Frame game: Mere politics? Just birth control?

The frame game continues, with a coalition of conservative religious groups — the traditionalist wings of most major religious groups — insisting that their battle with the Obama White House is not essentially about birth control, but about religious liberty and the separation of church and state. The U.S. Department of Health and Human Services, of course, says the battle is about birth control and quality health care.

How is the press playing this, now that the president has offered up a compromise that supposedly exempts churches and other religious institutions (think explicitly religious colleges and hospitals) from having to pay for things that they consider evil?

The Washington Post second-day story contains a classic passage that shows precisely how not to cover this kind of complex issue, which has deep roots into religious doctrine as well as Constitutional law.

Read carefully. The lede states:

After initially telegraphing optimism about President Obama’s decision Friday to amend the religious exemption for mandatory birth-control and sterilization coverage, the U.S. Conference of Catholic Bishops has declared total opposition to any compromise on the issue.

Then here is the crunch section:

The bishops’ broadside is evidence that Obama’s effort to limit the damage from this unusually complicated moral, legal, medical and financial issue isn’t necessarily working. Most of the Republican presidential candidates have hammered Obama for what they contend is a trampling of religious freedom. Even many of the president’s supporters believe that the original exemption was too narrow and the policymaking handled clumsily — although they supported the amendment announced Friday.

An administration official not authorized to speak on the record expressed little surprise at the bishops’ statement, which if anything represents a hardening of their position.

“We never anticipated that this announcement would win the endorsement of an organization that opposed health reform from the very beginning,” the official said. “But we believe it’s the right way to fully address concerns about religious liberty and ensure women get the coverage they need.”

Where to begin?

The key for me is that the religious-liberty dispute has been building behind the scenes — ignored by the press, for the most part — for several years now. Even the GOP candidates have been very, very late to the game.

So, on one level, it is true that: “Most of the Republican presidential candidates have hammered Obama for what they contend is a trampling of religious freedom.” But that is almost beside the point. The key to the whole dispute is that a wide variety of religious groups considered the HHS mandate the straw that broke this particular church-state camel’s back.

From the point of view of the religious groups, this is not about election-year horse racing. For them, it matters little that GOP candidates “contend” that this dispute is about religious liberty. Who cares what the GOP candidates “contend”? What matters is the end game, the court cases that are already being ramped up in this church-state clash.

At some point, journalists need to realize that, in the end, there is more to this issue than political gamesmanship. There are Constitutional issues to settle. Also, it is clear that there is a battle going on inside the structures of Catholicism in America and, yes, the Obama administration is not going to be able to please both Pope Benedict XVI and HHS Secretary Kathleen Sebelius.

Here are some key issues to look for in the ongoing coverage:

* Will reporters continue to say that the “religious liberty” issue is mere political spin? Perhaps it’s time to call Constitutional scholars on both sides of this dispute.

* In the fine print, how will the Obama compromise deal with the large number of churches and religious groups that self-insure, that provide their own health coverage? Will this option be (a) banned or (b) will they simply be required to provide contraceptives, sterilization procedures, morning-after pills, etc., etc.?

* At some point, people are going to have to pay attention to the war cries inside the Southern Baptist Convention and other conservative Protestant groups. If this story is just about birth control, why are so many believers in other camps just as upset as the Catholics? Meanwhile, has the Church of Jesus Christ of Latter-day Saints said anything yet?

* Does the Obama compromise have teeth when it comes time to prevent health-insurance companies from simply raising their rates, thus passing the birth-control buck right back to the churches, religious colleges, hospitals, etc.?

* Do the new, new HHS rules still separate “churches” that worship from non-profit religious institutions that merely feed the poor, teach children, care for the elderly and all of that “non-religious” stuff? In the past, courts have frowned on government attempts to say that freedom of worship is different than freedom of religion. Well, courts in America have frowned on that. Courts in the People’s Republic of China? That’s another matter.

In conclusion, it’s clear that tempers are rising on both sides.

For example, did you catch that anonymous Post quote from inside the Obama team? This one:

“We never anticipated that this announcement would win the endorsement of an organization that opposed health reform from the very beginning,” the official said.

Oh my. Has there been any major group in American life that has been more consistent in its calls — for decades now — for universal health-care reform than the U.S. Conference of Catholic Bishops? Hey, I realize that the Post is not responsible for the accuracy of a quotation from a source. I’m just saying that it would be nice to allow someone on the other side to respond to that kind of verbal stab.

Stay tuned.

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About tmatt

Terry Mattingly directs the Washington Journalism Center at the Council for Christian Colleges and Universities. He writes a weekly column for the Universal Syndicate.

  • Judy Harrow

    `Hi, TMatt

    Y’know the more I think of this, the more I come to agree with you that this is, at its heart, a religious freedom issue. It’s become blatant now that some pro-lifers want the conscience exemtion extended to employers who run unarguably secular businesses and who also happen to adhere to religious groups that forbid contraception etc.

    What happens when an employer and a worker hold different beliefs about reproductive issues, or, for that matter on any other question? Whose freedom of conscience should be protected?

    Extending freedom of conscience to the employer means granting that employer the right to impose their beliefs on their employees.

    The question isn’t really whether this is a freedom of conscience issue, but whose freedom of conscience is being protected by the government.

  • Martha

    “We never anticipated that this announcement would win the endorsement of an organization that opposed health reform from the very beginning,”

    Oh, now. Where to begin with this? How about the long tradition of social justice within the Church? How about the fact that a lot of conservative (both politically and religiously) Catholic opinion is saying that the bishops were so enthusiastic for “Obamacare”, they never considered the notion that it might turn around and bite them? How about what Pope Benedict XVI said in a message to the 25th International Conference of the Pontifical Council for Health Care Ministry, held at the Vatican in 2010?

    “Pope Benedict XVI and other church leaders said it was the moral responsibility of nations to guarantee access to health care for all of their citizens, regardless of social and economic status or their ability to pay.”

    Yeah, that sounds like an organisation that is opposed to health care reform, right enough.

    I know that politics is all about the art of the spin and making your opponents defend charges they never envisioned, so I recognise that of course they want to shift the focus from ‘separation of church and state’ to ‘these people are opposed to all health care, not just for women, but for everyone!’.

    I still don’t see any explanation as to where the magic money tree is growing, the one that will pay insurance companies to provide free insurance that nobody has to pay for – not by increasing the premia charged to all subscribers, not by charging the employer directly, not by asking anyone at all to pay anything. That is one announcement I await with interest.

  • Martha

    Judy, way back when she was a young immigrant to Britain in the 1950s, my (Irish Catholic) mother worked in a kosher jam and tinned fruit factory.

    Was this an unarguably secular business? What about certain restrictions the employees (non-Jewish as well as Jewish) had to follow when processing the food materials? Was that the employer imposing their beliefs on their employees?

    How about a non-Jewish employee bringing ham sandwiches to eat in the staff canteen at such a business? I don’t know if that’s enough to incur ritual impurity, but I have a feeling it would make for some awkwardness.

    Your employee working for a religious employer in a secular business who doesn’t want to pay for certain coverage has the option of purchasing that coverage him- or herself. When an employer can legally prevent an employee from purchasing a private plan, then that is a matter for the courts to decide if the business is secular or not – and as I instanced above, that’s not always so clear-cut. And besides, I don’t think even the bishops can enforce that an employee of a Catholic university, who is not covered by employer’s insurance for sterilisation, can be stopped from going off and spending his or her own money on it. It might cost you your job (depending, like the teacher who became a single mother via artificial insemination) but they can’t force anyone not to buy what that person wants to buy.

  • Chris Jones

    Ms. Harrow,

    Employees of Catholic institutions remain free to believe what they like about birth control, and to act on those beliefs. The fact that their Catholic employers do not foot the bill for their acting on their beliefs is not a restriction of their liberty.

    In other words, employees of Catholic institutions are free to use birth control, have abortions, engage in homosexual sex, and all manner of other things that the Catholic Church does not approve of — on their own dime.

  • Observer

    Well, I actually think that the Birth Control vs Religious Liberty frame is unfair. It makes the liberal side look grubby and materialistic (concerned only with money and sex), and the conservative side pure and high-minded (concerned only with moral principle).

    A fairer and more realistic frame would be Individual Liberty vs. Corporate Liberty. There is little tensions between these two principles when institutions are fully voluntary, egalitarian, and internally democratic. A condition that – obviously – does not apply to large hospital systems, or the Roman Catholic Church itself. There is a reason this is, first and foremost, a Catholic issue.

    Religious exemptions put those in command of religious institutions at liberty to burden the conscience of their subordinates. It steepens the power gradient inside the institutions. The issue is, then, how much Individual Liberty are you willing to trade away for the purpose of accommodating Corporate Liberty ?

    The American tradition leans heavily towards Individual Liberty. It is by no means clear that the First Amendment straightforwardly protects Corporate Liberty in this case. When people claim it does, it is absolutely necessary to get them to back it up.

  • SouthCoast

    ” Individual Liberty vs. Corporate Liberty”. Gemeinschaft, Gesellschaft, it’s still all the same shaft.

  • Richard Mounts

    Chris Jones I believe that you have expressed it well. The issue for religious employers of any type or faiith is the “providing” of the objectionable coverage. “Providing” can also mean “paying.”

    The compromise announced Friday still means that the employer is providing the coverage because the benefit is still under the policy the employer purchased. And as mentioned by many the cost of the so-called free benefit is ultimately going to be paid by the purchaser, even if it’s hidden in higher rates. For many years I was an insurance company undewriter; no way will a insurance company give away a benefit.

    Why can’t an insurane company offer a separate policy to women who want this coverage? Because it has to be free to the insured woman. To me this whole issue is a great argument for a single-payer health insurance system.

  • Mark Baddeley

    RE: 5

    I like the question you’re asking. It raises a much bigger journalism question to my mind. Given that the White House seems to have strongly pitched this as a women’s health issue, and not a religious liberty issue; and now Obama appears to have said that the accommodation is about balancing a women’s health right with a religious liberty right, should the media reframe it in a way that neither side likes?

    Personally, I’m instinctively against that. I want to hear how both sides are framing it, and I want their best (and worst) arguments put forward without the cards being stacked. I’m not sure I want ‘the media’ taking it upon themselves to offer a third frame that isn’t the preference of any of the people involved in the debate.

    But, I am open to some persuasion on this. Is it journalism’s job to decide that neither side is framing the issue correctly and to ‘build a better mousetrap’? Or is it simply to report things in their own words as best possible?

  • http://www.getreligion.org Mollie

    There are so many angles here that haven’t been explored in much of the coverage. A few come to mind: 1) the fact that there are lots of people who are not concerned about religious liberty but who are still concerned about the idea the federal government can tell any employer the specifics of what should be in the benefits packages offered to employees. In other words, this framing of “right to free sterilization/contraception/abortifacients” vs. “freedom of religion” might miss what bothers many people — simply government telling private employers how to run every single aspect of their business in a “free” country.

    2) the fact that the coverage doesn’t explain how it affects individuals of conscience (I think of a friend of mine with a small medical practice who would not, in good conscience, contract for abortifacients, etc.). I haven’t seen this well covered but I’m under the impression that even if this revised mandate were acceptable to the bishops, it wouldn’t protect individuals who employ others, right?

    3) the fact that some religious groups aren’t just standing with Catholics but also mildly perturbed by their work getting everyone to this point. Without Catholic support, as you note, would all these other religious groups be vulnerable to losing more religious freedom due to the government’s size and scope?

    I know that these things are not readily apparent to the average reporter, but having just gotten home from church where folks were discussing each of these things, a bit of shoe-leather reporting would go a long way to getting beyond the simple framing we’ve seen thus far. I’m sure there are additional problems from other perspectives, needless to say.

  • Chris Jones

    The same can be said for anything paid from the common pot

    Perhaps so, but we are not talking about something that is “paid from the common pot.” We are talking about something that private organizations are being compelled to pay for from their own private pot. It would be different if we were talking about something paid for by the government our of the tax dollars we are all compelled to pay; even by the standards of Roman Catholic doctrine the state has the right to levy taxes (and believers are obligated to pay them) even when the government uses those funds for what the Church regards as immoral purposes. But things have come to a pretty pass when “majority rule” applies not only to how much tax I have to pay, but also to what I must spend the money I have left after taxes on.

    As far as the so-called “elephant in the room,” I am not a Roman Catholic and I carry no brief for the Church’s behaviour in The Scandal, but I have to say that inalienable rights are not dependent on the perceived moral worthiness of the rights-holder. The Catholic Church is to enjoy religious liberty not because it claims to be, is, or deserves to be, a “moral bulwark”, but because it is a bona fide religion and the Constitution says “Congress shall make no law … prohibiting the free exercise [of religion].” There’s no qualifying clause in the first amendment that says “provided the members of each religion meet our moral standards.”

  • Mike O.

    Molly, I’m number one on your list!

    Ok, let me rephrase that :) . Among the list of angles you note are being underreported, I most identify with number one (although I am for religious liberty I feel it’s shortsighted to focus solely on religious employers).

    One problem I have is I would like both sides to set a clear line as to how far they think they can go. For the government I’d ask: Is there an upper limit to what government can require of employers? For those fighting the HHS regulations I’d ask: Is there a lower limit to what any employer can claim an exemption for (including but not limited to things like wages and OSHA regulations)?

  • Ann

    On Friday, President Obama issued the final rules to be published in the Federal Register.

    FACT SHEET: Women’s Preventive Services and Religious Institutions, February 10, 2012, in part:

    objecting non-profit religious employers will not have to provide contraceptive coverage or refer women to organizations that provide contraception

    o Exempts churches, other houses of worship, and similar organizations from covering contraception on the basis of their religious objections.”

    o The new policy does not affect existing state requirements concerning contraception coverage.

    Summary of current state laws
    http://www.guttmacher.org/statecenter/spibs/spib_ICC.pdf

  • Deacon John M. Bresnahan

    Obama has pitched this as a health-care issue. Others have pitched this as a broad religious liberty issue.
    All day today, even on Fox, I heard no mention of religions other than Catholicism specifically named. Yet on the internet I am learning how many other religions have educational, medical, and charitable enterprises which will be entangled in this dictatorship by insurance mandate. Funny how the media can’t find an Orthodox Jewish educational or Baptist medical enterprise that is as upset at what is transpiring as the Catholic bishops.(Though they never seem to have any trouble finding Planned Parenthood’s phone number.)
    Also, all day on TV News or radio news breaks I heard for the “headline” lead-in nothing but: The “birth control,” issue–the “contraception” issue, etc. Not once did I hear: The “First Amendment” issue, the “religious liberty” issue.
    Yet there is no “contraception” issue. Condoms, pills, abortifacent pills, sterilizations
    are not under siege here. What is at stake is the power of the state to order people to participate in what they consider immorality.
    Also, today I only heard once the issue raised of the president ordering on his own say-so what insurance companies must do. He apparently takes for granted Obamacare gives him unprecedented and unlimited dictatorial powers. Is this what Americans thought they would be getting???

  • John M.

    Mollie,

    File me under #2 on your list. I have thought multiple times about starting a business. Were I to do so, would I be required to provide coverage for abortifacients for my employees? I’d like to know how these policies affect business owners of faith and conscience.

    -John

  • Jeff

    “Well, I actually think that the [Kulturkampf] vs Religious Liberty frame is unfair. It makes the [pro-Obama] side look grubby and materialistic (concerned only with money and sex), and the [anti-Obama] side [look] pure and high-minded (concerned only with moral principle).”

    The pro-Obama side looks grubby and materialistic (concerned only with money [and power] and sex) because they are grubby and materialistic (concerned only with money [and power] and sex).

    The anti-Obama side looks pure and high-minded (concerned only with moral principle) because they are pure and high-minded (concerned only with moral principle).

    This is what it is.

  • Deacon John M. Bresnahan

    Considering the liberal (Obama protective Society dept.) of the media doesn’t seem to want to mention groups which support the Catholic Church in its struggle for religious liberty–herein is a brief list of some who are speaking up for religious liberty in America: The Union of Orthodox Jewish Congregations of America, The National Association of Evangelicals, the Southern Baptist Church, the leaders of the Lutheran Church-Missouri Synod, and many others.
    (The list is from the website Christian News Wire which left out the canonical bishops of the Orthdox Christian Churches.)
    Try to find any of this in the mass media. Somewhere, I suppose, it is buried –deeply– so they can later say they provided all the news

  • Dave

    Will reporters continue to say that the “religious liberty” issue is mere political spin?

    I’ve not seen this posture taken on the PBS NewsHour.

    [...H]ow will the Obama compromise deal with the large number of churches and religious groups that self-insure

    I’ve seen this explored in print, still rather tentatively.

    Does the Obama compromise have teeth when it comes time to prevent health-insurance companies from simply raising their rates, thus passing the birth-control buck right back to the churches, religious colleges, hospitals, etc.?

    I daresay the right will respond to this question to the effect that such teeth would constitute an unconscionable government intrustion into the private market, putting Obama into a damned if you do, damned if you don’t bind. Try getting any MSM reporter to cover that as anything but a political story.

    * Do the new, new HHS rules still separate “churches” that worship from non-profit religious institutions that merely feed the poor, teach children, care for the elderly and all of that “non-religious” stuff?

    AFAIK this is still below the horizon.

  • http://www.tmatt.net tmatt

    Folks it is too late to spike some items that should be spiked. I have been out most of the day.

    Please take your jabs at Obama or the Catholic church elsewhere.

  • http://returntorome.com Francis J. Beckwith

    Observer writes: “The American tradition leans heavily towards Individual Liberty. It is by no means clear that the First Amendment straightforwardly protects Corporate Liberty in this case. When people claim it does, it is absolutely necessary to get them to back it up.”

    A church is a collection of individuals. So, if the First Amendment does not protect corporate liberty, it cannot protect the individual liberty of those church members to congregate. For if that were not the case, then no corporate institution except the state would have any protected status in a liberal democracy. This, it seems to me, would provide no buffers between the individual and the state. With churches, synagogues, mosques, etc., not to mention families, civic organizations, and even businesses, you have institutions that provide many goods that the individual (because he is too small) and the state (because it is not competent to do so) simply cannot do.

    When the Founders penned the First Amendment, the philosopher who influenced them the most was John Locke, especially on religious liberty. Read his Letter on Toleration, and you will begin to hear Jefferson and Madison. What was vital to all three thinkers was the separation of church and state, not the separation of the individual from corporate persons. For if it were the latter, it would be a direct assault on conscience, since religious liberty necessitates the freedom to join with others and live the life of faith. In fact, in Christianity, it is the Church, and not the individual believer, who is the bride of Christ.

    Because you believe in religious liberty, you would no doubt condemn the state if it forced an individual Catholic priest to directly pay for someone’s birth control. Suppose the individual priest is a pastor of a Catholic parish that runs a soup kitchen, and the soup kitchen has a bank account in which their donations go. And suppose that from that bank account comes the small salaries provided to the soup kitchens’ workers. Now imagine that the Obama administration passes a regulation through HHS that requires that the soup kitchen set aside 5% donations to pay for contraceptives that they must distribute to the homeless they help. According to your theory of liberty, this is perfectly fine, since there is no corporate religious liberty. But since Christians, including Catholics, are Christians only because they belong to the Church, you are in effect saying that they have no religious liberty when they in fact act in concert as a Church.

    This, of course, is tyranny.

  • http://catholicecology.blogspot.com/ Bill P.

    There are two journalistic angles about which more coverage would benefit us all:

    1. Whether or not the HHS mandate was a wise move by the President. He may have delighted many in his base, but he has busted open a beehive of fury over artificial birth control, an issue that most people thought was settled. Now today, print and cable news outlets are providing a forum for media-savvy priests, who have learned how to get their message out effectively (for instance, this interview from MSNBC; go in about 2:45). And so here we are in 2012 discussing the morality of artificial birth control and the meaning of Humane Vitae to a new, young audience. And some secular commentators are helping this conversation take off.
    2. Similarly, the bishops (and archbishops, and soon-to-be cardinals) of today are not as conciliatory as those in the 1960s or 70s (or 80s). I’d like to see coverage of why this is the case, and how the history of the Church these past few decades have affected up-and-coming priests and bishops.

  • Passing By

    Bill P -

    Re: #2 – that story has been told

    http://www.firstthings.com/article/2011/01/the-end-of-the-bernardin-era

    I agree with your #1, although it’s arguably a political story of the ”horse-race variety rather than religious, per se.

    Of course, if people actually readHumanae Vitae before pontificating on birth control, that’s all to the good.

  • Harris

    One story aspect that I have not seen covered is that of the recipient of these pills. Let’s call her Hanna in Housekeeping, the single mom with two pre-schoolers. This is the human interest side, the one with real skin in the game. Up until now we have pretty much dealt with the story as told by one of the two institutional players, the administration or the Catholic hierarchy, but the individual story actually gives some substance as to what is involved here, what these larger decisions mean for those who do the work.

    A second under-reported story in this would be the scale of institutions that we are speaking about. Whether social services or medical care, these institutions play an important role in many communities, and sometimes are event the sole provider of care for their community. This again adds dimension to the story beyond the rather narrow framing issues.

  • http://catholicecology.blogspot.com/ Bill P.

    Thanks, Passing By. As always, much appreciated.

    Your observation on #2 is dead on. And it’s sort of where I was leading: that a political decision opened up a conversation on faith — unexpectedly for many, for sure. So the questions becomes, why would that have been so unexpected? I think there is to be found a treasure of topics on the importance of faith among many Americans.

    As for the First Things piece: I’d like to see AP cover something like that and have it out in mainstream papers nationwide!

  • Bain Wellington

    As an outsider, I am still stuck on the fundamental premise that artificial contraceptives and sterilisations are preventive health services. Sure, they are preventive, but all they do is prevent/block/inhibit conception. The USCCB began by hammering the idea that pregnancy is a disease, and I just hope that that doesn’t get over-looked.

    Despite the risk of peri- and post-natal death (mercifully much lower in the US than in Africa, for example), pregnancy is fundamentally life-giving and women’s health demands not more and more ways of blocking reproduction, but greater efforts to make pregnancy and birthing safe.

    From what the Institute of Medicine wrote by way of introduction to its consensus report published last July:-

    Given the magnitude of change, the U.S. Department of Health and Human Services charged the IOM with reviewing what preventive services are important to women’s health and well-being and then recommending which of these should be considered in the development of comprehensive guidelines. The IOM defined preventive health services as measures—including medications, procedures, devices, tests, education and counseling—shown to improve well-being, and/or decrease the likelihood or delay the onset of a targeted disease or condition. The IOM recommends that women’s preventive services include: . . . a fuller range of contraceptive education, counseling, methods, and services so that women can better avoid unwanted pregnancies and space their pregnancies to promote optimal birth outcomes

    This “optimal birth outcomes” (in a health context) can only mean reducing the number of pregnancies in order to reduce the incidence of perinatal mortality. Sure the incidence is reduced, but prevalence remains the same unless steps are taken to improve health care for expectant and in-labour mothers.

  • http://gottagetgoing.blogspot.com Kunoichi

    Is there anyone who can explain to this Canuck why birth control is even on the table for coverage at all? We have a national medicare system, and birth control is not covered. There are *some* private health insurances (yes, we still need those) that will reimburse for *some* types of prescribed birth control, but otherwise we have to pay for it out of pocket. So for me, I can’t understand why it’s an issue in the first place. Why on earth would the state or the employer provide birth control at all?

  • Dave_c

    I came across an opinion article on WSJ that approaches the issue from a different angle. There are definitely voices that oppose the HHS mandate not because of religious liberty issues, we need to hear more of those in the news.

  • http://!)! Passing By

    Bill P -

    In my world, First Things is mainstream. :-)

    Kunoichi -

    You ask the great question. Why this issue and why such radical terms?

  • sari

    As an outsider, I am still stuck on the fundamental premise that artificial contraceptives and sterilisations are preventive health services. Sure, they are preventive, but all they do is prevent/block/inhibit conception. The USCCB began by hammering the idea that pregnancy is a disease, and I just hope that that doesn’t get over-looked.

    That’s a question a good journalist would ask, just as they did about Medicaid and Medicare coverage of Viagra for impotent men. Pregnancy probably became a disease when insurers were pushed to provide routine coverage. I don’t know whether this is still true, but adding maternity used to require a separate rider and a considerably higher premium. Employer-sponsored coverage spreads those costs so that employees who cannot or choose not to conceive pay part of those premiums, just as younger workers help subsidize older workers’ higher costs.

    The optimal outcomes in a health context include healthy mother and healthy baby, not baby alone. My own parent chose to bear a subsequent child after nearly dying during delivery and spent six weeks in the hospital after delivering the last. The baby was healthy and went home on schedule; she nearly died from clots and blood loss. On the more recent end, I know two Orthodox women, one Hasidische, who now use doctor-mandated birth control after failing to recover from or almost dying during pregnancy. Both are in their mid-twenties and fundamentally healthy, except during pregnancy; in the old days, they would have died in childbirth. With modern medicine, their risk is still high. So while pregnancy is not a disease, it continues to pose huge medical risks for a small subset of women.

  • Allan

    The Roman Catholic Church knows the fear of an underemployed, unwed pregnant girl today. She can have an abortion for $451 or a live birth for $9,000. Which is she to choose unless there’s a way to at least close this $8,500 gap?

    Obamacare is broken. But something must be done to protect the least of these and help the multitude of mothers who carry them in utero.

  • Paul of Alexandria

    Harris (22): Hanna is actually irrelevant to this story, even though the Democrats keep trying to drag her in. This issue is about the rights of the employers, not the employees.

  • Paul of Alexandria

    Allan (29): The insurance will cover birth. The Church will always support birth. It cannot and will not support abortion.

  • Suzanne

    I would love for a journalist to look at the actual cost of contraception — how much under a typical insurance plan, how much without insurance at all. My own plan provides it for $12.50 a month via mail order — literally the lowest co-pay available.

    Yet I’ve heard many reports that the cost without insurance is prohibitively high. Seems nuts for a medication that is available generically. I wonder if there’s any discussion being given to making this available OTC to avoid the argument entirely.

    Also, there are many, many ways to frame this debate. One that I have seen in the progressive press but not mainstream, has been to look at the linkage between this debate and the recent “personhood” initiatives, which even some supporters say could be used to outlaw hormonal contraceptives. We have a major party candidate saying he believes Griswold was wrongly decided. Are we seeing a concerted push to make contraception less available?

  • Passing By

    It is not and never was true that people lack health care. What they lack is health insurance. Uncritically repeated endlessly in the press, sad stories and hard cases have led to the disaster we are setting now. My work has for twenty-give years put me in close contact with the existing public health services which trend to the poor. I’ve often joked that my clients have better care than me.

  • Chris Jones

    Suzanne,

    We have a major party candidate saying he believes Griswold was wrongly decided. Are we seeing a concerted push to make contraception less available?

    It takes more than one candidate with an opinion to make a “concerted” push. That takes two or more people acting “in concert” to achieve a goal.

    In any case, believing that Griswold was wrongly decided is an opinion about constitutional law, not an opinion about policy. One may believe that the states have the constitutional authority to ban contraception without believing that banning contraception is a good idea. If I am not mistaken, Mr Santorum (I think that’s the candidate you are talking about) has specifically stated that he does not think contraception should be outlawed.

    From a social conservative perspective, the problem with Griswold is not that it enacts a policy that social conservatives generally disagree with (because not all of them in fact disagree with it). The problem with Griswold is that it is bad constitutional law. It reads into the Constitution speculative notions about privacy — notions which are not only bad constitutional law in themselves, but which also lay the groundwork for the bad constitutional reasoning in Roe v. Wade.

    So you needn’t worry about your contraceptives. Even if Griswold were reversed, any effort to ban them would have to gain a majority in a state legislature somewhere. I don’t think there is any state in the union where that is possible.

  • Chris Jones

    I’ve heard many reports that the cost without insurance is prohibitively high.

    I doubt this. A quick Google search tells me (from the Planned Parenthood website and several others) that the cost without insurance is about $50.00 / month. That is not trivial for a poor woman, but compared to the cost of raising a child for a couple of decades it is probably a good investment.

    Seems nuts for a medication that is available generically.

    Just because a medication is generic does not mean that it is cheap. Generics are generally cheaper than branded medications but there is still the cost to manufacture which must be recovered. I am sure that if any of the manufacturers of birth control pills were able to reduce their costs enough to sell them profitably for $20.00 / month instead of $50.00, they would do so in a heartbeat to gain market share.

    I wonder if there’s any discussion being given to making this available OTC to avoid the argument entirely.

    Making a medication available OTC does nothing to reduce the cost of manufacture, nor does it necessarily mean that the medication cannot be covered by insurance. I can’t see how making birth control pills OTC would avoid the argument.

  • http://writtenandnoted.wordpress.com/ Harris

    Paul (30): Hanna belongs. While the nominal controversy can be framed as one of government v. employer rights that particular frame has been decided by courts; the government possesses the power to establish uniform measures for employers. The issue here does not turn on that rather unexceptionable finding, but rather on the violation of particular institutional religious tenets.

    When we engage in religious battles we encounter a landscape in which multiple claims to rights are made. As has been demonstrated on GR for many years, there is a persistent tension between the right of religious practice and societal limits in the concern of equity; this roughly the battle between the 1st and the 14th amendment. This battleline keeps shifting, these concerns are constantly recalibrated with respect to each other.

    Seen as a battleline, the conflict does become one of winners and losers, the easy stuff of political conflict. here is where the human interest story actually helps us out. We meet the stakeholders being affected. A good focus on the individual not only makes for some interesting story-telling (e.g. why are you working at this Catholic hospital and not the big one on the hill?), it also helps humanize the hospital — itself, not a bad outcome.

    There is also one other story not getting told well at all in this: that of the Church’s own position — this too arises from the battle-line coverage of winners and losers. If we miss the impact on the female employees (the Hannas), we also miss the actual reasoning for the position. The New York Times went a little down that road, in spelling out the reasoning that pushed the American Church to this decision. Ironically, one of the best presentations of the Church’s case for this outsider, showed up in comments by “theAmericanist” on Ed Kilore’s post “Contraception and ‘Religious Liberty’” at Political Animal.

  • Suzanne

    Chris,

    Santorum has called contraception “a license to do things in a sexual realm that is counter to how things are supposed to be.” He may say (now) that he doesn’t wish to outlaw it, but has he been asked whether he would make decisions designed to obstruct access to it? (for example not paying for it in insurance plans for federal workers)?

    In addition, Mitch McConnell has said Republicans will force a vote on legislation permitting any employer (not just religious entities or religiously affilated entities) to deny birth control coverage in their health insurance plan by claiming a moral or religious objection. That opens up the potential list of non-covering employers exponentially.

    Again, added to the personhood initiatives, it’s reasonable for reporters to ask whether the new conservative push is for less access to contraception. So far, I haven’t seen such questions in a mainstream publication.

    And I agree with you that making this OTC would not solve the problem of access, but could be a politically expedient way of dodging it. Once it’s on the open market, insurance companies aren’t paying for it, so religious exemptions aren’t an issue. There has been talk in the past about OTC availability, but generally the debate has been around whether women should be required to come in for an exam first.

  • Chris Jones

    Suzanne,

    It is not the government’s job to provide “access” to birth control (or anything else). If you want “access” to something, do it yourself.

    It would be another thing if government were pro-actively to put roadblocks in the way of women getting contraceptives if they want them (for example, restricting doctors from freely prescribing them, or putting a special tax on them (as is done with tobacco products, for example)). But the government is not doing that, and no one is proposing that it should do so. But if the government simply refrains from paying for the contraceptives, or refrains from forcing private companies to pay for them, that is not “restricting access.” That is, strictly speaking, doing nothing (which is quite often the best thing for a government to do).

    Do you want “access” to contraceptives? Then go to your doctor, get a prescription, take the prescription to a drugstore, and buy your contraceptives. That is all the “access” that you need, and it is not the responsibility of the United States government to provide it for you.

  • Deacon John M. Bresnahan

    Does anyone know how the Amish fall under the bill?? The Mormon Church??? Mennonites??? How are they reacting??? What are they being told about how they must comply? All the focus is on the Catholic Church But there are hundreds–maybe even thousands– of other churches, all of which have varying attitudes toward insurance, birth control, abortion inducing drugs, sterilization, government power over the churches, etc.

  • Rachel K

    I’ve also wanted to see stories involving Hanna the Housekeeper, as I’ve mentioned previously. The only women who will be directly affected by this are women who work for religious employers. Quoting women’s advocacy groups rather than an actual woman who will be affected is like interviewing general religious liberties groups without actually talking to the bishops or Mother Angelica or any other religious employers. Really, how hard is it to have a human-interest lede along the lines of, “Hanna Jones lives on a tight budget, and one thing she wants to take out of her monthly budget is birth control . . .” or “Hanna Jones pays $x a month for birth control, but as an employee at a Catholic institution, she feels this is fair”?

    The insidious part of this is that by framing it as “Bishops vs. women in general” rather than “Catholic employers vs. Catholic employees who don’t currently get birth control coverage but want it” is that it makes it seem like the bishops are COMING FOR YOUR BIRTH CONTROL (cue scary music)–as though somehow, women who currently have birth control coverage will lose it if those nasty old bishops get their way. Grounding it in the story of a Catholic employee would make the stakes a lot clearer.

  • http://www.tmatt.net tmatt

    Just spiked a bunch of comments that were purely political, with no references whatsoever to the journalism issues.

    Hey folks, head over to Fox or MSNBC. Do your shouting there.

  • Bain Wellington

    The jury is still out on how the insurance companies see the “accommodation”. According to The WSJ, they were not consulted in advance, any more than the bishops were. And see a CBS report to similar effect.

    Of course, employers (in general) would be highly supportive of female employees not getting pregnant. But that still doesn’t make the prevention of pregnancy a health issue.

  • John Pack Lambert

    Well this http://www.deseretnews.com/article/865550092/BYU-law-professors-sign-letter-declaring-Obama-compromise-unacceptable.html Deseret News article is not quite The Church of Jesus Christ of Latter-day Saints, but Lynn Wardle, one of the two BYU professors mentioned, was the main legal mind behind Proposition 8. Cole Durham on the other hand is a leading proponent of religious freedom. The LDS Church very rarely makes statements on such matters.

    On a slightly different topic this DN article http://www.deseretnews.com/article/865550200/Sibelius-tells-Orrin-Hatch-she-did-not-consult-with-bishops-on-contraceptive-mandate.html shows that Orrin Hatch has been pushing for answers and pressing this as a religious freedom issue since at least last July. Since Hatch was the lead co-author (with the late Sen. Edward Kennedy) of both the RFRA and the RLUIPA, this is probably not surprising.

  • John Pack Lambert

    The intriguing thing is that employers in certain “grandfathered” plans, and employers with under I think 30 full-time employees are exempt from these rules. So it actually does not apply to all employers, which makes it even odder that Sedelius is fighting tooth and nail to avoid giving religious institutions and exemption.

    This is an angle that the media has recklessly ignored. Why are small employers exempt from giving coverage in the case of vital preventative care anyway? How does this work out with some industries chalk full of sub-contractors?


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