Weekly Standard: Obamacare Vs. The Catholics

U.S. bishop Charles John Brown is being appointed by Pope Benedict XVI on Jan. 6, 2012 at St Peter's basilica at the Vatican. The Catholic Church in the U.S. and the Obama administration have been feuding over health insurance coverage of contraception. Gabriel Bouys/AFP/Getty Images hide caption

Jonathan V. Last is a senior writer at The Weekly Standard.

On the last weekend of January, priests in Catholic churches across America read extraordinary letters to their congregations. The missives informed the laity that President Obama and his administration had launched an assault on the church. In Virginia, Catholics heard from Bishop Paul Loverde, who wrote, "I am absolutely convinced that an unprecedented and very dangerous line has been crossed." In Phoenix, Bishop Thomas Olmsted wrote, "We cannot​ — ​we will not​ — ​comply with this unjust law." In Pittsburgh, Bishop David Zubik wrote that President Obama had told Catholics, "To Hell with your religious beliefs." Bishop Daniel Jenky of Peoria asked his flock to join him in the Prayer to St. Michael the Archangel, which concludes: By the Divine Power of God / cast into Hell, Satan and all the evil spirits / who prowl about the world seeking the ruin of souls.

It was a remarkable moment, in part because despite their stern reputation, most Catholic bishops are not terribly conservative. They tend to be politically liberal and socially cautious. If they were less holy men, stauncher conservatives would call them squishes. Real live conservative bishops are so few and far between that whenever one appears on the scene, such as Philadelphia's Archbishop Charles Chaput, he's seen as a vaguely threatening curiosity. You can tell when a bishop is conservative because you will hear him referred to as "hardline" or "ultra-orthodox," so as to mark him apart from the rest of the herd.

But what made the moment even more remarkable is that the bishops were not exaggerating. It is now a requirement of Obamacare that every Catholic institution larger than a single church​ — and even including some single churches​ — ​must pay for contraceptives, sterilization, and morning-after abortifacients for its employees. Each of these is directly contrary to the Catholic faith. But the Obama administration does not care. They have said, in effect, Do what we tell you — or else.

The beginnings of this confrontation lay in an obscure provision of Obama's Patient Protection and Affordable Care Act, which stated that all insurers will be required to provide "preventive health services." When the law was passed, "preventive" was not defined but left to be determined at a later date.

This past August, Health and Human Services secretary Kathleen Sebelius finally got around to explaining the administration's interpretation of the phrase. Based on a recommendation from the Institute of Medicine, the administration would define "preventive health services" to include contraceptives, morning-after pills, and female sterilization. And they would interpret the "all insurers" section to include religious organizations, whatever their beliefs.

Sebelius included one small conscience exemption: A religious employer who objects to medical treatment aimed at prevention of the disease commonly known as "pregnancy" may leave it out of their health insurance coverage provided the employer satisfies three criteria: (1) It has religious inculcation as its primary duty; (2) It primarily employs people of the same faith; and (3) It primarily serves people of the same faith. This fig leaf is enough to cover most small churches​ — ​so long as your parish employs only a couple of priests and a secretary, it would probably get a pass. Larger institutions would not.

In the Catholic world, for instance, a diocesan office often employs lots of people​ — ​lawyers, janitors, administrative staff​ — ​who are not necessarily Catholic. And the duties of such offices extend far beyond inculcation of the faith​ — ​to include charity, community service, and education. Or take Catholic universities. There are more than 200 of them, serving some 750,000 students. They clearly do not fit the exemption. Neither would any of the 6,980 Catholic elementary or secondary schools. Nor the country's 600 Catholic hospitals; nor its 1,400 Catholic long-term care centers. Ditto the network of Catholic social services organizations that spend billions of dollars a year to serve the needy and disadvantaged.

As soon as Sebelius released this decision, the Catholic church panicked. The Conference of Catholic Bishops reached out to the administration to explain the position in which it had put them. But the tone of their concern was largely friendly: Most Catholic leaders were convinced that the entire thing was a misunderstanding and that the policy​ — ​which was labeled an "interim" measure​ — ​would eventually be amended.

The reason for this optimism was that more than a few important Catholics had previously climbed out on a high branch for Obama politically, and for his health care reform as a matter of policy. Despite what you may read in the New York Times, most lay Catholics are nominally at home in the Democratic party. (Remember that a majority of Catholics voted for Obama in 2008.) And what is true of the laity goes double for those in religious life. In 2009, Notre Dame president Father John Jenkins welcomed President Obama as the school's commencement speaker in the face of a heated student protest. The U.S. Conference of Catholic Bishops mostly kept its powder dry during the fight over Obamacare, and very few members of the church hierarchy actively, or even tacitly, opposed the bill. Others, such as Sister Carol Keehan, the president of the Catholic Health Association, actually lobbied in favor of it, early and often. So most Catholics took the president at his word when he met with Archbishop Timothy Dolan last fall and assured him that when the final version of the policy was eventually released, any fears would be allayed.

That was their mistake. Obama telephoned Dolan on the morning of January 20 to inform him that the only concession he intended to offer in the final policy was to extend the deadline for conformity to August 2013. Every other aspect of the policy enunciated by Sebelius would remain rigidly in place.

It's unclear whether Obama anticipated the blowback which resulted from this announcement, or perhaps even welcomed the fight. The liberal Catholic establishment nearly exploded. Sister Keehan was so horrified she threw her lot in with the more conservative Dolan in full-throated opposition to Obama. Cardinal Roger Mahony, the spectacularly liberal archbishop emeritus of Los Angeles, wrote, "I cannot imagine a more direct and frontal attack on freedom of conscience. This decision must be fought against with all the energies the Catholic community can muster." Michael Sean Winters, the National Catholic Reporter's leftist lion, penned a 1,800-word cri de coeur titled "J'accuse!" in which he declared that, as God was his witness, he would never again vote for Obama. The editors of the Jesuit magazine America denounced a "wrong decision," while the Washington Post columnist E. J. Dionne called the policy "unconscionable." When you've lost even E.J. and the Jesuits, you've lost the church.

The reason liberal Catholics were so wounded is twofold. First, this isn't a religio-cultural fight over Latin in the Mass or Gregorian chant. The subjects of contraception, abortion, and sterilization are not ornamental aspects of the Catholic faith; they flow from the Church's central teachings about the dignity of the human person. Second, Obama has left Catholic organizations a very narrow set of options. (1) They may truckle to the government's mandate, in violation of their beliefs. (2) They may cease providing health insurance to their employees altogether, though this would incur significant financial penalties under Obamacare. (The church seems unlikely to obtain any of Nancy Pelosi's golden waivers.) Or (3) they may simply shut down. There is precedent for this final option. In 2006, Boston's Catholic Charities closed its adoption service​ — ​one of the most successful in the nation​ — ​after Massachusetts law required that the organization must place children in same-sex households.

Which means that what is actually on the block are precisely the kind of social-justice services​ — ​education, health care, and aid to the needy​ — ​that liberal Catholics believe to be the most vital works of the church. For conservative Catholics, Obama merely confirmed their darkest suspicions; for liberals, it was a betrayal in full.

As a matter of law, this decision by Obama's health care bureaucrats seems unlikely to survive. Last month, the Supreme Court struck down another attempt by the administration to bully religious believers in the Hosanna-Tabor case. In that instance, Obama's Equal Employment Opportunity Commission argued that a religious organization does not have the right to control its hiring and firing according to its religious belief. The Court struck down this argument 9-0 in a rebuke so embarrassing that Justice Elena Kagan came close to openly mocking her successor as Obama's solicitor general during oral arguments. It was the kind of sweeping decision that should have deterred the Obama administration from forcing Catholics into complying with the health insurance mandate, because it suggested that the Court will very likely side against the administration once this matter comes before it. Presidents typically dislike being overturned unanimously by the High Court.

The trick, of course, is that when Sebelius issued the final protocol, her lone concession was the one-year delay in implementation. Which, for Obama, has the happy side-effect of pushing the moment of enforcement to August 2013. Meaning that no legal challenge can come until after the 2012 election. Which suggests that the thinking behind the policy may be primarily political. The question, then, is whether Obama's confrontation with Catholics makes electoral sense.

While Catholics were blindsided by the January decision, the left had been paying close attention to the subject for months. In November, several leftist and feminist blogs began beating the war drums, warning Obama not to "cave" (their word) to the bishops. They were joined by the Nation, Salon, the Huffington Post, and the usual suspects. (Sample headline: "The Men Behind the War on Women.") At the same time, Planned Parenthood and NARAL launched grassroots lobbying efforts and delivered petitions with 100,000 and 135,000 signatures respectively to the White House urging Obama to uphold the policy and not compromise.

In that sense, Obama's decision might be thought of as akin to his decision halting the Keystone oil pipeline: a conscious attempt to energize his base at the expense of swing voters, who he concluded were already lost.

The other possibility, of course, is that Obama sees the dismantling of Catholic institutions as part of a larger ideological mission, worth losing votes over. As Yuval Levin noted in National Review Online last week, institutions such as the Catholic church represent a mediating layer between the individual and the state. This layer, known as civil society, is one of the principal differences between Western liberal order and the socialist view.

Levin argues that the current fight is just one more example of President Obama's attempt to bulldoze civil society. He wants to sweep away the middle layer so that individuals may have a more direct and personal encounter with the state. The attack on Catholics is, Levin concludes, "an attack on mediating institutions of all sorts, moved by the genuine belief that they are obstacles to a good society."

Seen in this light, Obama's confrontation with the Catholic church is of a piece with the administration's pursuit of the rickety Hosanna-Tabor case and another incident from last October, when the Department of Health and Human Services defunded a grant to the Conference of Catholic Bishops. That program supported aid to victims of human trafficking. The Obama administration decided that they no longer wanted the Catholic church in the business of helping these poor souls. That, evidently, is the government's job.

Of course, there is a third possibility in explaining the president's motives. It could be that, in deciding to go to war with the Catholic church, President Obama has hit on one of those rare moments where his electoral interests — at least as he perceives them — and his ideological goals are blessedly aligned.