I'm a big advocate of the separation of church and state. Knowing this, the other day someone asked me how I felt about the controvery surrounding health care, contraception, and religious employers. Here's my line of thought:
- The government has an interest in guaranteeing non-discriminatory access to health care coverage.
- Medical contraception is part of health care, not only for legitimate pregnancy prevention purposes, but also for a range of medical reasons related to the regulation of hormones. "The pill" is not used only for contraceptive purposes, but for other legitimate medical reasons, as well.
- Medical contraception is used only for women. Denying such coverage affects only women. Thus, denying access to medical contraception violates the government's interests in ensuring non-discriminatory access to health care.
- In this country we have an odd, informal but long-held, "grand bargain" between employers and the government that employers provide health insurance to their employees. It is a benefit that employers offer, but is not required by law.
- Employers could opt not to offer health insurance, especially if they find regulations too burdensome (morally, financially, etc.), and instead offer other benefits – such as increased salary – to attract employees. Such employees could then purchase health insurance on the open market.
- The Hosanna-Tabor case recently decided by the Supreme Court distinguishes between the staff of religious institutions hired for "ministerial" roles and those hired for non-ministerial roles. In that case, it was ruled that the government could not protect an employee hired for a "ministerial" role who accused her employer of unlawful termination. The government, simply put, does not interfere with how religious organizations employ or terminate employment of people serving in ministerial roles. However, the government continues to have an interest and role in protecting the rights of employees of religious institutions who serve in non-ministerial roles.
- If the government has an interest in ensuring equal, non-discriminatory access to health insurance (#1, above) and has a role in protecting the rights of staff serving in non-ministerial roles of religious institutions, it has a role and duty to ensure that such staff receive equal, non-discriminatory access to health insurance.
- The government has granted that organizations whose primary purpose is the propogation of the faith, and whose staff overwhelmingly comes from the faith, and whose organizations primarily serve people of that faith (ie, houses of worship) may offer health insurance to their employees that does not cover medical contraception, so as to adhere to religious teaching.
- Other church-sponsored organizations, whose employees and whose clientele do not necessarily come from the faith (social service organizations, colleges, etc.) and whose mission has a broad social reach, are treated just like other employers when it comes to the provision of health insurance.