Politics, drugs, money, religion. Oh, and sex.

This is not just a list of what not to talk about over Thanksgiving dinner, but rather the major topics of the recent Health and Human Services “contraception compromise.”  Given the presence of all of these factors it is no wonder that there were more than a few people upset.



The basic plot goes like this: late January, the Department of Health and Human Services announced that, as part of the Affordable Care Act, employers would have to cover the full costs of certain contraceptive and sterilization products as well as certain drugs like Plan B. There was a narrow clause that exempted organizations like churches from having to cover such measures, but would not have covered religiously affiliated organizations such as schools, charities, or universities. After strong backlash (both religious and secular), the Obama administration backpedaled and suggested a plan that will substantially broaden the exemption and will instead require the insurance companies of exempted organizations to provide contraceptive care to their coverees.

This compromise has appeased the Catholic Health Association and NETWORK Lobby (both credited for tipping the political scales in the passage of the Affordable Care Act), Planned Parenthood, and many at-one-point-wavering Democrats.  You don’t typically see these three groups agreeing on anything and, given the composition of the compromise, there should have been even more groups in support of it.

So why don’t Republicans (in Congress and on the presidential campaign trail) and the Catholic Bishops agree to the contraception compromise?  Explaining the Republicans’ discontent is easy: they want Obama out of office.  They saw that Obama had made a tactical mistake with the initial HHS decision and tried to exploit it.  Their “problem” with requiring insurance companies to provide contraception to all women is not really a “problem,” but simply an attempt to pick up votes come November.

However, that does not cover up the fact that this is a GIANT mistake by the Obama administration. It is disturbingly apparent that this problem could have been avoided as early as last October. The administration floated a policy, based on a Hawaii law, which would have secured birth control access through health insurance while allowing religious organizations to opt out. Catholic groups were on board for a policy like this, but Obama chose a decidedly more confrontational tack instead.*


*Given how easily it seems this all could have been avoided, some have suggested that this compromise was the White House’s plan all along. HHS only issued the stricter mandate in order to draw the opposition into a more politically difficult situation once the compromise was announced. That’s fine for collecting sound bites from Republicans, but regardless of their personal stance on contraception, Catholics don’t like seeing their Church dismissed so cavalierly.

If Republican opposition is rooted in realpolitik, the Catholic Bishops’ qualms are strictly ideological.  Although the compromise expands the exemption to all religiously-affiliated organizations, it still provides a mechanism for employees to obtain contraceptive services directly from the insurance company. The Bishops argue that this still implicates the employer in those immoral acts. 

And the truth is that to some degree it does. But the truth is also that similar rules are already on the books (seemingly without controversy) in 28 other states. After the initial ruling in January, the Bishops’ major concern was that Catholic schools and service agencies were going to have to pay directly for contraceptive services.  With the compromise announced this week, they won’t.  

Because the Bishops’ concern was addressed in this compromise, they should be in agreement that this was the best possible deal, but they aren’t.  Rather, the Bishops are taking this as an opportunity to push an anti-contraception more agenda broadly. They have a problem with the mandate in general, not just the narrowness of the religious exemption.

It is perfectly understandable for the Bishops to take a stand against the use of all contraception.  It is what the Catechism teaches, plain and simple.  However, society’s use of contraception is beyond the scope of the current discussion.  Rather, it is about how contraception services will be paid for and provided to employees of religious organizations. 

The Bishops were right to push back strongly and eloquently against the original HHS mandate, but it is reckless to reject a fair compromise simply because they wanted more.  Given the circumstances, this is a good outcome.  The Bishops fought the good fight and won: Catholic organizations will no longer have to pay directly for contraceptive services.

-Joe and Patrick