The Provision of Health Insurance by Religious Employers

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:

  1. The government has an interest in guaranteeing non-discriminatory access to health care coverage.
  2. 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.
  3. 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.
  4. 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. 
  5. 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.
  6. 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.
  7. 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.
  8. 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.
  9. 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. 

Published by Chris Duckworth

Spouse. Parent. Lutheran Pastor. Veteran. Jedi. Political Junkie. Baseball Fan.

7 thoughts on “The Provision of Health Insurance by Religious Employers

  1. I believe that you are mistaken on this.
    The problem is in point two: Medical contraception is part of health care. Birth control pills are prescribed to women who are perfectly healthy, not as a treatment for any disease or disability, nor as a prophylactic against any potential disease or disability, but to prevent a condition — pregnancy — which is not a disease nor a disability. When a woman is pregnant, her body is precisely “working as designed,” and it is not a problem to be corrected.
    In fact, calling it “medical contraception” as you do is a misnomer, since it is not generally prescribed as a treatment for any medical condition. The only characteristic that distinguishes it from “non-medical” contraception is the requirement that it be prescribed by a physician. But that requirement exists not because the birth control pill is a treatment for any medical condition, but because of the potential ill effects of the pill itself; the physician’s role before prescribing the Pill is merely to ensure that there are no contraindications, not to identify a disease or other medical condition for which the Pill is a treatment.
    Of course, there is nothing to stop an insurance carrier from including coverage for contraceptives in the policies it offers, if there is a market demand for it and the carrier may profitably do so. But for the government to require carriers to include such coverage under the guise of a purported right to “equal access to health care” is nothing but rhetorical base-stealing. It is not health care, and it is not necessary (or appropriate) to include it in any government “health care reform.”
    And of course, to compel Catholic employers to pay for such coverage for their employees is indeed an assault on conscience and on religious liberty. (I hasten to add that I am not Catholic and don’t agree with the RC teaching on birth control. I do, however, believe in religious liberty.)

  2. I should also like to point out that if you are a big advocate of the separation of church and state you should be on the other side of this issue. The point of the first amendment separation of Church and State is not to prevent interference by the Church in the State, but to prevent control of the Church by the State (that is what the establishment clause is about). The more narrowly you draw the definition of what constitutes religious practice, the more scope you give to the State to control the affairs of churches. So by taking the position on this issue that you are, you are actually damaging the separation of Church and State, not strengthening it.

  3. I am responding to your statement: “prescribed to women who are perfectly healthy, not as a treatment for any disease or disability, nor as a prophylactic against any potential disease or disability, but to prevent a condition — pregnancy — which is not a disease nor a disability.” Counter to that are statements in a letter to the editor in the Star Tribune on Feb. 14 from Dr. Charles R. Peterson which says, “Recent studies show that 14% of women taking these medications do so for conditions other than contraception. The most common are excessive menstrual bleeding and/or pain, which can be disabling for many women. Often this treatment is used because it preserves fertility, whereas surgical removal of the ovaries and uterus, while effective in relieving symptoms, would cause ssterility. An irony is that for these conditions, those opposing oral contraceptives are in fact encouraging the more expensive, risky and sterilizing option.” In these cases I see why it contraceptives seem to be under “equal access to health care.”

  4. Are you sure about the separation definition? Why would not the church be prevented from interference in the State as well as the State being prevented from interference in the church? I don’t know — I am going back to read the Amendment.

  5. When someone takes a birth control pill for conditions other than contraception, then it is not a contraceptive and does not fall under the strictures of Roman Catholic teaching on the subject of contraception. I feel certain that if the HHS mandate were limited to the use of the pill for non-contraceptive purposes, the Roman Catholic Church would have no objection.
    In other words, my comment was in regard to the pill used as a contraceptive. When it is so used, it is not legitimately “health care” and ought not to be included in governmental health care legislation.

  6. Yes, I am sure. The First Amendment, like the rest of the Bill of Rights, only places restrictions on what the government can do. It does not restrict what churches, individuals, or other non-governmental bodies can do.

  7. Health plays vital role in every person’s life. You share such nice provision of health. We should take care of our health. Also we should have health insurance.

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