Tag Archives: ObamaCare

Liberty … hanging by a thread

The Little Sisters of the Poor are happiest when they do what they love most: caring for the elderly in the 27 nursing homes they operate across the United States.


Pope Francis meets with the Little Sisters of the Poor during his visit to the United States on Sept. 23

But that happiness has been strained by their legal battle against the Obama Administration, which began in 2013. Their lawsuit – Little Sisters of the Poor v. Burwell – stems from the order’s opposition to the Administration’s Health and Human Services contraception mandate.

The U.S. Supreme Court heard oral arguments in the case on March 23. The nuns’ attorneys argued that they must not be forced to pay for contraception, sterilizations and abortion-inducing drugs for their employees – things the HHS mandate would force them to do.

“This is the first time we have ever done anything like this, going to the Supreme Court,” said Sr. Constance Viet, Communications Director for the Little Sisters of the Poor. “It’s definitely outside of our comfort zones as nuns. So we are praying very much. We even held a live-streamed holy hour on March 10.”

 A fake accommodation

Sean Fieler

Sean Fieler

“America has made a unique contribution in the world for modeling religious liberty — in particular accommodating people of different faiths,” said Sean Fieler, a member of Legatus’ New York City Chapter and a board member of the Becket Fund, the firm defending the Little Sisters. “But what we have seen in the last 50 years is a stepping back. What’s happening now is not religious liberty as understood by the Constitution. Forcing the Little Sisters to provide contraception is very upsetting.”

The Little Sisters employ about 3,000 people across the country. If they lose this case — which will likely be decided in late June — they must pay fines of $70 million per year, which is 40% of their operating budget. The nuns would have to close their nursing homes, throwing hundreds of poor elderly men and women into the streets — all because of the government’s contraceptive rule, which none of their employees ever requested.

In order to pacify religious non-profits like the Little Sisters, the federal government came up with an “accommodation” last year whereby employers could tell the government that they morally object to the mandate. The government would then tell the health plan issuer to provide the contraceptive coverage, basically inserting itself into the employer’s health plan.

“We get asked, ‘Why don’t you just sign the paper?’ But this is basically a permission slip that allows our health plan to provide these services,” Sr. Constance explained. “It’s cooperation with something which is morally objectionable.”

littlesisters-1Since there are health exchanges available, employees who really want contraception coverage could simply opt out of the Little Sisters’ health plan and get contraceptive coverage from an exchange.

“There are many cases in a diverse country like the U.S. where there can be conflicts because of religious beliefs,” said Mark Rienzi, senior counsel for the Becket Fund. “But in this case, it’s obvious that the government can do this another way.”

Grassroots opposition

In fact, the HHS mandate doesn’t even cover one-third of Americans. Companies like Exxon, Visa and Pepsi are exempt because their health insurance plans were “grandfathered.” They already existed before the mandate.

The U.S. military, which is the single largest employer in the world, is exempt from the mandate. Several large cities — including New York — are also exempt. None of these groups has a moral issue with contraception. But since the Little Sisters of the Poor do, they and many Catholic analysts struggle to understand the Obama administration’s logic for picking on a group of nuns.

Helen Alvaré

Helen Alvaré

“With just his signature, Obama can undo this,” said Helen Alvaré, founder of Women Speak For Themselves (WSFT), a grassroots organization fighting the contraception mandate. “When I think of what the U.S. government has spent on litigation to defend the mandate against over 300 plaintiffs — why didn’t they spend it all on free contraception if it was that important to them?”

The Obama administration issued the HHS mandate in 2011 after recommendations they received from the Institute of Medicine (IOM). It was later revealed that nearly every member of the IOM had ties to abortion advocacy groups. None of them was pro-life.

“The HHS mandate has distilled the message that sexual expression without children is more important than religious freedom,” Alvaré explained. “But this ethic is really harmful to women, and women strongly support religious freedom, so the government has it upside down.

“Religious freedom — which involves searching for God and living in accordance with God’s will — is central to human happiness and freedom. But to take something which immiserates women — a sexual life which is not tied to marriage or children — and say that it is the essence of happiness is a level of lying I just can’t tolerate.”

From this frustration, WSFT was born. The group currently has over 41,000 supporters nationwide. The group asked supporters to send good wishes to the Little Sisters on Valentines Day. The nuns received over 800 messages saying, “I stand with the Little Sisters of the Poor.”

Freedom at stake

Hundreds of religious and lay people rally in front of the U.S. Supreme in support of the Little Sisters of the Poor and religious freedom on March 23 (Becket Fund photo)

Hundreds of religious and lay people rally in front of the U.S. Supreme in support of the Little Sisters of the Poor and religious freedom on March 23 (Becket Fund photo)

With the Becket Fund, WSFT organized a March 23 rally at the U.S. Supreme Court. Over 160 women religious from different communities showed their support. That same day, there were peaceful rallies in front of Little Sisters’ facilities in 15 states.

“I can tell you that amid the anxiety and concern of our case, it has been a very beautiful experience realizing how many people across the country are supporting us,” said Sr. Constance.

The Supreme Court has received 43 amicus or “friend of the court” briefs on behalf of the Little Sisters.

When Justice Antonin Scalia died suddenly on Feb. 13, those involved with the case mourned the loss of someone they were confident would support the Little Sisters in their case.

“It was certainly very sad when I heard of his passing,” said Sr. Constance, “but I choose to believe that we have an extra intercessor in heaven. We have a long history of depending on God’s providence for our survival. But He sometimes waits until the last minutes to push us beyond our comfort zone. We have to renew our confidence in God.

“I look back on our history as a source of courage,” she continued. “This kind of struggle for religious freedom is written into our DNA. Our founder St. Jeanne Jugan founded our order in the aftermath of the French Revolution when religious rights were trampled on. Our sisters have never given up.”

SABRINA ARENA FERRISI is a Legatus magazine staff writer.

Learn more: becketfund.org/little-sisters-poor-v-burwell littlesistersofthepoor.org

ObamaCare vs. Little Sisters of the Poor

by John Garvey

On Wednesday the Supreme Court will hear oral arguments in Little Sisters of the Poor v. Burwell, a landmark case challenging the Department of Health and Human Services contraceptive mandate under the Affordable Care Act.

In addition to the Little Sisters of the Poor, an order of Catholic nuns whose mission is to “offer the neediest elderly of every race and religion a home where they will be welcomed as Christ,” the objecting parties include the university I head, the Catholic University of America, the Archdiocese of Washington, and a host of other religious institutions.

When the Affordable Care Act was passed in 2010, President Obama vowed that he wouldn’t let it be used for federal funding of abortions. That promise was necessary to get the law passed. Bart Stupak, a congressman at the time, and a small group of pro-life Democrats provided the necessary votes. In regulations implementing the act, HHS has chosen a different, and more offensive, way to fund abortions: It makes Catholic and other religious employers pay for them.

It is common knowledge that the Catholic Church has taught the immorality of abortion and contraceptive use for millennia. Yet the regulations in question force our institutions to pay for insurance that covers abortifacients like Ella and Plan B, plus prescription contraceptives and surgical sterilizations.

Some people defend these regulations by pointing out that they don’t make anyone get an abortion or use contraceptives. The regulations only require employers to provide insurance, leaving decisions about reproductive health up to individual employees. But we believe it is wrong to cooperate with evil acts, even if we are not the primary actor.

The government has offered to solve the problem for scrupulous employers by moving them one step further away from the wrongful act. Many employers, like Catholic University, hire an insurance company to handle their employees’ health claims. In return, we pay our insurer an annual premium, set to cover our usual claims experience. HHS proposes that instead of paying for abortions (and other objectionable services) ourselves, we can opt out, and the government will direct our insurance company to pay. The regulations add that the payments can’t come out of our premiums.

So where does the money come from? HHS suggests that insurers should front the money themselves, and it says that they will actually save money by offering free abortions and “preventive services.” According to the regulations, because the mandated services reduce childbirths, insurers can recoup their costs “from reduced pregnancy-related expenses and other health care costs.”

There isn’t much empirical evidence for this, but let us suppose it is true. In that case, the premiums that Catholic University pays once again cover the costs of abortifacients, contraceptives and sterilizations. Our insurance company simply moves the change around in its pockets so the objectionable services don’t get posted to our account. But we pay the insurer enough to cover the bills.

What the insurance company should do in future years, if HHS’s hypothesis is true, is lower our premiums to take account of the “reduced pregnancy-related expenses and other health care costs.” But in that case we have another moral dilemma. Then we are sharing in the financial rewards produced by giving our employees free early-term abortions and other “preventive services.”

Consider this analogy. I give my builder $100,000 to build a home. He finishes the job $10,000 below budget by employing underage workers and using black-market materials. It would be wrong for me to share in the savings from those immoral activities, even if I didn’t make the arrangements.

The Affordable Care Act requires employers like Catholic University to carry health insurance. The problem we are trying to solve arises because HHS has imposed a further obligation to cover “preventive services,” and insisted that either we or our agent (the insurance company) pay for them. A more tolerant solution would be for the federal government to fund “preventive services.” But President Obama had to promise not to do that to get the law passed. A still more tolerant solution would be to exempt religious organizations like ours from a duty to pay for services that go against the fundamental tenets of our faith.

The United States was founded on the concept of religious freedom. The First Amendment says clearly that “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof.” The Little Sisters of the Poor, the university I represent, and countless other religious institutions across the country ask that the Supreme Court recognize our religious beliefs and strike down those regulations that would force us to violate them.

JOHN GARVEY is president of the Catholic University of America and a member of Legatus’ Washington, DC, Chapter. This article originally appeared in the WSJ on 03/20/16.

ObamaCare five years later

JOHN BREHANY writes that Catholic business leaders are still burdened by ObamaCare . . .

John F. Brehany

John Brehany

by John Brehany

The Patient Protection and Affordable Care Act (aka ObamaCare) is five years old. Legatus members should continue to learn about and respond to this flawed legislation.

Where do we stand at this point? It’s hard to say. The Administration has not provided regular and reliable data about implementation. And the Galen Institute has identified 49 significant changes in ObamaCare (30 by unilateral executive action) since 2010. Most have involved delays or waivers of mandates, deadlines and fees. Another significant change — providing federal subsidies in states without insurance exchanges — is under review by the Supreme Court.

After these caveats, it’s clear that there has been some progress in providing access to health insurance. In 2014, a total of 14 million people obtained new access to health insurance (5.8 million bought health insurance and 8.7 million were added to Medicaid). The net increase, however, was closer to 10 million due to millions losing their employment or private insurance. Significantly, only half of those buying insurance at Healthcare.gov were uninsured, and only one-third of those eligible for subsidies signed up. This lack of participation should be concerning. In 2014, health insurance premiums increased an average of 49% despite President Obama’s pledge that families would see an average $2,500 reduction in annual health insurance premiums. For now these increases are being masked by subsidies.

What will we be facing? The real impact of ObamaCare will be felt in the next few years. First, the employer mandate is set to be enforced in 2016. Employers have already cut employee hours and reduced benefits, and this trend is likely to continue. The disruption in employment-based health insurance could be greater than that in the individual market in 2013. Second, the full costs of ObamaCare will become more apparent in 2017. The Administration has been tapping a $25 billion reinsurance fund to backstop health insurance companies’ losses, allowing them to keep premiums artificially low. After this fund expires at the end of 2016 and insurance companies gain claims experience with the newly insured — who are older, sicker, and poorer than originally projected — on Healthcare.gov, costs almost certainly will be much higher.

What should we do? Catholics and Catholic business leaders in particular should play a key role in proposing and enacting substantive changes to the current law as soon as the window for action opens — after a new president takes office. The Catechism teaches: “It’s not the role of the pastors of the Church to intervene directly in the political structuring and organization of social life. This task is part of the vocation of the lay faithful, acting on their own initiative with their fellow citizens” (#2442).

While being cognizant of key data and of the rules for effective political discourse, Catholic business leaders should make a compelling and comprehensive moral case for substantial changes in ObamaCare that will achieve authentic health care reform and protect essential human goods. I suggest there are at least three indispensable components of this moral case.

First, a moral case should be built on the foundation of Catholic social teachings, especially the principles of social justice and subsidiarity. We respect social justice (CCC #1928) when we ensure that the vulnerable and marginalized have access to adequate health insurance and health care. We respect the principle of subsidiarity (CCC #1883) when we ensure that decisions about health insurance and health care are made at the lowest, most local level.

Second, a moral case should be built on the dignity of the human person and on respect for fundamental human goods — above all, respect for the right to life, of conscience, and of religious freedom. ObamaCare’s sloppily written legislative language undermines longstanding protections for these rights in federal and state law. And the HHS mandate has been imposed with disregard for the religious beliefs of millions.

Third, a moral case can and should build on the strengths of the American social tradition. These strengths go beyond broad human freedom and decentralized governance to include high levels of generosity across the population. America is the most generous nation on earth. Philanthropy has been essential to building the finest and most advanced health care institutions. Legislation and taxes are necessary to protect human rights and the common good. Yet, where the welfare state is strongest, generosity of philanthropy dedicated to serving those in need is the weakest. Sound political and economic measures for health care reform should be supplemented by encouraging philanthropy.

JOHN BREHANY is the director of institutional relations at the National Catholic Bioethics Center.

ObamaCare and cooperation with evil

Marie Hilliard: Organizations helping enroll people in ObamaCare may be problematic . . .

Marie T. Hilliard

Marie T. Hilliard

ObamaCare has caused confusion and reams of additional paperwork for Americans. The National Catholic Bioethics Center (NCBC) continues to review the various enrollee registration roles developed to implement this law and is advising Catholic agencies to exercise caution.

As new information is disclosed on the implementation of the Affordable Care Act (ACA), the NCBC deems it prudent to advise Catholic agencies assuming ACA Navigator and other related roles in enrolling persons for coverage. There are three specific roles:

Navigator: All exchanges (also known as marketplaces) — whether state-based, partnership or federally facilitated — are required to establish a navigator program. Each exchange will designate entities as navigators and provide them with grants for helping individuals and small employers with the application and enrollment process.

In-Person Assisters (IPAs): In the final exchange blueprint, the Center for Consumer Information and Insurance Oversight (CCIIO) outlined IPAs as a second type of assister that is distinct from navigators and other application assistance programs.

Certified Application Counselors (CACs): Being certified as CACs enables organizations that would likely be engaged in application assistance anyway to help consumers in a more formal capacity. For example, although not all community health centers and community-based organizations will be chosen to serve as navigators or IPAs, they are well-positioned to provide application assistance because they are trusted messengers.

There is a significant possibility of scandal, which is to be judged by the diocesan bishop, when a Catholic agency participates not only as a Navigator but also in providing IPAs or CACs for enrollment in coverage. This is not just because of the morally illicit drugs and procedures which will be facilitated by implementing the ACA, but also because of the violation of religious liberty occurring pursuant to the Department of Health and Human Services’ contraceptive mandate in the ACA’s implementation.

There are also additional concerns, especially for states that have not banned abortion coverage in the Exchanges. The ACA stipulates that by 2017 only one plan per Exchange must not include such coverage; all of the other plans may or may not cover abortion, and all plans include coverage of abortifacients.

In order to circumvent certain restrictions on government funding for abortion, the ACA requires that persons holding an Exchange policy which includes abortion coverage, pay a private surcharge of at least $12 per year specifically for the abortion coverage. Enrollers may be engaging in formal cooperation in evil, which is always morally illicit. Explicit formal cooperation in evil occurs when the cooperator (enroller) has the same evil intent as the principal agent (enrollee, who desires insurance coverage specifically for abortion, intending to make use of it if the occasion arises). If the enroller would prefer that coverage not include abortion coverage, yet acts to ensure that the enrollee has this specific type of coverage as an IPA, CAC, or contracted Navigator, this could constitute implicit formal cooperation.

This scenario is complicated by the fact that the law prohibits insurers from telling potential enrollees whether a plan under consideration includes abortion. It allows the abortion surcharge and its amount to be disclosed only at the time of enrollment and prohibits insurers from itemizing it on premium bills. Obviously, if enrollers have no knowledge of whether the plan includes abortion coverage, they are not engaging in cooperation in evil. If they have reasonable certitude that the plan includes abortion coverage, but the enrollee has not explicitly requested such coverage, they may be engaging in justifiable mediate material cooperation in evil; however, an enroller has the responsibility to discover, if possible, whether abortion is part of a particular plan.

It may make the evil possible by contributing to the overall financing of the plan, not dissimilar to paying taxes. For such an enrollee, who acts for the sake of the proportionate good of the family’s health care coverage, this remote mediate material cooperation could be justified, with the understanding that the family does not intend to utilize the immoral drugs and devices, makes known its objections to the public policy, and works to effectuate policy change.

The NCBC opinion is that Catholic agencies cautiously and diligently assess the danger of formal cooperation and weigh the proportionate good to evil in terms of mediate material cooperation before sponsoring or assuming the roles of Navigator, IPA, or CAC for the Exchanges.

MARIE T. HILLIARD, JCL, PHD, RN, is a staff ethicist at the National Catholic Bioethics Center.

ObamaCare and the truth of abortion funding

Dorinda Bordlee: SBA List challenges an Ohio statute criminalizing political speech . . .

Dorinda C. Bordlee

Dorinda C. Bordlee

The U.S. Supreme Court is reviewing a challenge that involves abortion, lies and ObamaCare. The case, Susan B. Anthony v. Driehaus, involves a free speech challenge to an Ohio law that criminalizes “false statements” about a candidate’s voting record.

The case raises important questions about the rights of citizens and advocacy groups to criticize elected officials’ votes without fearing criminal prosecution by partisans who claim that truth is false.

“Congressman Steve Driehaus voted for taxpayer funding of abortion when he cast a vote for the health care reform bill.” Those words, communicated by the Susan B. Anthony List to Ohio voters in the midst of the 2010 mid-term elections, are true. Yet the Susan B. Anthony List (SBA List), a pro-life advocacy group under the leadership of Legate Marjorie Dannenfelser, was soon haled before Ohio’s elections commission, which — by a 2-1 vote along partisan lines — found “probable cause” to believe that such speech violated Ohio’s false-statement law. Another group wanted to communicate the same message, but refrained from doing so for fear of criminal prosecution, demonstrating how the Ohio law chills political speech.

The election complaint was brought by now-former Rep. Driehaus, a “Blue Dog Democrat” who was a member of the infamous Stupak 10. Like many in that group, Driehaus abandoned his resolve to vote against any health care bill that did not include a Hyde-like amendment expressly prohibiting abortion funding across the entire act. As you may recall, then-Speaker Nancy Pelosi refused to allow a vote on the Stupak Amendment that would have done just that.

Despite the lack of any abortion-limiting language in the bill, Driehaus justified his “yes” vote on ObamaCare on the hollow executive order provided as cover by the President. Planned Parenthood’s president even called the order “a symbolic gesture.” Driehaus’ vote cost him his seat in Congress, but it hasn’t stopped litigation over both the truthfulness of the claim and the constitutionality of a state law that chills the speech of citizens who dare to say that the Emperor has no clothes.

This spring, the Supreme Court will address the question of whether the Sixth Circuit erred by holding, in direct conflict with the Eighth Circuit, that state laws which punish “false” political speech are not subject to pre-enforcement First Amendment review so long as the speaker maintains that its speech is true, even if others who enforce the law manifestly disagree.

SBA List attorneys argue that the Sixth Circuit holding flies in the face of the Supreme Court’s case law and undermines the most basic First Amendment values. In support, Bioethics Defense Fund filed a key amicus brief to aid the Court in answering the underlying question that started the controversy: namely, whether the Patient Protection and Affordable Care Act (ACA) authorizes taxpayer funding of abortion.

The answer is “yes.” Yet the federal district court concluded otherwise, reasoning that “the express language of the ACA does not provide for tax-payer funded abortion. That is a fact and it is clear on its face.” But, as our brief explains, this conclusion is superficial, and therefore erroneous. The court’s conclusion ignores both the jurisprudential context in which the ACA was enacted (showing that courts compel abortion coverage unless expressly excluded), and it ignores the Act’s drafting history that shows the repeated rejection and thwarting of House-adopted abortion-limiting language on the ACA’s billions of dollars of independent appropriations.

Our brief explains that the final ACA did not — and still does not — contain an amendment limiting abortion funding across the entire Act. In fact, the President issued a veto threat of a 2011 House-passed bill that would have added that language. This has resulted in concrete examples of how implementation has authorized funding of elective abortion in federal programs, as well as the use of taxpayer dollars to subsidize exchange plans that cover surgical abortion and the abortion-inducing drugs required by the HHS mandate.

In short, SBA List seeks to challenge an Ohio statute that criminalizes core political speech that Bioethics Defense Fund demonstrates to be truthful. Yet the Sixth Circuit decision has concluded that the challenge is not ripe given that the election is over, ignoring the fact that their political speech has been erroneously labeled false and concretely constrained by an elections commission that has the statutory power to act as a truth-squad. If free speech is to be protected, the Supreme Court must reverse the decision and allow the statute’s constitutionality to be challenged.

DORINDA C. BORDLEE is co-founder of Bioethics Defense Fund, a non-profit legal organization that advocates for the dignity of human life through litigation, legislation and public education.

Is Catholic health care a thing of the past?

Matthew Rarey: consolidation, regulation, and persecution pose a three-fold challenge . . . 

Health care providers are taking a beating from ObamaCare, and Catholic hospitals and physicians fighting to keep the faith are no exception. Many suspect that the end game is not only a singlepayer system, but a shutdown of faith-based delivery.

“Catholics should be worried,” warns John M. Haas, president of the National Catholic Bioethics Center. “It’s not so much a Catholic identity issue within Catholic health care, but fierce and relentless threats from government and a profound shift in cultural attitudes regarding issues such as contraception.”

Such threats have already forced the Church out of other social ministries — including adoption services — thanks to laws and mores condoning same-sex “marriage.”

Regulatory culture

A statue of the Blessed Mother stands in front of Loretto Hospital in New Ulm, Minn.

A statue of the Blessed Mother stands in front of Loretto Hospital in New Ulm, Minn.

John F. Brehany is executive director and ethicist of the Catholic Medical Association, an association of individuals across the country dedicated to learning, implementing, and sharing their faith in the health care industry. Most of its 2,000 members are physicians.

He cites two factors militating against a robust Catholic identity in health care.

“First, the federal government is actively hostile to the Catholic faith and at best indifferent to the protection of conscience rights in organized medicine,” Brehany says. Of particular concern is the Health and Human Services (HHS) mandate. This employer requirement to provide insurance plans covering contraceptives, abortifacients, and sterilization procedures is “proving a real challenge to the Catholic institutional presence in health care.”

The U.S. Supreme Court heard cases seeking the mandate’s repeal in late March and is expected to give its ruling at the end of June.

Second, says Brehany, is the financial pressure being exerted upon health care providers to stay in business. To “cut more costs out of the delivery structure, many are consolidating,” he notes. Encouraging this trend is the need to comply with ever more burdensome federal regulations — a costly procedure that’s putting many physicians out of private practice.

“Government has so ramped up regulations and penalties for compliance with federal law that private physicians are being driven out of business and joining hospitals,” Brehany explains. “They can’t afford the software systems and lawyers necessary to letting them know whether they’re in continual compliance,” thus avoiding crippling penalties. When Catholic hospitals consolidate with non-Catholic hospitals for similar reasons, these consolidations can pose “a challenge to maintaining a robust Catholic identity.”

Consolidation, not compromise

John Haas

John Haas

In 2012, Catholic Healthcare West relinquished its formal Catholic identity in order to expand its network to include non-Catholic hospitals, thus increasing its marketing power and profitability. Now called Dignity Health, it may be a harbinger of further consolidations by which Catholic health care providers drop their Catholic identity for the sake of the bottom line.Despite that change in name and formal identity, “there’s more than meets the eye with the Catholic Healthcare West issue,” Haas notes. Dignity Health’s transformation was made in consultation with the Church and approved by former San Francisco Archbishop George Niederauer. It has promised to run its Catholic hospitals in accord with the U.S. Conference of Catholic Bishops (USCCB) document Ethical and Religious Directives for Catholic Health Care Services.

“But it now means that the overarching system of Dignity can bring non-Catholic hospitals into the system and have them continue doing things Catholic hospitals can’t,” says Haas, citing sterilization procedures. “Dignity has said none of its hospitals can perform abortions, however. There’s still a strong Catholic moral influence.”

Haas says that consolidation is the trend of the future.

“You can find almost no freestanding hospitals anymore — they’re all entering into collaborative arrangements to survive,” he told Legatus magazine shortly after returning from a meeting in Rome, where he is a member of the Pontifical Academy for Life. “When a non-Catholic hospital or system puts pressure on a Catholic partner to do things not in accord with moral law, that’s where the threats come in.”

The National Catholic Bioethics Center, led by Haas, gives ethical guidance to Catholic health care providers considering collaborative arrangements with non-Catholic entities, helping them stay true to their Catholic identity. A major concern is maintaining the principle of non-material cooperation with evil.

The NCBC worked with one Catholic health care system for over a year to maintain its integrity through the consolidation process, Haas says. The $620 million deal did not happen until the NCBC affirmed that no ethical or religious directives would be broken.

“What came into play were tubal ligations, contraception, and sterilization, which are such a miniscule part of the overall delivery of health care but in our day and age, such a neuralgic issue,” says Haas.

Peter Breen

Peter Breen

For now, vigilant bishops are key to ensuring the Catholic identity of Catholic health care, Haas says. However, a game changer may be in the works: The Obama administration’s repeal of conscience provisions, which had allowed health care providers to receive federal funds despite refusing to perform procedures the Church deems unethical, could threaten the very existence of Catholic health care.

“You often hear people saying with great bravado that a Catholic hospital would close down before it did abortions [to receive the government funding so vital to their operation],” he notes. “If it came to that and a Catholic hospital refused to do abortions, the state could take it over and say this institution exists by our leave as a non-profit. It’s happened before in Church history, but not yet here in America.”

Catholic health care in the catacombs?

Peter Breen, executive director and legal counsel of the Thomas More Society, says the movement in politics to devalue faith-based ministries has turned into active hostility.

Concerning mergers between Catholic and secular health care institutions, Breen says “there’s a real fight over whose ethics will win out.” In a case not yet made public, the Thomas More Society is defending a Catholic doctor that a secular hospital involved in a partnership with a Catholic hospital refused to hire because of his opposition to administering abortifacient birth control.

Even more ominous, Breen cites a recent suit that the American Civil Liberties Union filed against the USCCB because its Ethical and Religious Directives bars abortion.

“I don’t mean to be apocalyptic,” says Breen, “but if Catholic bishops are unable to set ethical guidelines for institutions calling themselves Catholic, we’re going to have a hard time maintaining an official relation between the Church and not-for-profit Catholic health facilities. If the ACLU is successful, we’ll be put in a tough spot as a Church.”

Joseph Piccione, senior vice president for mission and ethics at Peoria, Ill.-based OSF HealthCare System, says he’s hopeful yet realistic about the continuance of that fundamental part of Catholic discipleship and identity: caring for the sick.

“When we see how Catholic ministries have struggled to remain active even in oppressive communist regimes, we know that we have a learned flexibility from their example,” says Piccione, who holds a licentiate in theology as well as a civil law degree. “We need to be quick on our feet and find ways to continue to serve. Why? Because that’s what the Lord wants of us.”

MATTHEW A. RAREY is Legatus magazine’s editorial assistant.

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If you like your health care plan

John Hunt contends that the only way to comply with ObamaCare is to deny your faith . . .

John Hunt

John Hunt

Not a day goes by that I don’t thank Our Lord and his Blessed Mother for the gift of being a U.S. citizen. The freedoms we enjoy and the abundance we have been blessed with are gifts that cost our forebears much blood and treasure.

Most of our ancestors arrived on our shores in search of the freedoms we often take for granted — the freedom to worship as we choose, to pursue our dreams, to live where we choose, and to aspire to a life that provides the very best for our children and grandchildren. Those blessings include the availability of quality health care that is incomprehensible to those who have gone before us — and is unmatched in any other country on earth.

The beauty of the recently enacted Affordable Care Act (aka ObamaCare) is that — as President Obama has stated on numerous occasions — “if you like your health care plan, you can keep your health care plan.” The freedom inherent in the president’s promise is certainly consistent with the freedoms Americans have enjoyed since our country’s founding.

For Catholics, however, the President’s promise requires a bit more analysis. Consider this: “If you like your health care plan you can keep your health care plan as long as you would deny the truths of our faith, that all life is sacred and worthy of protection from conception to natural death.”

Or consider the Catholic physician who is obligated under the Affordable Care Act (ACA) to perform abortions and provide contraceptive and abortifacient services to his patients despite his/her Catholic beliefs. Or consider a Catholic hospital, forced by law to provide abortion-related services for its patients, contrary to Church teaching.

Or consider the position of the Catholic employer who, under the ACA’s Health and Human Services mandate, is required by force of law to provide contraceptive and abortifacient services in the company’s group health plan.

When one considers the unwarranted and unconstitutional intrusion into the lives of Catholics that the ACA imposes (the basis of Legatus’ current lawsuit against the U.S. government), when combined with governmental mandates imposed on Catholic adoption agencies to place children with gay “families,” it is clear that the Catholic Church is under attack in our country.

So, “if you like your health care plan, you can keep your health care plan” so long as you are willing to deny your Catholic faith in the process. Thank you, Mr. President!

JOHN HUNT is Legatus’ executive director. He and his wife Kathie are charter members of Legatus’ Chicago Chapter.

Navigating murky waters

John F. Brehany: Catholic business owners and the challenge of ObamaCare  . . . .

John F. Brehany

John F. Brehany

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.

The courage of St. Thomas More

John Hunt applauds Legatus members for their profound courage in defending the faith . . .

John J. Hunt

John J. Hunt

Cour-age, noun, the quality of mind or spirit that enables a person to face difficulty, danger, pain, etc., without fear; bravery.

Each year Legatus honors a number of outstanding members. I had the privilege of presenting the 2012 Courage in the Marketplace award to the Weingartz family (Detroit Northeast Chapter) and to Bill and Andy Newland (Denver Chapter). Christopher and Mary Anne Yep of the Chicago Chapter had previously received the Courage in the Marketplace award at our 2013 Summit.

These Legates exhibited extraordinary courage for their bold decisions to file lawsuits against the U.S. government in defense of their religious freedom, which is under attack in the Patient Protection and Affordable Care Act (ObamaCare). As I became aware of the paths these individuals followed in making such a decision, I was particularly impressed that their lawsuits were filed on behalf of their companies, all family-owned businesses. In varied  ways, the lives of these courageous individuals — and the businesses they founded — will likely be forever changed by their decisions.

Facing difficulty, danger, pain, etc., without fear — that’s courage. Legates in the 21st century are called by God to be courageous in our daily lives, sometimes in small and insignificant ways; sometimes in life-changing ways. Courage can present itself in a number of ways, but it will present itself.

Personal courage to “do the right thing in business transactions, ethically and morally” is an opportunity that is part of the activities of a functioning marketplace.

Corporate courage for business leaders means recognizing the burden we bear for our employees and associates – to provide a fair wage, benefits and working conditions that contribute to elevating their quality of life.

Spiritual courage means understanding that each of us has to grow in love for and service to Our Lord, a relationship that is a lifetime in the making but is cultivated by a day-by-day struggle punctuated whenever possible by Mass, rosary, prayer, etc.

Cultural courage means defending the truths of the Natural Law and the teachings of our faith visibly and boldly in a way that exhibits the depth of our love for the truth.

St. Thomas More is a model for all who cultivate courage as a virtue. While being trusted and respected by King Henry VIII, More would not compromise the truth and teachings of the Catholic faith. The saint would say that he was “the king’s good servant, but God’s first.” Might we say as much?

JOHN HUNT is Legatus’ executive director. He and his wife Kathie are charter members of Legatus’ Chicago Chapter.

Birth control pretext for destroying religious liberty

Wesley Smith blasts the HHS mandate, saying the ultimate target is Christian morality . . .

Wesley J. Smith

Wesley J. Smith

Government secularism is on the march against religion, and its generals have announced they intend to take few prisoners. For proof, look no further than the Free Birth Control Rule (as I call it) promulgated by the U.S. Department of Health and Human Services.

This rule requires employers with 50 or more workers to provide coverage for free contraception, sterilization, and morning-after pills — even if it violates their religious beliefs. A very narrow conscience exemption was carved out for churches with religious objections. But two other categories of dissenting employers must comply despite their faith objections: religious organizations (such as universities and hospitals) and private business owners.

Nonprofit religious organizations: When first announced, the FBCR would have required Catholic universities, schools, charities, and other non-profits to offer employees free contraception just like any business. That sparked a political firestorm, causing the Obama administration to delay implementation for these groups until Aug. 1 of this year with the promise of devising a reasonable compromise.

That proposal is now in, and it is all sleight of hand. The administration still requires all female employees (and eligible dependents, meaning teenage girls, among others) of these objecting organizations to be covered for free contraception — like it or not. Here’s how the “accommodation” will work:

• Nonprofit religious employers must comply with the provisions of the Affordable Care Act and purchase a general group health plan.
• The employer must certify to its insurance carrier that it objects to contraception for religious reasons.
• The health insurance carrier then must “automatically enroll participants and beneficiaries in a separate health insurance policy that covers recommended contraceptive services.”
• The insurance carrier must provide this supplemental policy to these girls and women free of charge.

Thus, the mere act of purchasing health insurance — required by law — automatically triggers forced free coverage for contraception. This means that in many cases, even nuns will have to be insured for birth control, with the only opt-out breaking the law by refusing to buy health insurance, which triggers a stiff fine. Any concomitant harm caused to employees will be the government’s fault for forcing dissenting faith employers to choose between offering benefits and violating their religious beliefs.

Private business owners: The Obama administration’s attempt to force its moral values upon private business owners is even more onerous. Not only are business men and women forced to pay out of their own pockets for that which they perceive to be sinful, but the administration contends that business owners sacrifice their religious liberties in operating their enterprises simply by seeking profit Scores of business owners have sued, so far with mixed results. The cases primarily hinge on the applicability of the Religious Freedom Restoration Act, which requires that the government prove it has a “compelling state interest” when legally forcing individuals to violate their faith tenets.

To get around the RFRA, the Department of Justice argues that business owners cannot “practice religion” in the commercial context. Or to put it another way, the administration believes that business is a religion-free zone. That’s only part of the Obama secularizing agenda. In another radical move, the DOJ argues that by standing up for religious liberty, dissenting business owners are actually forcing their religion on workers. In other words, the administration has recast business owners as theocratic tyrants.

That’s topsy-turvy. Refuse-to-pay is not synonymous with prevent-from-obtaining. Dissenting business owners are not preventing their female workers from using birth control simply because they won’t pay for it.

Ironically, the administration is attempting to impose its ideology on religious dissenting business owners and religious organizations. The DOJ argues that forcing all employers to provide free contraception (one way or the other) is essential to secure “equal access … to goods, privileges, and advantages” that otherwise are denied females due to the “unique health care burdens and responsibilities” borne by women.

Birth control isn’t the real issue. There is an important principle at stake. Indeed, once a legal precedent is established, one day there could be a free abortion rule, a free IVF rule, or a free sex-change operation rule. And it wouldn’t end with health-related issues, either. In the end, the administration is using birth control as the blade that sacrifices religious liberty on the altar of naked secularism.

WESLEY J. SMITH is a senior fellow at the Discovery Institute’s Center on Human Exceptionalism.