm, on Friday the President announced a shift in policy. Rather than requiring objecting institutions to pay for birth control through their insurance plans, he proposed requiring insurers to pay for it themselves. This looked workable from the monetary standpoint, but the bishops, after a moment of hesitation, refused to buy it because contraception, no matter who paid for it, would still be written into their insurance plans, amounting to tacit approval.

And the administration thought it was all about money.

The sad thing about this flap is that if the country were on a single-payer plan, this issue would never have come up. Without having to subscribe to private insurance plans, Catholic institutions would be free of guilt-by-association. Hospitals and college health services would refuse to prescribe contraceptives just as they do now, but people could get them elsewhere simply by showing their Medicare-for-All card.

Thus the true culprit in this case is the very concept of private health insurance as a component of universal health coverage, be it ObamaCare or RomneyCare. Were health care publicly funded, there would be no First Amendment recourse.

Perhaps the President could try something truly creative by bypassing the insurers altogether and funding, even purchasing, contraceptives directly, as the federal government does for immunizations. The bishops would object to that too, but solely on the basis of their theological opposition to contraception, which has virtually no support in the public square. They'd be far less likely to get their way in Congress, given the longstanding federal policy of funding birth control through Medicaid and other government agencies.

This issue of contraception has turned out to be stickier than L.A.’s La Brea Tar Pits. Our national mastodon is sinking in the ooze, but the Republican saber-toothed cats, attacking their beleaguered prey, may well end up sunk in it themselves.