If it weren’t for Obamacare, we wouldn’t have this problem. By “this problem,” we mean of course the Obamacare regulation that forces health insurance plans to provide coverage, without co-pay, for contraception, sterilization, and what many people believe are abortion-inducing drugs.
When it was announced last August, the forced coverage mandate contained only a very narrow religious exemption. That meant it would apply to many religious employers who object on religious or moral grounds to providing, paying for, or otherwise participating in abortion, sterilization, and contraception. This result, as Heritage has explained on several occasions, was a blatant violation of religious freedom.
Under pressure for trampling religious freedom, last Friday the Obama Administration announced certain potential modifications to the rule. Sort of. What the Administration actually did was post the final rule without any changes. That’s right—they posted the final rule without any modifications from the August 2011 version that caused the furor in the first place. And then they promised that sometime during the next year, they would pursue a new rule to address concerns about religious freedom.
Decide for yourself how much weight to put on the Administration’s promise to protect religious freedom in some future rulemaking process. Even if the Administration does exactly what it says it will do, however, the announced “compromises” are little more than a fig leaf, meaning the forced coverage mandate—on this and future issues—persists as a serious threat to religious freedom.
In short, this issue isn’t going away, as badly as the Administration might want it to. That means more spin from the Administration and its allies in the days and weeks ahead.
Concerned citizens, leaders of religious institutions, and public officials should respond by keeping their focus on three basic points:
- Religious freedom goes hand in hand with limited government and with greater freedom in general.
- The basic structure of Obamacare makes these kinds of conflicts both inevitable and recurring.
- Properly designed health reforms would never have produced this situation in the first place.
Indeed, as the American public is beginning to realize, Obamacare builds a giant government box around freedom:
- The individual mandate and employer mandate form the sides. These mandates force both individuals and employers into the market for health insurance. Whether you are an individual or an employer, you don’t have the option not to buy if you are subject to one of these mandates and you’re not otherwise exempt, without facing a financial penalty.
- The bottom of the Obamacare box is formed by the various benefit mandates in the legislation. Some of these mandates are imposed only on insurers. Others, such as the forced coverage mandate at issue here, apply to insurance companies and employer health plans, including self-insured plans. Whereas the individual and employer mandates force individuals and businesses into the market, the benefit mandates tell individuals and employers what they must buy and insurance companies what they must sell. This standardization of insurance products will inevitably create problems of conscience for many Americans.
- The top of the box—the lid that keeps everyone inside—is made up of the various penalties that Obamacare imposes on individuals, employers, and insurance companies that fail to comply. As Heritage has explained here, here, and here, these penalties are significant not only in legal terms, but also have the potential to be quite burdensome in practical terms.
This is the box that Obamacare builds around freedom, and any person or group subject to Obamacare’s mandates and not qualified for some special exemption or discretionary waiver is in danger of getting trapped. And when freedom in general gets trapped, religious freedom is likely to get trapped, too. This is precisely what happened in this case, when the Department of Health and Human Services defined mandated “preventive care” services to include sterilization, contraception, and abortion-inducing drugs. Once Obamacare forces individuals and businesses into the market and dictates what goods and services must be bought and sold, it is only a matter of time before federal regulations run smack into religious and moral conscience.
It is essential for religious leaders who are justifiably outraged at the forced coverage mandate and its infringement on religious freedom to understand that the sterilization-contraception-abortifacient mandate and the resulting conflict is not an aberration. Rather, this particular burden on religious freedom is an entirely predictable result of legislation that was deliberately designed to create not a uniform national health system, but one that conforms, even in detailed particulars, to the liberal outlook of its political authors. It is implemented through a massive, sweepingly broad, and intensely detailed application of federal power to every public and private health system stakeholder and, indeed, to all Americans.
Thus, however this particular issue is eventually resolved, the root problem will still very much exist. Given the enormous amount of discretion the law grants to unelected bureaucrats in numerous places, there are likely many other ways that Obamacare can conflict with religious freedom. We have yet to see, for example, how the essential benefits package rules will affect issues related to reproduction, end of life, and parental authority over medical care and testing for minor children.
Indeed, when it comes to religious freedom, the most fundamental problem with Obamacare is that it empowers an overweening federal government—often through a vast regulatory system administered by unelected bureaucrats—to micro-manage every corner of the health care system and everyone who participates in it. Furthermore, from the perspective of the legislation’s authors, this result is, in the parlance of software developers, not a bug but a feature.
When a building is so badly designed and built that no amount of renovation can fix it, the only solution is to call in the bulldozers and start over—preferably with different architects and engineers. The same is true of Obamacare.