President Barack Obama has just announced his "compromise" on the contraceptive mandate that requires religious organizations to provide insurance that offers free contraception to all of their female workers.
As I predicted this morning (see "The Contraception Mandate: A Defining Moment"), the President had no intention of meeting his opponents part way. His remarks made it plain that, despite the administration's attempts to portray the new version of the mandate as addressing the concerns of, among others, the nation's Catholic bishops, President Obama regards the new version as equal in its essentials to the old version.
President Obama is correct: No substantive change has been made. The new version is simply an attempt to pull the wool over the eyes of the public. As administration officials told the New York Times this morning, the compromise was designed to "shore up support among wavering Democrats, who have also expressed doubt about the rule, along with more liberal religious organizations and charities, who oppose the rule but not as vehemently as the Catholic leadership."
The new version of the contraceptive mandate is essentially a shell game. As the White House Fact Sheet on Women's Preventive Services and Religious Institutions summarizes the changes:
- Religious organizations will not have to provide contraceptive coverage or refer their employees to organizations that provide contraception.
- Religious organizations will not be required to subsidize the cost of contraception.
- Contraception coverage will be offered to women by their employers’ insurance companies directly, with no role for religious employers who oppose contraception.
- Insurance companies will be required to provide contraception coverage to these women free of charge.
The problem is obvious: Insurance companies provide nothing "free of charge." To do so would decrease their profits, and they have no desire to do so. More importantly, the new version of the mandate does not require them to do so.
Let me say that again: The new version of the mandate does not require insurance companies to eat the costs of providing contraceptives "free of charge."
So how will insurance companies make up the money they spend on providing contraceptives to women who are employed by religious institutions?
By raising premiums.
Who pays the premiums?
The religious institutions who object to providing contraceptives to their employees.
In a White House conference call this morning before the President's announcement, administration officials tried to wave away this obvious objection to the new version of the mandate. Insurance companies, they argued, would voluntarily eat the costs because they will come out ahead, since bringing a pregnancy to term costs an insurance company more than preventing a pregnancy.
But that's not the way that the insurance industry works. The insurance industry covers the expected costs of expected pregnancies through higher premiums on those cohorts of women who are in their childbearing years. When the number of expected pregnancies for a particular cohort increases, they increase insurance premiums.
The insurance companies will cover the cost of the new version of the contraceptive mandate in the exact same way.
And here's the kicker: That's exactly what the insurance companies would have done under the original version of the mandate.
All that has changed is how the mandate is presented to the public. If the new version of the mandate stands, Catholic hospitals and charities will still be required to pay for contraception for their employees. The insurance companies, the Obama administration, and the administration's supporters will simply pretend that they are not doing so.
When is a compromise not a compromise? When it changes nothing.
I would not be surprised to learn that the administration had planned this all along: Announce the contraceptive mandate to celebrate the 39th anniversary of Roe v. Wade, expecting the Catholic Church and other religious organizations to oppose it; weather the storm for a few weeks; then announce the "new" version of the mandate to rounds of applause from "wavering Democrats" and "more liberal religious organizations and charities."
It's a smart public-relations move. It will make it much harder for religious leaders to explain to the public why the new mandate is no different from the old mandate. And because of that, it may even have bought President Obama a second term in the White House.
What it did not do, however, is address the very real attack on religious freedom that the contraceptive mandate represents. Nor did it provide any moral justification for Catholics to support this administration and this President.
Catholics and all others concerned with the free exercise of religion have to ask themselves this: If this is how Barack Obama treats religious freedom when he is running for reelection, what will he feel he can do once he has won a second term?
More on the Contraceptive Mandate:
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The clueless are asking “who’s paying for this?”
–The insurance companies will jump at it, since statistically a woman with contraceptives is a lot less expensive for an insurance company than one without. Think for a moment about it… DUHH!
Obama comes through again, and shows his Solomonic smarts. Four more years! He deserves reelection if only for reintroducing the word “compromise” to the presidential vocabulary, after it was so sorely missed from 2000-2008, when it was replaced by “swagger.”
Well, Frank, you’re right: Someone’s clueless. You’ve bought the administration’s talking point hook, line, and sinker: As I mentioned in the article, on the conference call they argued that insurance companies “would voluntarily eat the costs because they will come out ahead, since bringing a pregnancy to term costs an insurance company more than preventing a pregnancy.”
But if you had bothered to read the rest of my post, you might understand that that’s not the way that insurance companies determine premiums.
Insurance isn’t a zero-sum game; insurance companies are in the business of making money. They recalculate premiums every year. When they calculate them, they take into account the full range of services that they provide and the expected rate of utilization of those services by the cohort of the insured.
Contraception coverage won’t be left out of this equation; it will be figured in. And that means that, if this “revised” mandate stands, religious organizations will indeed be funding contraceptive coverage, even if everyone else pretends that they are not.
You are right about one thing: The insurance companies will jump at this, because it will provide them with the opportunity to provide contraceptive coverage to women who did not previously have it, and to cover the costs through the premiums paid by religious institutions.
By the way, while the Obama administration, Planned Parenthood, and the Susan G. Komen Race for the Cure all ignore the link between hormonal contraception and breast cancer, insurance companies do not, because the higher rate of breast cancer among users of hormonal contraception makes its way into actuarial tables. And that affects insurance premiums as well.
Tell me if I have this wrong. Under Obama’s latest promulgation, religious institutions that do not approve of artificial birth control will not have to pay for insurance for it for their employees, regardless of the employee’s religion or belief. However, those employees will still be provided with contraceptive coverage if they want it. The cost of the coverage will fall on the insurance company. That added cost would, therefore, be passed on to other employers who provide health insurance for their employees. So, a non-Catholic who works for a Catholic institution will be provided with contraceptives at no cost. However, a Catholic who works for a non-Catholic institution and does not use contraceptives will have his health insurance contribution increased, because his institution will have to pay for contraceptive coverage.
Howard, the flaw in your argument is assuming that the insurance company will pass the cost on to other employers. But they can’t legally do that.
What will happen is what I outlined in the post: The cost will be passed on to the Catholic institution through higher premiums; but the insurance company will not say that it is doing so. President Obama has given the insurance companies the political cover necessary to do this.
Scott, what happens if the religious institution is self-insured? It seemed to me this completely overlooks that possibility. I completely agree with you that if this is the way Obama thumbs his nose at religious freedom in an election year, what will his administration be like if he wins a second term. I posted Michael Gerson’s Washington Post opinion on how Obama’s policies are hurting the poor on to my Facebook page. People have to listen.
Excellent analysis. I worked 33 years in the insurance industry, mostly in the actuarial department of a large company and that is indeed how insurance works. Debra has a good question concerning the possibility of self-insurance. Has that been specifically dealt with in any way?
I totally support what Obama did. I would have preferred him not compromising at all but I understand what he did. It is absolutely wrong for a non-Catholic to be bound by Catholic rules. This is a pluralistic society and there are other points of view to be considered. As long as Catholic schools and hospitals don’t have to directly prescribe the medications, that should be enough. Given the percentage of Catholic women using contraception, I would say that the hierarchy is way out of step with the laity.
“It is absolutely wrong for a non-Catholic to be bound by Catholic rules.”
Karen, instead of spouting platitudes, why don’t you explain what that remark could possibly mean in this context? How would not requiring Catholic institutions to fund behavior that the Church says is objectively immoral amount to binding a non-Catholic by “Catholic rules”?
Currently, a non-Catholic woman who works at a Catholic hospital and wants to use artificial contraception can do so. She is not “bound by Catholic rules.” Forcing the Catholic hospital to pay to subsidize behavior that the Church teaches is objectively immoral changes only one thing: It places the state above the Church.
“Given the percentage of Catholic women using contraception, I would say that the hierarchy is way out of step with the laity.”
Morality isn’t determined by majority vote, Karen. The vast majority of Catholics lie frequently, too, yet you would never say that the “hierarchy is way out of step with the laity” when bishops say that you should tell the truth. Nor, I am sure, are you upset with the Ninth Circuit Court of Appeals decision striking down California’s Proposition 8, even though it shows that the court is “way out of step” with the majority of California voters.
As I stated in The Contraception Mandate: A Defining Moment, arguments about the number of Catholic women who use contraception are utterly irrelevant. What is at stake here is simply this: Does the Catholic Church have the freedom to exercise the Catholic Faith in the United States, or does the federal government have the authority to tell the Church to go to hell?
All of your posturing as a friend of the Catholic Church and even a fellow traveler means nothing, Karen, if you’re going to defend this grave violation of religious freedom.
Debra and Kirt, this “revised” mandate does not address institutions that are self-insured. That’s an important “tell”: It proves that this is a p.r. move, and nothing more, because those institutions will still be required to provide contraceptive coverage to their employees.
Thank you Scott for your articles, too many people are confused about this issue and need to hear the truth. We cannot let this administration dictate what our Church will and will not do. The Obama administration is way out of line on this. I am already so tired of people trying to say that 99% of Catholic women use birth control when A) it doesn’t matter and B) it isn’t true. This is about the government trying to do something that is clearly unconstitutional.
if president obama is a christian,agood one at that , he should go through the lines of the HOLY BOOK(BIBLE) and explain to the world if there is any portion that says that human beings should distort the work of GOD(procreation)? is politics devoid of GOD?is GOD not involved in political affairs? is there nothing as concience (good) in politics?OOOOOOOOOOOOOOOOOwhat a shame that this type of mandate should be discussed at all in a country that GOD loves so much .i pray that OUR LADY OF GOOD REMEDY SHOULD INTERVENE.thanks Scott.
What I find funny is when you go into any court room, there’s always a sign that says ‘In God we trust” Government authorities were put in place by God, yet they are going against their Creator. Acts 5:29 says:- “We ought to obey God rather than men.” Not sure how Obama sleeps at night or if he even thinks about what he’s teaching his daughters (the ones that God entrusted to him to raise in the ways of the Lord.) I will certainly be praying for him and his wife and children. I wouldn’t want to be him, teaching his own daughters to not have moral values.