Marian Ronan

Further Thoughts on the Church and the “Obamacare” Contraceptives Mandate

A number of things about the behavior of the US Catholic Bishops during the recent presidential campaign scandalized me, to use an old-fashioned word. But nothing equalled my horror at the bishops’ decision to stage their “Fortnight of Freedom” campaign in protest against the Affordable Care Act’s mandate of free contraceptive coverage four months before the presidential election. The following is a slight revision of an article I published last spring in EqualwRites, the Philadelphia Catholic feminist newsletter for which I’ve been writing for nearly twenty years. I think some of what I discuss there is worth reviewing as we move toward implementation of the Affordable Care Act (ACA) in a second Obama administration.

The re-election of Barack Obama would seem to have settled the question of the Affordable Care Act, which the Republican candidate promised to eviscerate on his first day in office. But the conflict between the US Catholic bishops and the Obama administration over the act’s mandated provision of contraceptives is unlikely to end any time soon, alas. The bishops, as you will recall, rejected the administration’s proposed compromise that insurance companies, not employers, cover the costs of contraceptives under the ACA. The bishops even claimed that individual employers be exempted from providing such coverage if it violated their “freedom of religion.” I imagine Cardinal Dolan and Co. are planning new forms of protest even as I write.

As we anticipate the next stage in the bishops’ war to control women’s reproductive functions,  there are, I believe, two aspects of the previous round of controversy that deserve attention.  The first is the failure of a wide range of journalists and commentators, including white male liberal Catholic commentators, to so much as hint that the question of contraceptive coverage has anything to do with women.

Before I examine what these commentators said, let’s clarify a few points. Not only do 98% of US Catholic women report having used contraceptives at some time, a significant majority of Catholic women—62%—supported the Affordable Care mandate that Catholic and other religious hospitals and universities provide free contraception coverage as part of their insurance coverage. Indeed, a majority of US Catholics across the board support that mandate.

But the commentators, even Catholic commentators, rarely addressed this reality in the months leading up to the election. Early on there was Michael Sean Winters’s article, “J’accuse,” in the National Catholic Reporter.  Let’s set aside Winters’s outrageous comparison of the contraceptives mandate with the first in a series of anti-semitic events, the Dreyfus affair, that culminated in the Holocaust. (“J’Accuse” is the title of a famous newspaper article by the French writer Emile Zola accusing the French government of antisemitism for convicting Captain Dreyfus of  treason.) Only once in the entire article does Winters use the word “woman,” and that in reference to Sister Carol Keehan, the head of the Catholic Health Association, presumably one of the 2% of Catholic women who has never used, or needed, contraception (and who at that point agreed with him). Instead he states, in typically Catholic binary language, that “It is a mistake of analysis to see this as a decision about contraception. The issue here is conscience.” No reference is made to the National Institutes of Medicine ruling that contraception coverage is an essential part of preventive health care for women, never mind to the millions of actual US Catholic women whose health, and sometimes lives, depend on such care.

And Winters isn’t the only one. The NCR, in its February 9^th editorial, echoes Winters’s claim that “conscience, not contraception, is the essential issue,” while not using the word “women” once. And on the PBS News Hour, Mark Shields and David Brooks likewise managed to reject the HHS mandate two weeks in a row without uttering the word “women.” On Weekend Edition, NPR’s Scott Simon, apparently oblivious to the statistics on US Catholic women’s support of the mandate, opined that just because Catholic women use contraceptives doesn’t mean that they support the denial of religious freedom to their church. And in their February 24 editorial, the more moderate Commonweal also rejected the mandate on the basis of religious freedom, though it does at least nod in women’s direction in the last paragraph.

A few Catholic women—Gail Collins in the New York Times, and moral theologian Lisa Fullam on the Commonweal blog page—did indeed speak out. By and large, however, the most recent phase of the contraceptives controversy was a phallic struggle between white Catholic men, bishops and lay journalists, on one side, and the Obama administration. The majority of US Catholics and even larger majorities of Catholic women, people of color, and Millenials, support the mandate. This struggle may be about conscience, but it’s even more about anyone daring to tell old white guys what to do.

The other dismaying aspect of the current  “(some) Catholics against the HHS mandate” brouhaha is that it feeds into a growing Right Wing effort to undermine access to contraceptives in the US and around the world. As Mark Oppenheimer explains in a January 20^th New York Times op-ed piece, after decades of supporting the use of contraceptives, increasing numbers of US Evangelicals are now joining Catholic conservatives in their opposition to them. One aspect of this is the “Quiverfull” movement, which advocates large families, as exemplified by the Duggar family, the enthusiastic Rick Santorum supporters featured on the reality show, “19 Kids and Counting.”

All these kids jumping around can seem rather jolly, but there’s scary stuff underneath these developments. One is the increasing support for the argument—also advanced by the institutional Church—that most contraceptives are abortifacients. This is argued because oral contraceptives and others that contain hormones make the endometrium less receptive to embryonic implantation. But the embryo, opponents of contraception argue, is a person from the moment of conception. Or, as the American Association of Pro-Life ObGyns puts it, “There is an unarguable logic connecting the contraceptive act and the abortive act.

But as Jamie Manson argues convincingly on her NCR blogpage,* even Catholic Health Association ethicists have acknowledged that neither the IUD nor Plan B work by preventing implantation; instead, they prevent fertilization. At first, the argument against Ella seems more compelling, since its “chemical structure is similar to that of RU-486,” an acknowledged abortifacient not covered under ACA. But Ella comprises a much smaller dose of the chemical similar to the one in RU-486 and functions to delay or prevent ovulation. As an article from the British medical journal the Lancet indicates, only if Ella is given in a dose far beyond that provided under the ACA can implantation be impaired.”

Scientific evidence does not deter those determined to deprive women of reproductive health care, however. Thus far, attempts to enforce this belief by getting the “personhood” amendment added to state constitutions have failed, but the “personhood” movement continues its efforts. Meanwhile, Republican members of the House Foreign Affairs committee voted eleven times in October of 2011 to block funding for the United Nations Population Fund (UNFPA), which provides reproductive services to women, men, and young people in 150 countries around the world.

Surely Michael Sean Winters, Mark Shields, the NCR, and the rest, in their opposition to the ACA-mandated contraceptives coverage by Catholic universities and hospitals, do not intend to support the drive to make contraceptives illegal. I fear that by eliding women, and especially Catholic women, from the conversation, they have done so despite their good intentions