It’s hard to find a better reason why I’m a raving fan of Douthat than his column from this weekend about the Obama administration’s inexplicable and (the irony) unconscionable decision to force religious employers to provide contraception.   The ending:

 Critics of the administration’s policy are framing this as a religious liberty issue, and rightly so. But what’s at stake here is bigger even than religious freedom. The Obama White House’s decision is a threat to any kind of voluntary community that doesn’t share the moral sensibilities of whichever party controls the health care bureaucracy.

The Catholic Church’s position on contraception is not widely appreciated, to put it mildly, and many liberals are inclined to see the White House’s decision as a blow for the progressive cause. They should think again. Once claimed, such powers tend to be used in ways that nobody quite anticipated, and the logic behind these regulations could be applied in equally punitive ways by administrations with very different values from this one.

The more the federal government becomes an instrument of culture war, the greater the incentive for both conservatives and liberals to expand its powers and turn them to ideological ends. It is Catholics hospitals today; it will be someone else tomorrow.

The White House attack on conscience is a vindication of health care reform’s critics, who saw exactly this kind of overreach coming. But it’s also an intimation of a darker American future, in which our voluntary communities wither away and government becomes the only word we have for the things we do together.

Douthat follows up in a blog post that’s also worth your time, highlighting the vast network of social services that the Mormons have brought to their localities.

More to come on all this, I hope, anon.  But for now, read and feast.  And then let me know what you think.


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Posted by Matthew Lee Anderson

Matthew Lee Anderson is the Founder and Lead Writer of Mere Orthodoxy. He is the author of Earthen Vessels: Why Our Bodies Matter to our Faith and The End of Our Exploring: A Book about Questioning and the Confidence of Faith. Follow him on Twitter or on Facebook.


  1. One of the best columns I’ve read in the Times. And one of Douthat’s best too.


  2. I don’t have much of a bone in this fight, but here are a couple things I don’t understand.

    1) Douthat suggests this there is a financial issue here. But in my research the cost of providing contraception is negligible and in some cases cheaper. Illinois started requiring insurance to cover contraception about six or seven years ago and there has not been a noticeable increase in insurance costs compared to states that do not require contraception coverage.

    2)I honestly am confused by religious liberty issue. This is not about requiring Catholic hospitals to give abortions, this is about Catholic hospitals providing insurance to their employees. It is then the employees that have the religious liberty to use or not use contraception. A corporation or organization can not choose contraception only individuals can. And if 1) is true, then there is not really financial excuse.

    3) Why is this not an issue for taxes? Why are we not protesting paying taxes because money is being used for things that we do not think are Christian?

    4) I am completely in favor of the array of social services that Catholics, Mormons and others bring to communities. But why not argue that the ADA should not require these same non-profits to provide wheelchair ramps because it takes away money from their other social services.

    It seems to me that you may disagree with the requirement based on your understanding of the role of government, but that the issue of religious liberty here is pretty tenuous.


    1. Matthew Lee Anderson January 31, 2012 at 3:01 pm


      Great comment. Lots to chew on, and I may unpack in a future post.

      I think the quick answer is that it’s the *equivalent* of forcing the Catholic church to use its insurance funds to cover something that it has a moral objection to. Use the abortion case: if the church has a moral objection to it in principle, then isn’t it complicit if it provides funds for people to get it even if it doesn’t require people to get one? The question of what liberties it has as a religious employer to not fund things it has moral objections to.

      That, I think, is the main funding issue, rather than the amount. Douthat’s not saying that it’s more or less expensive to provide contraception. Even if it’s less expensive, that won’t matter one whit to Catholics. Rather, the issue is that in limited resources, the more expansive the government gets through taxes the less resources there will be for other voluntary associations.

      Does that make sense? More on this latter, I hope.



      1. I don’t really find it all that helpful because we have a government that has forced all kinds of things because it views it as in the best interest of society. There are those that believe that bi-racial marriage is unscriptural. It was not until the last couple decades that the majority of US Christians agreed. So pragmatically the government can say we will wait until 99% agree that bi-racial marriage is ok before we approve. But our system of government has said that there are principals of fairness that allow us to force things that some find objectionable.

        Now this may be a bad system of government. I see all kinds of future problems. But on the other hand Brown vs Board of Education had religious implications. Universal healthcare access has moral implications, as does lack of universal health care.

        This is a case where I understand the point of the objection. But the Catholic church has not even convinced the majority of its own regular attenders that contraception is wrong. All numbers I have seen say that actual catholic women, even very active ones, use contraception at the same rates as non Catholics.

        So this is a fight that seems basically theoretical. The majority of women and men that work at Catholic and other organizations that currently object will choose to make use of contraception services.


        1. Adam,

          Yeah, I understand that there is a history of those sorts of decisions. However, that doesn’t invalidate the argument that this is a genuine impingement upon religious liberties. Simply because it’s happened in the past doesn’t mean that the government ought to keep on doing it.

          Besides, I think this is a pretty different case than Brown, or the ending of bi-racial marriage. Unless access to contraception is now a fundamental human right, such that not providing it is somehow impinging upon someone’s basic rights.

          As to Catholic women, I agree. However, that is (to me) neither here nor there when it comes to the question of what should be done in a case like this.



          1. The practical implications matter. For instance in the recent Supreme Court case on religious liberty (which may actually be construed to mean that this policy can’t be enforced), the church was allowed to discriminated against someone with a treatable disease in a way that no other organization can do.

            I cannot believe that rationally as Christians we can look at that case and say (regardless of the longer term implications) that the right thing to do was to fire a woman with a disease.

            So we have the odd position that the non-Christian government was arguing that people should be treated fairly in regard to health and employment and that the church is arguing that we can fire people arbitrarily in ways that others cannot.

            I am in favor of religious liberty. I just don’t happen to think that in this case it is an issue of religious liberty.

            As a side note, I wonder if this is a case of whether we are arguing about non-church, religious organization being given personhood. I am not prepared to argue that health care is a universal human right. But I am also not clear that a non-church organization can be denied religious liberty. (I know there is all kinds of slippery slope arguments about what a church is and when a group of Christians can be denied a religious liberty.)

          2. Adam,

            I don’t mean to say that the practical implications don’t matter. Only that I don’t think the sociological fact of most Catholics not using contraception has the same bearing on our consideration that you do.

            As to H. v. Tabor, there’s multiple questions there. Was the church right to fire her? Almost certainly not. Did the church have the right to fire her? Yes, because I suspect the court had more in mind than discrimination against employees with disabilities. So we can, I think, welcome the ruling while critiquing the church.

            The hiring/firing issue is a crucial one for churches, as non-discrimination laws extend well beyond disabilities to sexuality as well. And that, I think, is where the issue really lies.

            Your final note is right on the money, though. I favor an expansive understanding of what counts as a church, for various reasons. But more on all that later.


  3. Douthat is by far one of the best oped columnists on NYT.


  4. So this is a fight that seems basically theoretical. The majority of women and men that work at Catholic and other organizations that currently object will choose to make use of contraception services.

    The point is not that many will choose to use contraception; the point is that the Catholic organization should not be forced to fund it. Hence, the religious liberty of said organization is being undermined. I’m really not seeing your objection or why you’re not clearly seeing this. This isn’t theoretical but actual — when the law passes, the Catholic organization will be forced to fund something that it believes is immoral.

    Among Catholic women, the “very active ones” are actually the ones who, by and large, do not practice artificial contraception. There is a massive gap between the vast majority of Catholics who go to Mass a few times a year and the Catholic who goes to Mass every week (and some weekdays too!). I’ve had the privilege of knowing many in this latter, much smaller, group of Catholics. They read the Catholic books, pray the Catholic prayers and devotionals, watch ETWN, and start NFP (natural family planning) groups at their parish.


    1. My point is that, historically there isn’t an increased cost for providing contraception coverage. So there isn’t actually difference in funding.

      Second, the large scale surveys agree that the actual average active Catholic woman uses contraception at about the same rate as non-Catholics. I am sure there are subsets and churches that do a better job teaching. But on the whole the percentages are almost the same.

      But even if they are not, then there is no additional cost to the organizations. And if Catholics couples that work for these organizations don’t actually use the contraception as you suggest they wouldn’t, then again we are back to a theoretical fight because not only is there no cost, there is not one that is actually using the contraception. So I really don’t get the fight.


      1. Matthew Lee Anderson February 1, 2012 at 10:07 am


        Right. But the moral calculus of the Catholic church isn’t treating the funds as an aggregate the way you are. Run out a hypothetical: suppose that the decision actually was beneficial to the insurer’s bottom line, as they would now be paying for the delivery of fewer infants. The Catholic Church wouldn’t care one whit, because their question isn’t whether the contraceptive coverage increases their overall costs. It’s whether they are paying for it at all.



        1. Matt I get that. I understand that any use of funds for contraception, even if that is a negative cost to the actual insurance cost is money they believe that goes to fund abortion because contraception and abortion are moral equivalents.

          But I think it should matter to non-Catholics that are treating this as a religious freedom issue. There is a calculus here. Some fights are winnable, some are not. Fighting every fight means that you are using scare protest resources for one thing and not for another.

          My issues tend to be practical. I think the theoretical is important, but only when the theoretical and the practical are aligned. Maybe that just means I am a bad moral theologian.

          The people that are affected by this are two sets in my mind. 1) Those non-Catholic (or non-practicing Catholics) that work for Catholic related organizations that are not the church. 2) Those that work for pragmatic organizations that opt out not for moral reasons but those that believe that there will be actual cost savings.

          I know many (primarily Evangelical) organizations that use the exemptions opened up by Catholic organizations (because of actual moral objections) for cost savings. So churches don’t pay into social security or unemployment using religious exemptions but do not care for their staff in ways that were assumed by the exemption. Those that suffer then are the staff, which usually don’t vocally complain.

          I fear this will happen again. So like the recent Supreme Court case, the court rules in favor (I agree rightly) in a case where the actual facts on the ground show that the church acted improperly according to biblical standards.


          1. Matthew Lee Anderson February 2, 2012 at 10:38 am

            That’s an interesting point about other institutions using the loophole. I’ll have to think through it a little more. But initially, I don’t know how worried I am about it. After all, why are we so concerned about insurance coverage for contraception? It’s relatively pretty cheap, isn’t it?


          2. Contraception really isn’t that expensive for most people. When we were young and had insurance that didn’t cover it, we were paying about $380 a year, which was the most expensive part of our medical care other than the actual premium. Problems come when people (like my sister in law) that are allergic to the cheap stuff and have to go on the expensive stuff.

            But usually riders preventing contraception also prevent paying for things like services if you can’t get pregnant. That is where money really ads up. I really have no idea where that falls in this. I know the catholic church is against IVF and many other techniques, but I don’t know if this action requires the coverage of it or not.

            Again, those that have low paying jobs (many orderlies and social service workers) are those that can least afford to pay for anything extra. Doctors, upper echelons of nurses can pay. It is the lower paid staff that are probably least likely to be denominationally affiliated and least likely to be able to afford more.

            I think there is a real public policy discussion here. I just worry a bit about too easily throwing the ‘religious liberties’ card.

          3. Matthew Lee Anderson February 2, 2012 at 5:44 pm


            I’ll look into it more, but given my wife’s current policy at a Catholic institution, things like IVF are not covered but some hormonal treatments are and diagnosis for infertility is as well. I don’t think, though, that any of that is wrapped into this discussion. As far as I know, it’s just about birth control.

            Here’s the concern: I agree about throwing the “religious liberty” card around. But there are two ways to frame this: (a) this is an overreaction on the part of conservatives and they’re “playing the religious liberties card” as a scare tactic to get their way, or (b) this is an actual, substantive infringement of religious liberties, such that to call it anything else would be to label it wrongly.

            If it’s actually (b), what would you have the Catholic church and her defenders do?



          4. You almost have me convinced.

            Here is where I am at. In many ways I view Christian oppression (loss of liberty) in a similar way as White discrimination. Yes it is possible, but when the majority of people int he US are Christian and White, the more likely senario is not Christian or White discrimination, but bureaucracy that is unintentionally acting in a way that may be construed as discrimination.

            I think that is the case here. There are legitimate reasons for the government, given out system of insurance and employment and government regulation to pursue this policy.

            What really gives me pause is whether this is not an issue of Christian discrimination, but Catholic discrimination. The distinction to me (again using a racial metaphor) would be like discriminating against the Irish, but not Whites. Outsiders might not see any distinction, but insiders can tell the difference.

            So while there is not overall discrimination going on, there is a sub-set of Christians (Catholics) who have cultural behaviors and beliefs that are different from the larger category of Christians.

            I am concerned about cultural values that get wrapped up in Christian values. So I view the changes in Blue Laws not as an attack against Christian values, but an attack against traditional conservative values. Nothing in scripture tells me that no Sunday liquor sales is part of being a Christian. It may be part of being a particular type of American Christian. But it is not part of Christianity as a whole.

            I know this is tricky (and probably worthless) distinction. My tendency is to view this like Christian Lawyer does. But I want to be open to the fact that there really may be discrimination on a particular Catholic religious understanding of sexuality. So the official teaching of the Catholic church is that contraception is wrong. But the actual practice is that contraception is acceptable.

            I still am torn.

    2. Christian Lawyer February 3, 2012 at 3:46 am

      But it’s NOT a question of whether a religious university or hospital will be “forced to fund” or to “pay for” something to which it has a religious objection. Framing the question that way, or using that shorthand reference, assumes that the policy DOES “require” such “funding.” But that’s not an accurate statement of what the policy requires or how the money would flow. Here’s why.

      Let’s start from what the religious universities and hospitals already do, which everyone agrees is NOT an imposition on their religious liberty. Specifically, a Catholic university cannot condition the payment of salary to its employees (except, under Hosanna Tabor, to its ministerial employees) on the their agreement to refrain from using part of their salary to pay for contraception or an abortion. That would be requiring secular employees to follow Catholic teaching on contraception, which would be discriminatory.

      When paying salary, the funds flow from the university to the employee, who then chooses how to spend the money. Thus, no one argues that a Catholic university is being required to “fund” or “pay for” contraception when one of its employees uses their salary from the Univeristy to make such a purchase. The university’s religious liberty does not extend to dictating how funds are used once they are provided to a non-ministerial employee as salary because the funds go out of the control of the employer and into the control of the employee.

      Health insurance is another form of compensation provided to an employee. Employer-sponsored or -provided insurance policies are a form of non-monetary compensation in which the employer contracts with an insurance company and pays a portion of the premiums to the insurer, which holds the money to be paid out only as directed by the employee. We know that this non-monetary form of compensation is substantively and legally no different from monetary compensation (salary) because, without the specific exemption in the IRS Code, the employer-paid cost of the health insurance policy would be taxed as ordinary income to the employee even though the employee receives it in the form of non-monetary insurance benefits.

      Even if the government requires the employer to make arrangements for an insurance plan that covers contraception, there is no funding that ever flows from the employer to the actual provider of the contraceptives or abortion. The insurance company is not “providing” contraception. It merely holds the funds (or benefits) controlled by the employee. Thus, funds only go from the insurer to the actual provider of contraception if the employee so directs.

      Just as with the monetary part of their compensation (salary), HHS is requiring that the employers provide whatever non-monetary compensation they choose to provide in such a way as to not prohibit the employees from being able to use that non-monetary compensation to purchase or contraceptives. There is no more infringement on the employer’s religious liberty when an employee uses non-monetary compensation to purchase contraception than when the employee uses monetary compensation to make such a purchase. In neither case is it fair to say that the employer is being “forced to fund” or “pay for” the contraceptives.

      Even without the new health care law, we have decided in this country to provide health insurance through the employment relationship and hospitals and universities voluntarily choose to provide their employees with health insurance as part of a competitive compensation package. Notably, this problem doesn’t arise in countries such as the U.K., where the government directly operates the healthcare system, and where, BTW, there are far fewer abortions.

      Given how our health insurance system is currently set up, how is it any more of an infringement on a Catholic hospital, as an employer, to be required to provide non-monetary compensation in a form that allows its employees to use that compensation to purchase contraceptives than it is to be required to provide monetary compensation without prohibitions on what that monetary compensation can be used to purchase? In each case, it is the employee choosing how to spend the compensation it receives. Once the compensation is under the control of the employee, whether as monetary compensation (salary) or as non-monetary compensation (insurance benefits), it is not the employer who is “funding” or “paying for” whatever it is that the employee chooses to spend that compensation on.


  5. Hmm. I don’t really think this is an issue of religious liberties; I think it’s a difference of opinion about which group should be forced to abide by a standard that isn’t theirs. Do you side with the hospital and force non-Catholic hospital workers to act like they’re Catholics, or do you side with the non-Catholic hospital workers and force the hospital to act like it isn’t Catholic? Or, put differently, whose rights are more important in a conflict between individuals and an institution?

    I don’t really know the answers, but I’m not entirely sure that the religious liberties conversation is asking the right question. Catholic hospitals probably shouldn’t hire non-Catholic workers if they don’t want to have to deal with conflicts like this.


    1. Matthew Lee Anderson February 2, 2012 at 10:40 am


      No one is suggesting that Catholics are “forcing” people to live like them if they don’t pay for their contraception. You can go get contraception elsewhere if you want it. Additionally, you can go find a different job if the insurance plan doesn’t meet your needs.

      Which is to say, you presume that having your contraception covered by insurance is a “right” that can be in conflict with the right of Catholic institutions to not pay for things that they are morally opposed to. But if that actually is a right, it’s going to need some defending.



      1. Well, it seems significant to me that the American Institute of Medicine and the Department of Health and Human Services lists contraception as a part of basic health care. Obviously we are free to avoid the use of contraceptives if ethical concerns prevent us, but inasmuch as basic health care is a right (I’m assuming it is), it seems like contraception would be as well. Otherwise you’d have to argue with prominent medical boards about the definition of basic health care, and I’m certainly not prepared to do that.

        And I really do think that there’s an element of force involved. The reality is that a lot of people simply can’t afford to “get contraception elsewhere”, much less quit their job entirely, because their current employer won’t cover it. Nobody is holding a gun to their head and demanding that they not use contraception, but coercion needn’t always be so direct as that. Again, it’s a complicated issue and, after several different conversations about it, I’m really not completely sure where I stand. But I don’t think it’s so cut-and-dried as an obvious violation of religious liberties.


        1. Matthew Lee Anderson February 2, 2012 at 5:39 pm

          Of course they do. They don’t have a moral objection to it the way the Catholic church does. One can grant that “health care” is a basic right and still reject the idea that contraception is a basic right.

          Which is to say, you may not be prepared to argue with AMI and HHS about those definitions. But Catholic lawyers and doctors and nurses will go to the mat for this. And they absolutely should, given the narrowness of HHS’s ruling on the matter.

          As to coercion, someone is holding a gun to the corporate head of Catholic institutions demanding that they provide contraception. If there’s coercion at work, it’s there. I can’t start to make sense of the idea that not *insuring* something is coercion one way or the other. If my home insurance doesn’t provide flood insurance for my house because I live in a flood plane, they’re not coercing me into moving, are they? I make my life decisions accordingly, and for some people that may mean the burden of moving. I don’t see, in other words, how not providing a particular service to me is “coercing” me.

          The only way I can see that the coercion argument works is if contraception is a fundamental human right, such that the state has a compelling reason to overrule the Catholics’ religious (which is to say, moral) objections to it. But that would be remarkable, given that it didn’t exist in ways that could actually be given to every human in ways until the 1900s, and we would be suggesting that someone’s human dignity and personhood depends upon access to it.



  6. Matthew Lee Anderson February 6, 2012 at 8:54 am


    Apologies for not responding sooner. This is just another promissory note. Busy day ahead, but I hope to be able to offer a full reply soon.



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