Parsing the Administration’s New Position in the HHS Controversy

The Administration says this in its announcement:

Under the new policy to be announced today, women will have free preventive care that includes contraceptive services no matter where she [sic] works.  The policy also ensures that if a woman works for a religious employer with objections to providing contraceptive services as part of its health plan, the religious employer will not be required to provide, pay for or refer for contraception coverage, but her insurance company will be required to directly offer her contraceptive care free of charge.

And some of the bullet points say this:

o Religious organizations will not have to provide contraceptive coverage or refer their employees to organizations that provide contraception.

o Religious organizations will not be required to subsidize the cost of contraception.

o Contraception coverage will be offered to women by their employers’ insurance companies directly, with no role for religious employers who oppose contraception. 

o Insurance companies will be required to provide contraception coverage to these women free of charge.

Some thoughts after the jump.

First, the reference to contraceptive coverage being “free of charge” is specifically connected to the female employees in these statements.  Second, one of the bullets does say that religious organizations will not be required to “subsidize the cost of contraception.”  Third, there is recurring emphasis on the fact that the insurer will pay.

All of this leads one to think that it is the insurance company and not the religious institution which will pay for contraceptive products.  So the propositions are as follows 

  1. The employee/insured will “have free preventive care that includes contraceptive servces”;
  2. The employer “will not be required to subsidize the cost of contraception”;  and
  3. The insurer will be required to subsidize such costs “for free.”

The problem then is who will foot the bill for these services.  Obviously it will not be the employee.  By the terms of the proposition above, it looks like it will be the insurer.  But this resolution is wildly implausible.  Of course the insurer will not foot the bill.  It will find a way to defray the cost somehow.

One possibility is that it will pass off the costs to employers who do not object on grounds of religious conscience to these products and services by raising their premiums.  One might expect, though, that such employers would be resistant to subsidizing the health care of people who are not their employees.

A more likely possibility is that the insurer will raise the premiums of the religious employers.  Won’t that mean that these religious employers will, in fact, be paying for these services and products?  I think the answer to that question must be yes.  Indeed, I can see little difference between mandating that a religious employer subsidize these products and services explicitly (by the terms of the health plan that it offers) and implicitly (by paying increased premiums as a result of the mandate that its insurer must cover these products and services).

It might be that proponents of this change in plan would say that the insurer could not raise premiums explicitly in response to the new mandate.  But the problem here is that it is not at all clear to me that the insurer needs to state explicitly, “We hereby raise your premiums by X in direct response to new government regulations requiring us to offer contraceptives and abortifacients for free to your employees.”  The insurer could simply hide the cost in any number of items, and package it for the employer as a single quantum increase.

Another point of difficulty is that by the terms of the new arrangement, it appears that the religious institution is now compelling the insurer to pay for these products and services, just in virtue of contracting with the insurer.  To the extent that the religious employer has a conscience objection to paying for these items, it seems to me that it would also have a conscience objection to its own compelling of someone else to pay for them.

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3 responses to “Parsing the Administration’s New Position in the HHS Controversy

  1. I’m curious. How long do you suppose a dollar remains Catholic after the Church uses it to pay others and they use it to pay others, etc?

  2. Well, I am assuming that there would be something worth recognizing with respect to a conscience objection if a religious employer were compelled, against its conscience, to purchase a health plan which included contraceptive and abortifacient products. That seems to be the premise that even the President is accepting. So the relevant question is not the one you ask. The relevant question is whether there is a meaningful difference between what I’ve described, and, alternatively, compelling the religious organization’s insurer to supply these products and to offset the costs of doing so by increasing the premiums that the religious organization must pay, all the while requiring the religious organization to refer its employees to the insurer for access to products as to which it has a conscience objection.

  3. Marc,

    I can’t speak for Obama, but I doubt he remotely entertained the premise you suppose. I certainly don’t. Those demanding a “religious employer” exemption initially worked themselves into a lather with the claim that the law forced employers to provide their employees with health care plans offering services the employers considered immoral. The fact is that employers have the option of not providing any such plans and instead simply paying assessments to the government. Unless one supposes that the employers’ religion forbids payments of money to the government (all of us should enjoy such a religion), then the law’s requirement to pay assessments does not compel those employers to act contrary to their beliefs. Problem solved–except perhaps for an employer who really desires not just to avoid a moral bind, but rather wants to retain control of his employees’ health plans, limit their choices to conform to the employer’s religious beliefs, and avoid paying the assessments that otherwise would be owed. For that, an employer would need an exemption from the law.

    Indeed, some continued clamoring for just such an exemption, complaining that by paying assessments they would be paying for the very things they opposed. They seemingly missed that that is not a moral dilemma justifying an exemption to avoid being forced to act contrary to one’s beliefs, but rather is a gripe common to most taxpayers–who don’t much like paying taxes and who object to this or that action the government may take with the benefit of their tax dollars. Should each of us be exempted from paying our taxes so we aren’t thereby “forced” to pay for a war, health care, or whatever else the government does that each of us may consider wrong or even immoral?

    In any event, they put up enough of a stink that the government relented and announced that religious employers would be free to provide health plans with provisions to their liking and not be required to pay the assessments otherwise required. Problem solved–again, even more.

    Nonetheless, some continue to complain. They fret that somehow religious employers ultimately will pay for the services they oppose. They argue that if insurers (or, by the same logic, anyone, e.g., employees) pay for such services, those costs will somehow, someday be passed on to the employers in the form of demands for higher insurance premiums or higher wages. They counter what they call the government’s “accounting gimmick” with one of their own: the “Catholic dollar.” These dollars, once paid by a religious employer to others, e.g., insurers or employees, should be used only for things the religious employer would approve. The religious employers’ aim, we are assured, is not to control the actions of others, oh no, but rather is merely to assure that the employers themselves have not somehow acted contrary to their own beliefs by loosing “their” dollars into hands that would use them for things no self-respecting religious employer would himself buy. Their religious liberty, they say, requires not only that they be exempted from the law, but further that anyone to whom they pay money also be exempted and thus “free” to act according to their desires.

    I think they go a bridge too far.

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