Thursday, February 09, 2012

Compromise, No Compromise

No good deed goes unpunished.

And so it goes yet again with the Obama administration:     propose a policy, provoke bitter opposition, offer to compromise, provoke bitter opposition.

This time it's not from congressional Republicans and presidential candidates- themselves doing their best to stir up religious division- but the United States Conference of Catholic Bishops.      

Last August, the Department of Health and Human Services issued an interim rule requiring most new health insurance plans to cover preventive services, including contraceptive care, without a co-pay or deductible, under terms of the Patient Protection and Affordable Care Act.      Exempted were religious employers.    Clarifying the rule on January 29, the Department announced that it would maintain a strict definition of religous employers, thereby requiring Roman Catholic-related institutions (primarily colleges and hospitals) to cover contraceptive use, though it gave them a year's grace in the implementation date.    

A few of the Administration's critics reacted irrationally.     That would include liberal Democrat Melinda Henneberger, a Catholic who, arguing that the decision would harm the incumbent's re-election prospects, wrote "President Romney won't be forcing nuns to dole out free diaphragms in violation of their religious freedom."      But the edict does not unconstitutionally infringe on the first amendment, given that freedom to worship is not affected and no religion is being treated differently than another; and nuns wouldn't be forced to hand out free birth control, unless the religiously-affiliated employer prefers to offer contraception itself, rather than have the patient's medical practitioner do so.

Still, the Administration, as it usually does when faced with opposition to the right, signaled a willingness to compromise.        White House Press Secretary David Axelrod said on Tuesday "We certainly don’t want to abridge anyone’s religious freedoms, so we’re going to look for a way to move forward that both provides women with the preventative care that they need and respects the prerogatives of religious institutions."     Later that day, presidential Press Secretary Jay Carney responded to a question from ABC News' Jake Tapper by commenting "I'm not going to negotiate all the different possibilities of how this rule could be implemented in a way that might allay some of those concerns.    That's what the transition period is for."      The next day, he similarly remarked "The discussion, and it's an important one, but the discussion is how can we, in implementing this policy, try to allay some of the concerns that have been expressed?"

Offered an olive branch, Anthony Picarello, general counsel for the U.S. Conference of Catholic Bishops, responded 

The White House is "all talk, no action" on moving toward compromise (stated Picarello).      "There has been a lot of talk in the last couple days about compromise, but it sounds to us like a way to turn down the heat, to placate people without doing anything in particular.    We're not going to do anything until this is fixed."

That means removing the provision from the health care law altogether, he said, not simply changing it for Catholic employers and their insurers. He cited the problem that would create for "good Catholic business people who can't in good conscience cooperate with this."

"If I quit this job and opened a Taco Bell, I'd be covered by the mandate," Picarello said. 

Give an inch and- unless it's merely a negotiating tactic- the Catholic Bishops expect to take a mile.      For those of us taken in by the idea that opposition has been rooted in church doctrine, learning that Taco Bell also shouldn't be subject to the requirement is revelatory.     Religious freedom appears to have been less motivation than red herring.     Jodi Jacobson remarks

Well before the issue of the exemptions came up, the Bishops were fighting inclusion of contraception per se in the definition of preventive care. They did not want contraception to be included as part of the primary preventive care package of insurance coverage for anyone under any employer. So this is about their attempt to control public health a la Nicaragua, Peru, Bolivia, Ecuador, Kenya and other countries where they have succeeded in severely diminishing women's access to care across the board.

Split (by gender) over the policy, the Administration has allowed itself to be put on the defensive by never having made an affirmative case for contraception.     Jacobson maintains that the White House should have noted that artificial birth control is used at one time or another by almost every sexually active American woman and that its use is normal (a related, but slightly different, point).        We also should have been reminded that, as explained by the Women's Law Project

contraceptives benefit women’s health in many ways, including by preventing unintended pregnancies, treating certain health conditions such as polycystic ovarian syndrome, and, in the case of male or female condoms, reducing the risk of sexually transmitted infections.  Despite these benefits for women’s health, contraceptives are expensive, and many require an exam and prescription from a health care provider.  At the present time, contraceptives may be prohibitively expensive for many women, even for those with insurance plans because of high co-pays and deductibles. 

Instead, the White House has relied on its modus operandi, trying to split the difference, placate its enemies, and compromise what presumably are its principles.      It may be doing a good deed, but the punishment is visited upon women and their partners.

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