Evangelicals, Contraception, and the Affordable Care Act

Evangelicals, Contraception, and the Affordable Care Act December 7, 2012

Fred Clark (“slacktivist”) and other hard-left progressives have accused evangelicals of lying about the abortifacient nature of some contraceptives.  According to this view of things, evangelicals are really just dead-set on opposing anything associated with President Obama, so they have invented the excuse that some contraceptives are abortifacient (abortion-inducing) in order to give themselves a justification for joining Catholic efforts to overturn Obamacare or at least eliminate its contraceptive mandate.  In fact, with his usual charity and subtlety (/sarcasm), Clark conflates opposing contraception in principle (which evangelicals generally do not) with opposing the use of specific contraceptives that can cause the destruction of a fertilized egg (which evangelicals generally do), and likewise conflates opposing contraception (do not) with opposing church-supported distribution of condoms to unmarried young people (often do).

I asked Rob Schwarzwalder to lay out the argument on why so many evangelicals view some “emergency contraceptives” as abortifacient and why so many feel that the Affordable Care Act infringes upon their freedom of conscience.


Evangelicals, Contraception, and the Affordable Care Act

Rob Schwarzwalder

Senior Vice President of the Family Research Council

The Obama Administration’s demand that employers, including religious ones, offer health insurance plans including contraceptive drugs crosses several important lines.  It is for that reason that 40 cases have been filed against the contraception mandate with 110 plaintiffs.

First, the mandate applies to all businesses and non-profits. It does however provide an exemption for “religious employers” so narrow it applies only to “houses of worship.” This means that Evangelical and Catholic colleges and universities, Catholic hospitals, and privately-held businesses run according to the traditional theology of their owners (including Bible publishers) will be required to provide their employees with a menu of medical insurance programs at least one of which must contain a provision that includes coverage of contraceptives, drugs that can induce abortion (abortifacients), and sterilization.

The theology of many of these institutions and firms is such that to provide contraceptives and recognized abortifacients would require them to violate their convictions.  The Roman Catholic Church is opposed to all forms of contraception, believing such to be sin (“sexual pleasure within marriage becomes unnatural, and even harmful to the spouses, when it is used in a way that deliberately excludes the basic purpose of sex, which is procreation”).

Additionally, both Evangelical Protestants and Catholics believe abortion is the extinguishment of a person created by God, a being at whose conception personhood begins.  Thus, abortion is a profound assault on human dignity and a violation of the Sixth Commandment, “You shall not murder” (Exodus 20:13).

Clearly, the Affordable Care Act (often referred to as “Obamacare”) mandates coverage of both chemical contraceptives and and “emergency contraceptive” drugs that can function as abortifacients.  This was well-documented by my former colleague Jeanne Monahan, now president of the March for Life movement, in her February 28, 2012 testimony before the House Judiciary Committee:

In 1993, Congress enacted the Religious Freedom Restoration Act (“RFRA”) which holds a law or regulation that imposes a “substantial burden” on a person’s free exercise of religion to be allowed only when the government can demonstrate “that application of the burden” furthers “a compelling governmental interest.” In a related hearing on this mandate Bishop William Lori was asked if he believed that the government had a “compelling interest” sufficient to warrant a contraceptive mandate that will burden Catholic or others’ religious beliefs. Bishop Lori responded that if the government felt they had a “compelling interest” to burden religious liberty, it would not have provided for any kind of religious exemption … in the list of drugs to be provided with no cost-sharing are those categorized as emergency contraceptives (EC). The first of these drugs is Levonorgestral, or Plan B. Plan B possesses a number of mechanisms of action which can prevent a newly formed embryo from implanting in the uterine wall … The second problematic FDA-approved drug covered by the mandate is ulipristal acetate, marketed as Ella® by Watson Pharmaceuticals. Including Ella in the mandatory category of “preventive care service for women” means that HHS is requiring each health insurance plan to cover a drug which possesses the ability to kill an implanted embryo. The demise of an embryo post-implantation is widely agreed by all, even those who define pregnancy at implantation, to constitute an abortion.

Mandatory provision of insurance plans that include coverage of abortifacient drugs is a gross violation of what millions of Protestants and Catholics recognize as a biblical duty to protect, rather than end, human personhood.

However, it is troubling that some Evangelical Protestants seem willing to dismiss, or at least distance themselves from, Catholic teaching on contraception.  In recent years, on two occasions, prominent Evangelical leaders have said to me, with respect to contraception, “We’re not Catholic.”

And the point is – what?  That Catholics should be forced to pay for contraceptives because Evangelicals don’t believe all contraceptives result in abortion?  This is ludicrous moral reasoning: “We want respect for our beliefs about the sanctity of life, but those Catholics are just too extreme and we’re embarrassed by their stance, so they’ll have to pay.”

What rot.  While many Evangelicals who have studied the chemical mechanism of oral contraceptives have concluded that there is at least a possibility that such drugs can cause abortion and, therefore, have eschewed them as well, other Evangelicals who have studied the use of such drugs disagree.

What is more important is that Evangelicals – people of the Gospel – should be the first to recognize that human volition is a gift from God, not a bequest of the state, and as such it should be honored when exercised conscientiously and in consistency with what the Founders termed “ordered liberty.”  Not to stand with Catholics in their unwillingness to pay for contraception would be rank hypocrisy, a particularly distasteful form of moral cowardice and pretence of which Evangelicals should not be guilty.  Regardless of your view on contraceptives, we should all agree to protect the religious freedoms of all Americans, including those who believe paying for contraceptive coverage violates their conscience.

To come back to the first and integrating principle: One’s conscience is a matter between the individual and God, and the state is not an intermediary between them.  Someone might ask, “So if my conscience tells me to become a cannibal, should there no restraints?”

This question fails at a presuppositional level: Society is composed of individuals living according to a commonly understood code of ethical conduct, reflected in the second tablet of the Decalogue and confirmed by “the law written on the heart” (Romans 2:14), the conscience.  Respect for the exercise of moral judgment, insofar as such does not diminish the well-being of others, is essential to the American experiment in representative self-government.

As Melissa Moschella contended earlier this year in The Public Interest,

… conscience rights aren’t absolute trumps; they are conditioned by the needs of public order and others’ rights. Given their fundamental importance, however, the common good requires respecting conscience rights unless it is absolutely necessary for the achievement of a truly compelling state interest—as it would be, for example, if a religion required its members to engage in human sacrifice, or to act violently toward nonbelievers.

The conscience itself is not only a matter of universal moral intuition but of reason.  For example, if one’s most fundamental possession is himself, his murder is a form of both theft and also of substantial irreverence, as God is the author of life and alone has the right to “give and take away.”

Religious liberty is at the heart of who we are as a people.  The Founders recognized that if man’s allegiance were primarily to the state, the state could offer and retract “rights” at its will.  If, however, such liberty comes from God, the rights of man remain constant and should be politically and social immune from the whim of that servant of the people, the government.

This liberty applies both to religious non-profits, and for-profit businesses that hold moral and religious views. Proponents of the mandate claim businesses have no right to religious freedoms in the free market, and that religious beliefs should be protected only in church. But why should Tyndale House, the largest publisher of the Bible and also a for-profit business, not have its religious convictions recognized or have those convictions protected?

As my colleague Ken Klukowski, a respected constitutional scholar, has noted, “(If) religious exercise includes living out your faith in your daily life, then you would find it appalling that the federal government would order a business owner to subsidize something he considers immoral, and possibly even participating in the ending of an innocent human life” (http://www.breitbart.com/Big-Government/2012/11/25/Federal-Courts-Split-on-Religious-Liberty-and-Obamacare).

It is perilous to allow government to do violence to the conscience of an individual, a church, a business, or a college.  It’s immoral.  It’s anti-Christian.  And it’s un-American.


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  • I’m not sure that corporations–and other for-profit business entities–are entitled to freedom of religion.

    • Steve

      That makes sense if perhaps a “corporation” is a giant robot that walks around doing things. But corporations are just bodies of people. People have religious liberty – which includes not being forced to pay for the abortions of other people.

      You wouldn’t force a Jewish corporation to buy pork for people, would you? You wouldn’t force a vegetarian corporation to buy you a cheeseburger, would you? Its that simple.

      • LianneKaos

        I have a close friend who happens to be allergic to almost every vegan-friendly source of protein. And so if, for some reason, a “vegetarian corporation” were responsible for the provision of food to her, I bloody well would insist on her behalf that they provide food she can actually eat.

  • Does faith stop at the business door? The First Amendment allows for the free exercise of religion; it doesn’t say the free exercise of religion as long as it is in a non-profit setting. Kullevro, your take parallels where the administration is going, where faith-based charities like hospitals or colleges aren’t religious enough to qualify for a religious exemption.

  • Josh LymaN

    You got someone to say why they believe that contraceptives cause abortions and yet they never mention any medical or scientific evidence that contraceptives cause abortions. I wonder why that is…

    • John Haas

      Josh, it seems the author wants to stake his stand on conscience, not on what certain contraceptives may or may not do. Hence he says, “we should all agree to protect the religious freedoms of all Americans, including those who believe paying for contraceptive coverage violates their conscience.” Key word there being “believe.”

      There’s several problems with the author’s argument. 1) Is health-insurance the employer “paying for” health care? Usually insurance is regarded as a form of earned compensation. Hence, having contraceptives provided is little different from paying an employee who then purchases contraceptives with their earnings. Here the issues of “fungibility” and “self-insuring” are often brought forward, but it’s by no means obvious that those appeals solve the problem. (Oddly, religious employers have a solution easily at hand which for some reason they have eschewed: have a life-style covenant for prospective employees wherein the pledge not to use contraceptives.)

      2) The author seems to believe that since what is at stake is “conscience,” all employers with religious convictions should be exempt from the HHS requirement. It’s hard to believe anyone seriously believes this. If conscience is an absolute that can’t be violated, then any moral convictions about any issue should earn one an exemption from everything one claims is objectionable. This question has been addressed in United States v Lee (1982) in which an Amish employer objected on religious grounds to withholding Social Security for his employees, and the court ruled against him, saying, “Congress and the courts have been sensitive to the needs flowing from the Free Exercise Clause, but every person cannot be shielded from all the burdens incident to exercising every aspect of the right to practice religious beliefs. When followers of a particular sect enter into commercial activity as a matter of choice, the limits they accept on their own conduct as a matter of conscience and faith are not to be superimposed on the statutory schemes which are binding on others in that activity. Granting an exemption from social security taxes to an employer operates to impose the employer’s religious faith on the employees.”

      3) Following from that, the author simply assumes that “free exercise” is not merely a right, but an “absolute” right. No one’s going to get very far with that radical assertion, not as long as Reynolds v. United States (1878) still stands.

      • Former Student, I suspect

        Well said. I think you might be the John Haas who was my favorite history professor in undergrad. Yes?

        • John Haas

          Absolutely. I am, in fact, the only one out there. 😉

      • Yoyo

        If a catholic or other religiously based hospital takes government money or tax breaks they should follow the legislative requirements of the elected government. In addition I agree with John haas, give to Caesar what belongs to Caesar etc. The other, and I believe better choice is to move towards universal healthcare as almost all developed nations have and thereby take the issue out of the hands of the religious institutions.

        • Yoyo

          Ps: I don’t believe non profits should be exempt. I worked for many non-profits in my early years and although I supported the various causes I would have seemed blue murder if the tried to influence my private healthcare choices.

        • Chris

          Should people on food stamps be denied the right of free speech…or of the right to assembly? No, of course not. Your logic that accepting goverment money and or benefit should come with a dimished set of rights is not only ridiculous, but I would also guess that you would not agree to fairly apply it as I have outlined above. You are choosing to taregt religion only.

          • Barry

            And your logic is that the employers have rights and freedoms, while the employees can take what they get.

          • Timothy Dalrymple

            No, I think we all have rights of religious conscience. There’s no threat to religious conscience here for employees. It does not contradict their freedom of religion if they have to purchase their own contraceptives. It does contradict the employers’ freedom of religion if they have to pay for contraceptive methods to which they object on religious grounds.

            We all have the same rights, but I fail to see how anyone’s rights are being violated if they have to pay for their own contraceptives.

      • Kristen inDallas

        1) There is a big difference between paying an employee cash which is then used to go out and purchase something the employer considers wrong, and the employer being required to purchase the illicit item dirrectly. It comes down to choice. What if as an employee I’d rather spend that $5 a month on bread instead of artificial hormones. Most employers wouldn’t give me that choice. Most employers (well before Obamacare) offered health plans that already covered contraception. But if I felt really strongly about it, I could find an employer or a private insurance provider that offered me less coverage, but more cash in my pocket. No one is making contraceptives illegal. People can easily purchase it, and for those that are struggling financially there are plenty of clinics and NFPs that will offer it up for free. This law is telling employers, who already thinkk contraceptives are wrong, that they are no longer allowed to let their employees make the right choice. They are no longer allowed to let their employees make the decision between hormones and bread, because the money’s going to hormones, whether we want to take them or not.

        2&3) The author doesn’t say that concience is an absolute that can’t be violated; it’s a guiding principle that can’t be trumped UNLESS the state can prove it is integral to a compelling interest. If a law violates the first ammendment, the government hasd the onus to prove two things, 1) that the goals of the policy are compelling (that there is a real need for them) and 2) that the goals could not be met through another means that would not violate concience. The amicus brief filed for the lawsuits against HHS makes this point pretty obviously:

    • Joy

      The preponderance of evidence shows that some of these contraceptives, especially Plan B (which uses the same hormones, in different doses, as many mainstream birth control pills), probably do not work in the way described; that is, they have never been shown to “prevent a newly formed embryo from implanting in the uterine wall.” It was at one point speculated (a speculation that made its way into drug labeling) that the drug might work this way (thus the language “may> prevent a newly formed embryo from implanting in the uterine wall”–but recent studies have not shown any evidence of such a thing happening.
      cite: http://www.nytimes.com/2012/06/06/health/research/morning-after-pills-dont-block-implantation-science-suggests.html

      • Timothy Dalrymple

        It’s amazing how quickly that NyTimes article became gospel, isn’t it?

        If there’s one thing I’ve learned regarding these studies, Joy, it’s to show them a fair amount of healthy skepticism. The conventional wisdom until recently was that some of these pills, even if they *normally* functioned in non-abortive ways, could (having failed to prevent fertilization through their normal functions), *also* function to cause a fertilized egg to, in effect, perish. When that article appeared in the New York Times, it was really all that a lot of people needed to hear. The NYTimes says it, therefore, there is no real moral argument here. But of course that’s not really the case. Especially in a highly politicized environment, any one study, or even a couple studies, should be greeted in this case with hope, I think, but also viewed with some skepticism until further studies are performed. It’s also not necessarily the case that these studies suggest that emergency contraceptives like Ella and Plan B, even if they do not normally function in an abortifacient manner, do not also function in an abortifacient manner in those cases where the eggs are successfully fertilized.

        I think it’s quite an unscientific overstatement, in other words, to say “the preponderance of evidence” shows this. It’s more accurate at this point to say that both sides have their studies they point to, and even the possibility that these medications are acting in an abortive manner is enough for many pro-lifers to wish them avoided. But remember, too, the kind of skepticism you would show when a Shell-funded study shows that burning gasoline is good for the environment. These are highly charged issues, and not yet resolved, certainly not on the basis of a NYTimes scientific literature review.

  • Bill S

    No one is forcing employers to practice contraception. They are just required to make it available for their employees. There’s a big difference. If it’s such a model dilemma, don’t you have an excuse for doing it if the government requires you to?

    • Timothy Dalrymple

      The requirement is not merely “to make it available,” but effectively to pay for it. That’s where the problem comes in, for many people who have a moral objection to the use of emergency contraceptives that are potentially abortion-inducing.

      • John Evans

        So should Muslim Americans be able to opt out of funding war in the middle east?

  • Bill S

    “It’s also not necessarily the case that these studies suggest that emergency contraceptives like Ella and Plan B, even if they do not normally function in an abortifacient manner, do not also function in an abortifacient manner in those cases where the eggs are successfully fertilized.”

    The intelligent answers are in no specific order:
    1. So what?
    2. Why don’t employers avoid taking the pill and let their employees make their own moral decisions?
    3. Why don’t employers go to confession and tell the priest that Obama made them do it?

    • Kristen inDallas

      Don’t you get it? Employees with cash CAN make there own moral decisions. Giving emplyees less cash and more non-negotiable health insurance means the employees have less power and less control over their own lives. I bet if doctors made it as big of a habit of treating male patients the way they treat women (pushing steroids that make you sterile to ease the symptoms of a real medical illness rather than trying to actually treat the illness because it’s “already covered” and it’s easier for them) you wouldn’t be so quick to talk about choices. Do you know how many times they’ve tried developing a male hormaonal contraceptive and abandoned it b/c the test subjects complained about the exact same side effects women have been putting up with for the last 40-odd years? “So what?” check your priveledge, how ’bout?

  • Yoyo

    This is just silly. I think you will find most catholic families have already voted with their feet. How many families do you see with 7,8,9 or 10 children sitting in the pews? Barring the quiver full fundies how many evangelicals are having similarly large broods? Contraception is about choice, about taking the time to know one child before you’re delivering another baby, it’s about acknowledging that each child has needs emotional and financial and basically it’s nobody else’s business.

  • Jeff

    Could someone provide a source to support the claim that the religious exemption on the contraception mandate is so narrow as to cover only houses of worship. As I research this, I’m having trouble seeing a firm declaration of this anywhere. This, at least, seems to be an area with some different interpretations. One source I saw online suggested that, for example. Christian hospitals and Catholic universities WOULD qualify for the religious exemption. The clearest verbiage I can see refers to religious organization and businesses controlled by religious organization. Surely a business like Tyndale House must qualify as a religious organization.

    • Jeff

      Grammatical error that could effect how my meaning is seen. Sentence four should read:

      One source I saw online suggested that, for example, Christian hospitals and Catholic universities WOULD qualify for the religious exemption.

  • Monimonika

    So, if an employer believes that blood transfusions are against their religion, can they specifically deny to pay for insurance that covers blood transfusions for their employees? Would employees have to decide on whether to risk surgery without a blood transfusion (since the cost will not be covered) based, not on the employees’ own beliefs or medical needs, but on the employer’s personal beliefs/whim? Seriously, WHAT IS THE QUALIFYING DIFFERENCE HERE?

    Also, you may notice I added the word “whim” up there. Religious beliefs can change, so if an employer converts to a new set of beliefs, would that employer have the right to take away previously offered coverage?

    • John Haas

      Yes and yes, according to those who believe that “conscience” has absolute rights that cannot be violated, only if, of course, that conscience is possessed by the employer. If it’s that of the employee–well, tough luck. The employee’s conscience doesn’t factor into this “religious liberty” equation, for reasons that will likely forever remain mysterious . . .

    • Kristen inDallas

      The qualifying difference is that the state should have no trouble demonstrating a compelling interest when it comes to blood transfusions, as this is a medically necesary proceedure in many instances. BC pills, especially the “emergency” variety, do not function to help a body work, they function to make it stop working. At best, they are an elective, on par with diet pills and liposuction. (only “necesary” for those making particular lifestyle choices).

      … and don’t try to pull the “medically necesary” card. Cases when estrogen/progesterone is prescribed for a medical (non-contraceptive) is not the norm, and it is coded entirely differently with different insurance claim procedures. There is no reason we couldn’t cover only those uses and many/most religious organizations already did.

      • John Haas

        Karen, here and above you make good points. We will have to see how the arguments go regarding contraception.

        The other side of your argument (about harm, etc.) is the degree to which access to contraception has become an expected aspect of modern life, which features large numbers of female professionals and wage earners, which may constitute a compelling interest on the part of the state. This is, after all, why there something like twenty state-level precedents for the HHS rulings (many of which–like Arkansas’, which was signed into law by then-governor Mike Huckabee–draw the line between exempted and non-exempted religious employers just where HHS did).

        The other knot to untie is the reliance on “conscience.” The bishops’ lawyer has (thus far) argued that it’s not contraception per se or even the official religious character of the employer that’s crucial, but the inviolability of conscience–as he put it, this applies to the owner of a Taco Bell as much as it does, say, to the University of Notre Dame. Did the bishops decide to base their case on these grounds because they believed it would gain more supporters from non-Catholics, or did they (perhaps from considerations like those I just mentioned) believe it was a safer legal ground?

        Again, we’ll have to see how those arguments shape up before the court. Here, the discussion has been largely directed at the points made by the original article, which seem to center on the question of conscience. As I said, I believe this will be difficult to make in these cases, as it will involve saying that the employers’ consciences will in some degree be imposed on employees who don’t share those beliefs (and whom the employer is happy to employ, despite that).

      • Monimonika

        Karen, you have this positive image that pregnancy is a “normal” state of being with little to no significant health/medical consequences to a woman’s body(*), yet also have this very strange notion that having sex because sex is pleasurable is definitely not a normal part of being a woman. That’s what you meant by “lifestyle choices” right? Women having sex for pleasure is not normal, but being pregnant is normal? Those two ideas don’t really mesh well together unless women are supposed to be martyrs suffering through the physical torment of being touched and penetrated by men in order to fulfill their lifelong goal of bearing the next generation (the only positive outcome of sex, apparently).

        (*) A pregnant body is just working the way it’s supposed to do, so why do these pregnant women need a couple weeks of maternity leave? Pregnancy and birth can’t possibly be that hard of a thing for women to go through and recover from.

        • Monimonika

          I actually like this WP-SpamFree filter thing. Not sure what rules it applies, but it did force me to cut down my angry rant to a more civilized tone (see above). Just giving praise where it’s deserved. 🙂

      • kenneth

        Hormonal contraception is THE frontline non-surgical treatment option for bleeding related to uterine fibroids and other conditions. Contraception is the main indication for these drugs, but their use in non-contraception “real” medical conditions is not at all a rarity. Employers have no business making their employees prove the intent and ideological purity of their medical needs. You wouldn’t tolerate that sort of intrusion for five seconds if it came from an employer whose religious beliefs were alien to your own. Why should anyone else?

    • kenneth

      If religious beliefs can be used as a blanket excuse to avoid any coverage an employer doesn’t want to pay for, what’s to stop any business owned by a Christian Scientist from covering any service outside of faith healing? Any business owned or operated by Scientology could decide to not pay for any standard mental health services, since they believe psychiatry is an evil hoax. If citing a sincerely held religious principle insulates any commercial enterprise from any mandate, why would any corporation be bound to follow any rule? They could simply align themselves with any number of fringe groups that feel they answer to no Earthly authority on any matter whatsoever.

  • I’m always surprised in these arguments how everyone is so worried about the rights of the corporation and/or institution, yet there are no calls for the rights of the patient/contraceptive user. If someone is religiously opposed to oral contraceptives they don’t have to use them. It’s a matter between a doctor and a patient, not between a doctor, patient, moral authority employer. It’s nobody’s business whether or not someone uses oral contraception (or any other form). Just because you work for a Catholic institution doesn’t mean you are necessarily a Catholic. Why should someone be allowed to force their religious values on an employee? If a Pagan were forcing their religious values on an Evangelical you’d all be hopping mad, and justifiably. Why are some groups allowed to force their faith on others, while others are not permitted to do so?

    This can’t be boiled down to a money issue either, it’s far more cost effective to provide contraception than to pay for a child.

    • Timothy Dalrymple

      It’s not “the rights of the corporation” but the rights of *people* who own companies. There are many millions of small business owners, and their rights matter too.

      No one is saying that an employee should not be allowed to use contraception. They’re saying that the owners of the business should not be forced to pay for provision of specific kinds of contraception they find morally abhorrent. You’re right that it’s not the employee’s business if an employer wants to use a legal contraceptive. But the employee does not have a right for it to be *paid for* by the employer, and the employer should (within reasonable limits, of course) be free to run the business in a manner that reflects his or her moral convictions.

      • John Haas

        “. . . the employee does not have a right for it to be *paid for* by the employer . . .”

        Again, if health insurance is part of an employee’s compensation, then the employer is not “paying for the employee’s contraception.” The employer is providing health insurance that is purchased with the earnings due to the employee.

        • Timothy Dalrymple

          And is compelled to do so, and will be compelled to pay for things they find morally unconscionable.

          If the money were given to the employee, and the employee made the decision on health insurance options, then we would not have an issue here.

          • John Haas

            Not so. No employer has to offer health-insurance as part of the employees’ compensation package.

  • jgweekie

    This is why we need universal, single payer health insurance. Once health insurance is removed as a fringe benefit, employee and employer will each have freedom of conscience to not partake of particular medical benefits. This is such a simple solution, I’m surprised it hasn’t been mentioned.

    My problem with Obamacare is that it doesn’t go far enough. If it went farther, this discussion about contraception would be non-existent.