The Catholic clergy has aggressively lobbied against the Obama administration's proposed rules for contraception coverage for the past few months, arguing that a mandate that would require health plans to cover birth control at no cost to women would force Catholic hospitals and universities to abandon their religious beliefs. But many of these health care providers already cover birth control and even abortion services for their employees -- a reality that undermines the clergy's alarmist approach.
The Department of Health and Human Services (HHS) is currently considering a list of insurance coverage guidelines that would mandate that all health plans under the Affordable Care Act cover birth control at no cost for women. The rules have a religious exemption for churches, but many Catholic-affiliated organizations such as charities, schools and hospitals would still have to offer plans that cover birth control for their employees.
While the federal government has never before required private health plans to cover contraception, 28 states already have contraceptive equity laws that require health plans, if they offer any prescription drug coverage, to also cover birth control. Some of these states have religious exemptions for employers, and some don't -- but the exemptions rarely include religiously affiliated hospitals and schools.
The religious exemption initially proposed by the Department of Health and Human Services is similar to many state exemptions: Only organizations whose primary purpose is the inculcation of religious values and who mainly employ and serve people of their own faith would be able to refuse to cover contraception for their employees. Catholic hospitals have argued that the terms of the exemption would force them to either turn non-Catholic patients away at the door or try to convert them.
Lobbyists for the Catholic clergy argue that "even Jesus wouldn't qualify" for the exemption, since he served Samaritans, and that the new rules would force Catholic hospitals to turn ailing Baptists away from the door.
"The way it's written, a Catholic hospital has to make sure you're Catholic before treating you," Sr. Mary Ann Walsh, a spokesperson for the U.S. Conference of Catholic Bishops, told HuffPost. "That's an absurdity. One in six people who go to a hospital go to a Catholic hospital. The rule as it's written creates a catch-22."
John Garvey, the president of Catholic University in Washington, D.C., wrote in a Washington Post op-ed that the rule would put Catholic schools in an impossible position.
"If we comply, as the law requires, we will be helping our students do things that we teach them, in our classes and in our sacraments, are sinful — sometimes gravely so," he wrote. "It seems to us that a proper respect for religious liberty would warrant an exemption for our university and other institutions like it."
But many Catholic hospitals and universities have been covering contraception for their employees and students for years, and have managed to continue to serve non-Catholics and uphold their mission. Fordham University, Georgetown University, and DePaul University, for instance, all offer their employees health plans that cover contraception, as does Catholic Healthcare West, a large Catholic hospital system in California, Nevada and Arizona.
Fordham, which is forced to cover contraception because it is ineligible for the religious exemption in New York’s Women’s Health and Wellness Act, gets around the rule by refusing to prescribe birth control on campus.
"You go in [to the student health center] and get your gynecological exam, and that's when you find out there's religious health care going on," Bridgette Dunlap, a 31-year old law student at Fordham, told HuffPost. "You have to go to some other doctor for birth control, which, under our insurance plan, costs 100 dollars, even if the only thing you need is a prescription written. So a lot of people end up going to Planned Parenthood."
A spokesman for Fordham University confirmed that the health center covers students' birth control but does not prescribe it. "Fordham is a Catholic university and follows church teachings on reproductive issues," he said.
A Georgetown University spokeswoman said that it offers employees "access" to outside health insurance plans that cover contraception and abortion, but that the school's own insurance plan excludes those services. This way, Georgetown can comply with Virginia and Maryland's state mandates (the health plans are licensed in those states as well as D.C.) while adhering to its Catholic values.
Catholic Healthcare West, which runs more than 40 Catholic hospitals, also provides birth control coverage options to its staff of more than 60,000, a spokesperson for Anthem Blue Cross confirmed in an email. CHW did not respond to calls for comment.
Sr. Walsh said she did was not aware that there were any Catholic universities or hospitals that provided birth control coverage to employees.
"I have not looked into those details, but the fact that one or two people or institutions are not doing something certainly doesn't speak for the whole organization," she told HuffPost. "I'm sure there are Jews who don't abide by the Jewish dietary laws, but that doesn't mean the dietary laws are wrong."
Fordham's spokesperson said that even if HHS approves a broader religious exemption and the school is given the option to stop covering birth control, it will continue to cover it. But it is unclear whether the new federal guidelines would overrule the state guidelines currently in place, because HHS hasn't yet revealed its final draft.
"This is such a moving target that its difficult to nail down the exact impact [of expanding the religious exemption]," said Elizabeth Nash, a public policy associate at the Guttmacher Institute, a reproductive health research organization. "The very real concern is that in states where there is no refusal clause or a very narrow one, there may be entities that would be able to refuse that right now cannot, and many women would no longer have access to contraceptives under their health plans."
But the fact that several Catholic institutions already do manage to pay for their employees' birth control pills while still serving and hiring non-Catholics significantly weakens the clergy's central argument for expanding the refusal clause, Nash said.
"I think the Catholic Church is a very good example of upper management, and the worker bees not always being in tune with the Queen."