John F. Brehany: Catholic business owners and the challenge of ObamaCare . . . .
The looming implementation of the Patient Protection and Affordable Care Act (aka ObamaCare) is posing critical short-term and long-term challenges to Catholic business owners. How they respond will go a long way toward determining whether the Catholic faith will remain a viable and vibrant presence in American society.
Since ObamaCare’s passage in 2010, employers have waited to learn how the new law would affect their employees and their bottom lines. After missing multiple deadlines, the Obama administration was forced to delay the employer mandate until 2015. In the meantime, however, businesses have experienced significant uncertainty and rising costs, which have negatively impacted employers and employees alike.
A recent U.S. Chamber of Commerce survey showed that only 3 in 10 small business owners say they are ready to comply with ObamaCare, and 25% of business owners are still not sure of what the new law means for them. The average cost of health insurance for families increased by almost $2,500 during President Obama’s first term — almost the exact amount he promised that premiums would decrease as a result of his signature legislation — and a growing number of employers expect costs to rise even higher when ObamaCare is fully implemented. Businesses are responding in a variety of ways — like dropping “extra” benefits such as coverage of spouses, passing on more costs to employees, buying cut-rate health insurance, and by cutting employee hours.
Under ObamaCare, a person who works 30 hours per week is considered a “full-time employee” qualifying for health insurance. Many businesses have reduced employees’ hours below this threshold, causing labor leaders to publicly complain that ObamaCare is undermining the 40-hour work week and the economic benefits provided by full-time employment. Catholic business owners must exercise creativity and prudence in order to protect their businesses and their employees. But these choices pale in complexity to the ethical challenge posed by the HHS mandate.
The most radical change for Catholic business owners under ObamaCare in the short-term is the imposition of the HHS mandate, which requires all health insurance plans (not only those of businesses with more than 50 employees) to provide FDA approved contraceptives (including abortifacients), sterilization, and reproductive counseling to all girls and women without copays or deductibles. While faith-based institutions fought the Obama administration’s radically new definition of “religious employer,” the HHS mandate took effect months ago (in new health insurance plan years starting after Aug. 1, 2012) for practically all businesses in the United States.
Catholic business owners now face a significant ethical dilemma — to either comply with the HHS mandate and cooperate with the evils it entails or to refuse and accept the consequences. To comply with the mandate means to directly subsidize drugs, devices and operations which are objectively evil. Moreover, these “reproductive benefits” will be available not only to employees, but to their daughters, who will be able to access these “services” without the knowledge of their parents. Such a direct and confidential subsidy has long been a goal of Planned Parenthood.
However, refusing to comply with the HHS mandate can entail, at a minimum, either crippling fines of at least $100 per employee per day or dropping all health insurance coverage. Given the manifest evils being subsidized and the direct attack on religious freedom, Catholic businesses can justify providing health insurance in compliance with the HHS mandate (as remote mediate material cooperation) only on a temporary basis while seeking a long-term change in the law or an adequate exemption.
In the long term, it’s possible that the Obama administration and its supporters are hoping to eliminate employer-sponsored health insurance and impose a single-payer system, in which the federal government is the ultimate arbiter of health-care services, pricing and payments. Sen. Tom Coburn (R-Okla.) and Jeffrey Flier, M.D., dean of Harvard Medical School, both argued in the past that ObamaCare, by intent or by its very nature, is practically guaranteed to fail in a few years. Sen. Harry Reid (D-Nev.) admitted as much in an interview in August. What does this mean for Catholic business owners?
Radical changes in health-care financing may be unavoidable. Employer-provided health insurance is not mandated by Church teaching; a just wage and workplace are. In these challenging times, Catholic businesses can play a key role in promoting a whole range of goods identified by Catholic moral and social teachings, including religious freedom, human dignity, responsibility in the workplace, and subsidiarity, to name only a few. We are now facing a powerful federal government that is increasingly hostile to religious freedom and promoting a culture of death. Only if Catholics work together in new ways and establish new networks of support, can the Church sustain an authentic public witness to the faith.
In the coming months and years, Catholic business owners should view the challenges posed by ObamaCare as an opportunity to renew their Catholic faith and witness to it more explicitly — in their businesses and in the public square.
JOHN F. BREHANY, PH.D., STL, is the executive director and ethicist of the Catholic Medical Association.