Sr. Keehan does a 180 on the HHS mandate

In a remarkable about-face late today, the Catholic Health Association released a letter it sent to the Department of Health and Human Services voicing its objection to the mandate attached to the Affordable Care Act that requires employers to pay for contraception. Sr. Carol Keehan, president of the CHA, had previously expressed approval of the accommodation for religious employers announced by President Obama in February, saying it “protects the religious liberty and conscience rights of Catholic institutions.” The US bishops, of course, have quite vocally disagreed with Sr. Keehan’s assessment of the administration’s move.

Today’s letter from the CHA—signed by Sr. Keehan as well as the past and present chairs of the organization’s board—echoes many of the bishops’ stated concerns about the mandate and the accommodation for religious employers, saying that it is “narrower than any conscience clause ever enacted in federal law and reflects an unacceptable change in federal policy regarding religious beliefs.”

The CHA’s reversal is all the more remarkable given that the accommodation was, according to a New York Times report, put in place by the Obama administration in large part to secure Sr. Keehan’s continued support for the ACA, for which she had strongly advocated.

The CHA letter alludes to the organization’s previous optimism about the HHS regulations:

While [the accommodation for churches] seemed at the time to be a good first step, our examination and study of the proposal as outlined then and in the ANPRM has not relieved our initial concerns. Accordingly…we continue to believe that it is imperative for the Administration to abandon the narrow definition of “religious employer” and instead use an expanded definition to exempt from the contraceptive mandate not only churches, but also Catholic hospitals, health care organizations and other ministries of the Church. If the government continues to pursue the policy that all employees should have access to contraceptive services, then it should find a way to provide and pay for these services directly without requiring any direct or indirect involvement of “religious employers,” as broadly defined.

The CHA letter does not directly address the questions of the constitutionality of the HHS mandate or of conscience protections for non-religious employers who object to funding contraception. But the letter acknowledges those concerns, stating, “The United States Conference of Catholic Bishops has persuasively addresses [sic] these points it its comment letter.”

The CHA does share the USCCB’s objection that the mandate imposes an unacceptable divide between the Church’s mission to spread the Gospel and its obligations to help those in need, calling on the HHS to broaden its definition of a “religious employer” to include all church ministries:

Making this change could help address the serious constitutional questions created by the Departments’ current approach, in which the government essentially parses a bona fide religious organization into secular and religious components solely to impose burdens on the secular portion. To make this distinction is to create a false dichotomy between the Catholic Church and the ministries through which the Church lives out the teachings of Jesus Christ. Catholic health care providers are participants in the healing ministry of Jesus Christ. Our mission and our ethical standards in health care are rooted in and inseparable from the Catholic Church and it’s teachings about the dignity of the human person and the sanctity of human life from conception to natural death.

The CHA letter concludes with the suggestion that “if the government insists that all employees have access to contraceptive coverage without cost sharing, then it should provide and pay for these services directly,” presumably with tax-payer funds. The letter points out that the federal government already foots the bill for contraception through Title X and Medicaid legislation.