Why Catholics reject contraception coverage in health care law

By John M. Haas In July 2010 the Department of Health and Human Services invited the public to submit commentary … Continued

By John M. Haas

In July 2010 the Department of Health and Human Services invited the public to submit commentary on its interim final rule on mandated coverage for preventive services for group health plans and health insurance issuers to be found in the new health care law: the Patient Protection and Affordable Care Act (PPACA). The National Catholic Bioethics Center submitted its comments on September 17 urging the department not to include and of the following in the category of preventive services: contraceptives, drugs or devices causing abortions, surgical sterilizations, or abortions.

Preventive services for women’s health care would certainly include such procedures as screening for cervical cancer or mammograms for breast cancer. Senator Barbara Mikulski had amended the bill to make sure these kinds of services were provided for women.

Her office issued a press release on her position: “Services that would be covered under the Mikulski Amendment are likely to include cervical cancer screenings for a broad group of women; annual mammograms for women under 50; pregnancy and postpartum depression screenings; screenings for domestic violence; and annual women’s health screenings, which would include testing for diseases that are leading causes of death for women such as heart disease and diabetes.” All these interventions are clearly directed toward the prevention of disease, and they are not necessarily covered in all current health plans. PPACA wanted to make sure they would be covered under the new law.

However, many people became concerned when voices began to be raised advocating contraception availability as preventative measures for women’s health. Our center submitted its comments to make it clear that contraception does not achieve the prevention of disease but rather disrupts an otherwise healthy reproductive system of the woman and therefore ought not to be viewed as preventative medicine and mandated by PPACA. Fertility is not an illness but a sign of health, and pregnancy is not a disease. This is not simply a position of the Catholic Church. Traditionally health insurance plans did not cover contraception because the insurance companies themselves did not think that contraception addressed health issues. Whether or not to have a child is a decision that married couples legitimately make between themselves for the sake of the family. Indeed, in 2007 the Eighth Circuit Court ruled in Stanbridge v. Union Pacific Railroad Company that the largest railroad company in the country did not discriminate against its female employees by not providing contraceptives in its employee health care plan.

In rare cases a pregnancy could make a pre-existing illness worse and that a child should be avoided for that reason. But fertility or a possible pregnancy ought not to be confused with the illness or otherwise viewed as a pathology. Health insurance provisions should be directed toward the diseases themselves.

It has sometimes been argued that oral contraceptives should be mandated in drug prescription plans since medications for males for erectile dysfunction, such as Viagra, are covered. However, erectile dysfunction is a disorder that can be medically treated. Fertility is not a disorder. On the other hand, however, contraception actually engenders a disorder, that of infertility, rather than cures one.

Confusion sometimes arises when legitimate hormonal treatments for a disorder are referred to as “birth control pills”. Hormones can be given to regulate a woman’s cycle or to treat excessive bleeding or a skin condition which are indeed health problems. The hormones sometimes come in the same dosage and have to be administered on a regular basis like oral contraceptives. But the truth of the matter is that they are not contraceptives but legitimate hormonal therapies for various disorders. Obviously there would be no objection for such medically legitimate therapies.

Employers and health plan issuers need to have the assurance that the new health care law will not force them to provide drugs or interventions that do not in fact directly address an illness or health problem. Employers and health insurance companies must also, under the provisions of the new law, be protected from being required to provide drugs that indeed do, or in some circumstances may, bring about an abortion, either by preventing an embryo from attaching itself in the womb or by attacking the developing child. This is often the case with some oral “contraceptives” and especially with the “Morning after Pills” such as Plan B or ellaOne.

Legitimate concerns about the woman’s health can indeed lead one to postpone having a child. However, new methods of determining precisely when a woman is fertile, by observing certain bodily signs, allows a couple to avoid relations at a time when she might become pregnant. These methods have an efficacy rate as high as any contraceptives but they respect the fertility of the woman as a true sign of health and avoid her risking her health by ingesting sometimes dangerous chemicals or submitting herself to a surgical intervention. It is an approach which is truly most respectful of the health of the woman.

John M. Haas, Ph.D., President, The National Catholic Bioethics Center, Philadelphia.

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  • WmarkW

    And your male celibate organization is an expert on women’s sexual health because…

  • dwt301

    This is a load of horse pucky. (Some) Catholics oppose coverage of contraception in the health reform exchanges for a much simpler reason – because they oppose contraception period. The vast majority of Americans – including most American Catholics – do not oppose the use of contracpetion and would support its coverage. If you don’t like it, don’t use the contraception, there is no one forcing you to do so. You, however, are attempting to impose a policy decision on the rest of us based on your minority religious views.

  • potaboc

    1. It certainly is counterintuitive to claim pregnancy is a disease. As I understand the issue, people who want contraception services have every right to get them – however if they want medication for a non-health issue, they should pay for it themselves. 2. I am very tired of the continuous refrain that abortion is a woman’s issue and therefore verboten for men to comment on. If there are profound moral issues to contraception and abortion, it is a valid subject for all to speak on.

  • lepidopteryx

    So, according to the Church, if a woman wants to have sex but not risk pregnancy, she is just out of luck. She does not have the right to have sex on her own terms. She has to either be willing to accept a pregnancy if it happens, or remain celibate.As for sterilization, I knew after my daughter was born that I NEVER wanted to have another baby. Try finding a doctor who will perform a tubal ligation on an unmarried 20-something with only one child. They won’t do it. I went to several doctors and was told the same thing by every one: There are plenty of elective procedures covered by my health insurance plan that I personally find objectionable. I simply don’t have those procedures done. But that doesn’t give me the right to say that those who wish to have them shouldn’t be able to receive coverage for them.

  • dragondancer1814

    Lepidopteryx, I’m with you! I had to go on the birth control pill when I was 18 to control menstrual symptoms that were hellacious, to put it mildly. An irregular cycle, killer cramps (the kind that don’t respond to painkillers unless you’re in bed for a day) and practically hemorrhaging every time it DOES show up can really make life hard for women!So you’d think that I’d have no trouble with health insurance covering it, right? WRONG. Some flat-out refused to, other companies insisted that I provide a not from my doctor that it was for a “legitimate medical reason” first. Frankly, I think it’s nobody’s friggin’ business what you need the Pill for, whether it be preventing unwanted pregnancy (which wreaks not just physical havoc on a woman’s body, but also mental, financial, emotional, and career/educational havoc on her life!) or for controlling menstrual problems enough so that she can be a functioning member of society!My sister and brother-in-law ran into similar difficulties as you did when they decided to opt for being “childfree.” The hoops my sister had to jump through to get the ten-year IUD were absolutely ridiculous! Health insurance should absolutely cover contraception with no questions asked, just like they do for erectile dysfunction drugs. And I agree that there’s a major double standard when it comes to THAT! Goddess forbid a man shouldn’t be able to “rise to the occasion,” but let a woman decide she wants to have control over her body because she wants to be able to love her man without having to worry about being a mother before she’s ready or have control over her cycle so she can still be a functioning member of society, and there’a big brouhaha! Lose the double standards, people…what’s good for the gander should be good for the goose as well!

  • lepidopteryx

    POTABOC, I assume that you’re male.

  • funlol

    I have so much respect for the Catholic Church in how they provide for the poor and help those that are less fortunate than others. However, this stance on abortion at all costs hinders my opinion of them. Their are so many people suffereing from a lack of