To no great surprise, the Catholic Health Association (a trade organization for Catholic hospitals) has come out in support of the Obama administration’s final rule coercing groups to cover early-abortion items, contraception and sterilization in health plans. CHA infamously contradicted the U.S. Bishops’ objections to Obamacare–objections that this mandate proves were fully justified.
CHA has issued a legal memo purporting to describe the effect of the final rule, but the memo largely repeats the Obama administration’s own propaganda defending its rule.
The administration continues to exempt essentially only houses of worship from its mandate. But it has created a mantra, a kind of incantation, to describe its rule as if it really protects conscience. CHA repeats the mantra as its authors intended: that religious groups won’t have “to contract, provide, pay or refer for contraceptive coverage.”
These are basically magic words–think, “there’s no place like home.” The administration and CHA claim that by simply repeating these words over and over again, they will be true, regardless of what happens in the real world. Whenever you point out that the reality is different, the administration simply repeats its magic words back to you.
Here are CHA’s three big errors in defending this rule:
1) CHA: Insurance plans for non-profit religious groups won’t cover contraception?
FALSE. The final rule tells religious non-profits says that they will provide health insurance to their employees. Then it says the insurance company they are paying will give their employees what the rule calls “coverage” of early-abortion drugs, contraception and sterilization. The coverage comes in the form of “payments” for those items, which is what coverage is: when you incur a cost, the insurance company pays you for it. This coverage will go to the group’s employees, from the group’s insurance company, only because that religious group is paying that insurance company for that insurance.
How is this not providing a plan that provides objectionable coverage?
In response, the rule and CHA recite their mantra: the payments are not part of the health insurance plan. The health insurance plan even gets to write down on a piece of paper that this plan doesn’t cover these things.
But the coverage is necessarily part of the religious group’s insurance. There is no other insurance plan. There is only one plan. Where do the “payments” come from? Only from the same insurer, who the group is paying, for the employees’ one plan. The coverage is part of the plan.
So religious groups are unavoidably facilitating and causing the coverage–even “providing” it. Simply incanting the idea that they aren’t doing so doesn’t change the reality that they are. There is no other plan–the coverage comes from the religious group’s provision of a plan. Maybe some groups think that providing such coverage is morally acceptable. But denying that they are providing the coverage is denying the details of the arrangement.
The rule requires the insurer to “segregate” payments for the coverage from the insurance plan’s premiums. So it creates an accounting gimmick to claim that even though the coverage is there, someone else is paying. Ultimately, accounting gimmicks are just that: gimmicks. And regardless, not “paying” for coverage that a group morally objects to does not resolve their moral objection. Many groups also object to being the cause of the immoral coverage. That is what the final rule makes them do anyway.
2) CHA: Self-insured plan administrators can choose not to provide the coverage?
FALSE. The idea that “it’s not you doing it, it’s your insurer” runs into a brick wall when the religious group acts as its own insurance company, by “self-insuring.” The administration didn’t solve this problem, it ignored it.
The final rule says a self-insured religious group must sign a paper that contractually and legally designates someone else to provide the contraceptive coverage. That someone else is called a “third party administrator.” He isn’t an insurance company, necessarily–he just handles the paperwork when employees submit health costs and ask for reimbursement.
So point one: the final rule directly causes self-insured entities to “contract for” coverage of objectionable items. It literally forces them to sign language that contractually designates the TPA to go out and get the objectionable coverage. Tellingly, the final rule declares that “after” doing so, its mantra is still true, that religious groups won’t have to contract for the coverage. So after I force you to violate your conscience, I won’t do it again. Lovely.
Second, CHA simply misstates the law when it declares that “There is no legal requirement that a TPA accept this role” to go out and get coverage for the objectionable items. The contractual designation that religious groups sign is intended precisely to legally bind the TPA to do this. The final rule admits it, too. But the final rule says, basically, that TPAs don’t have to do this in the big picture because they could always quit their jobs: they could refuse to do any work at all for a religious group. The final rule repeats this twice.
Thanks a lot. The final rule basically makes self-insured religious groups pariahs in the self-insurance market, by law, but says who cares, you shouldn’t be self insuring in the first place. And CHA is OK with this for its self-insured entities.
3) CHA: Employees can opt out of objectionable coverage?
FALSE. This might be the most transparently dismissive part of the CHA memo. CHA itself asked the administration to let employees opt-out of the objectionable coverage if they don’t want themselves or their spouses or daughters to get free coverage of early-abortion drugs, contraceptives and sterilizations. The administration simply said no. And CHA’s response is, well nevermind.
The administration’s (and CHA’s) rationale for refusing an opt-out is the idea that the payments for these items won’t come from another insurance plan, it will come from the employer’s own insurance company, and employees can simply decline to buy IUD’s and tubal ligations, so they don’t need an opt out.
This reasoning insults the entire attempt to respect religious objections. The point of this whole debate is that people don’t just object to using these items themselves, they object to having it covered for free, especially in connection to their own insurance plan, especially for their own daughters. And the administration’s response to this is nothing at all. You, employee, even if you work at a Catholic organization so your health insurance won’t give your daughters free sterilizations, you will still get coverage guaranteeing those payments. You won’t even get it as a part of a separate plan. It’s from the insurance company whose plan you are participating in. Tough luck.
And the CHA is OK with this, despite having asked for this meager exception. The Obama administration wants minor girls and college girls to have free abortion-pills contraception and sterilization even if their parents are devoutly religious. Scratch that: especially if their parents are devoutly religious.
CHA has given its imprimatur to a regime that makes religious groups, and their employees, facilitate and cooperate in coverage they morally object to: through their own insurance plans, and their own insurance companies. Expected, but sad nonetheless.