HHS Proposal Falls Short In Meeting Church Concerns; Bishops Look Forward To Addressing Issues With Administration

WASHINGTON—The Feb. 1 Notice ofProposed Rulemakingfrom the U.S.Department of Health and Human Services related to the Patient Protection andAffordable Care Act (PPACA) shows some movement by the Administration but fallsshort of addressing U.S. bishops' concerns.

"Throughoutthe past year, we have been assured by the Administration that we will not haveto refer, pay for, or negotiate for the mandated coverage.We remain eager for the Administration tofulfill that pledge and to find acceptable solutions—we will affirm any genuineprogress that is made, and we will redouble our efforts to overcome obstaclesor setbacks," said Cardinal Timothy Dolan of New York, president of the U.S.Conference of Catholic Bishops (USCCB), in a February 7 statement. "Thus, wewelcome and will take seriously the Administration's invitation to submit ourconcerns through formal comments, and we will do so in the hope that anacceptable solution can be found that respects the consciences of all.At the same time, we will continue to standunited with brother bishops, religious institutions, and individual citizenswho seek redress in the courts for as long as this is necessary."

Helisted three key areas of concern: the narrow understanding of a religiousministry; compelling church ministries to fund and facilitate services such ascontraceptives, including abortion-inducing drugs, and sterilization thatviolate Catholic teaching; and disregard of the conscience rights of for-profitbusiness owners. These are the same concerns articulated by the USCCBAdministrative Committee in its March 2012 statement, United for Religious Freedom.

CardinalDolan said the new proposal seemed to address one part of the church's concernover the definition of a church ministry but stressed that "the Administration'sproposal maintains its inaccurate distinction among religious ministries.

"Itappears to offer second-class status to our first-class institutions in Catholichealth care, Catholic education and Catholic charities. HHS offers what itcalls an 'accommodation' rather than accepting the fact that these ministriesare integral to our church and worthy of the same exemption as our Catholicchurches."

CardinalDolan highlighted problems with the proposed "accommodation."

"It appears that the governmentwould require all employees in our 'accommodated' ministries to have theillicit coverage—they may not optout, nor even opt out for their children—under a separate policy," he said.

He also noted that "because of gapsin the proposed regulations, it is still unclear how directly these separatepolicies would be funded by objecting ministries, and what precise role thoseministries would have in arranging for these separate policies. Thus, thereremains the possibility that ministries may yet be forced to fund andfacilitate such morally illicit activities."

CardinalDolan also said the proposal refuses to acknowledge conscience rights ofbusiness owners who operate their businesses according to their faith and moralvalues.

"In obedience to our Judeo-Christianheritage, we have consistently taught our people to live their lives during theweek to reflect the same beliefs that they proclaim on the Sabbath," CardinalDolan said. "We cannot now abandon them to be forced to violate their morallywell-informed consciences."

The statement is attached.

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Keywords: Cardinal Timothy Dolan, Health and Human Services,Patient Protection and Affordable care Act, PPACA, Catholic, contraceptives,Ella, sterilization

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Statement of Cardinal Timothy DolanResponding to Feb. 1 Proposal from HHS

Foralmost a century, the Catholic bishops of the United States have worked hard tosupport the right of every person to affordable, accessible, comprehensive,life-affirming healthcare.As wecontinue to do so, our changeless values remain the same.We promote the protection of the dignity ofall human life and the innate rights that flow from it, including the right tolife from conception to natural death; care for the poorest among us and theundocumented; the right of the Church to define itself, its ministries, and itsministers; and freedom of conscience.

LastFriday, the Administration issued a Notice of Proposed Rulemaking (NPRM)regarding the HHS mandate that requires coverage for sterilization andcontraception, including drugs that may cause abortions.The Administration indicates that it hasheard some previously expressed concerns and that it is open to dialogue.With release of the NPRM, the Administrationseeks to offer a response to serious matters which have been raised throughoutthe past year.We look forward toengaging with the Administration, and all branches and levels of government, tocontinue to address serious issues that remain. Our efforts will requireadditional, careful study.Only in thisway can we best assure that healthcare for every woman, man and child isachieved without harm to our first, most cherished freedom.

Inevaluating Friday's action regarding the HHS mandate, our reference remains thestatement of our Administrative Committee made last March, United for Religious Freedom, and affirmed by the entire body ofbishops in June 2012.

Inthat statement, we first expressed concern over the mandate's "exceedinglynarrow" four-part definition of "religious employer," one that exempted ourhouses of worship, but left "our great ministries of service to our neighbors,namely, the poor, the homeless, the sick, the students in our schools anduniversities, and others in need" subject to the mandate.This created "a 'second class' of citizenshipwithin our religious community," "weakening [federal law's] healthy traditionof generous respect for religious freedom and diversity."And the exemption effectuated thisdistinction by requiring "among other things, [that employers] must hire andserve primarily those of their own faith."

OnFriday, the Administration proposed to drop the first three parts of thefour-part test.This might address thelast of the concerns above, but it seems not to address the rest.The Administration's proposal maintains itsinaccurate distinction among religious ministries. It appears to offersecond-class status to our first-class institutions in Catholic health care,Catholic education, and Catholic charities. HHS offers what it calls an"accommodation," rather than accepting the fact that these ministries areintegral to our Church and worthy of the same exemption as our Catholicchurches. And finally, it seems to take away something that we had previously—theability of an exempt employer (such as a diocese) to extend its coverage to theemployees of a ministry outside the exemption.

Second,United for Religious Freedomexplained that the religious ministries not deemed "religious employers" wouldsuffer the severe consequence of "be[ing] forced by government to violate theirown teachings within their very own institutions."After Friday, it appears that the governmentwould require all employees in our "accommodated" ministries to have theillicit coverage—they may not optout, nor even opt out for their children—under a separate policy.In part because of gaps in the proposedregulations, it is still unclear how directly these separate policies would befunded by objecting ministries, and what precise role those ministries wouldhave in arranging for these separate policies.Thus, there remains the possibility that ministries may yet be forced tofund and facilitate such morally illicit activities. Here, too, we will continueto analyze the proposal and to advocate for changes to the final rule thatreflect these concerns.

Third,the bishops explained that the "HHS mandate creates still a third class, thosewith no conscience protection at all:individuals who, in their daily lives, strive constantly to act inaccordance with their faith and moral values."This includes employers sponsoring and subsidizing the coverage,insurers writing it, and beneficiaries paying individual premiums for it.Friday's action confirms that HHS has nointention to provide any exemption or accommodation at all to this "thirdclass."In obedience to ourJudeo-Christian heritage, we have consistently taught our people to live theirlives during the week to reflect the same beliefs that they proclaim on theSabbath.We cannot now abandon them tobe forced to violate their morally well-informed consciences.

Becausethe stakes are so high, we will not cease from our effort to assure thathealthcare for all does not mean freedom for few.Throughout the past year, we have been assuredby the Administration that we will not have to refer, pay for, or negotiate forthe mandated coverage.We remain eagerfor the Administration to fulfill that pledge and to find acceptablesolutions—we will affirm any genuine progress that is made, and we willredouble our efforts to overcome obstacles or setbacks.Thus, we welcome and will take seriously theAdministration's invitation to submit our concerns through formal comments, andwe will do so in the hope that an acceptable solution can be found thatrespects the consciences of all.At thesame time, we will continue to stand united with brother bishops, religiousinstitutions, and individual citizens who seek redress in the courts for aslong as this is necessary.

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