“Considering” religious liberty

President Trump has issued an executive order on religious liberty, addressing in part the litigation between the government and the Little Sisters of the Poor over the government’s contraceptive mandate.  The Sisters are apparently off the hook, if I properly understood the remarks the President made before he signed the order.

(Some of my earlier posts about the mandate are collected here.)

Pope Francis visiting Little Sisters of the Poor. Photo from littlesistersofthepoor.org.

The Sisters are among the many plaintiffs who object to the contraceptive mandate in Obamacare on religious grounds. They don’t want to help procure contraception or abortion-inducing drugs and devices for their employees via employer-provided insurance. They have to go to court over this, lest they face fines that would destroy their ability to carry out their vocation to minister to impoverished elders.

The operative line in President Trump’s order is this: “The Secretary of the Treasury, the Secretary of Labor, and the Secretary of Health and Human Services shall consider issuing amended regulations, consistent with applicable law, to address conscience-based objections to the preventive-care mandate…” (Recall that contraception was declared to be “preventive” care under Obamacare.)

Consider issuing amended regulations?

I’m happy for the Sisters. This is good news, as far as it goes. But there’s a long way to go before the mandate is history.


Undermining the First Amendment in the name of “Health Care”

Short memories make for bad public policy. I can’t help but reflect on that.

As I write this, Congress is about to take a vote on doing something-or-another with Obamacare: repeal, replace, whatever. I’m not sure they know what they’re doing, despite good intentions all around. In all the tinkering, I am not hearing much from Members of Congress about what made the “Affordable Care Act” utterly unacceptable to so many Catholics, including me: the contraceptive mandate. Continue reading “Undermining the First Amendment in the name of “Health Care””

N.H. 1st Congressional District: remembering a Shea-Porter letter

Congressional candidate Frank Guinta speaks with 40 Days for Life coordinator Jennifer Robidoux
Congressional candidate Frank Guinta speaks with 40 Days for Life coordinator Jennifer Robidoux

In New Hampshire’s First Congressional district, incumbent Frank Guinta is facing former Member of Congress Carol Shea-Porter. This is the fourth time the two have gone head-to-head for the seat, with Shea-Porter holding a 2-1 edge.

Looking strictly at his pro-life record, Guinta has voted to keep taxpayers out of the abortion industry’s business, with exceptions for pregnancies resulting from rape and incest (Hyde Amendment language). The National Right to Life Committee has endorsed him. On his campaign web site, he writes “I believe in the sanctity of life and will work to make sure all children have the ability to grow up surrounded by their parents’ loving attention.”

Congresswoman Carol Shea-Porter (D-NH1). Facebook photo.
Congresswoman Carol Shea-Porter (D-NH1). Facebook photo.

Then there’s Carol Shea-Porter. She’s an EMILY’s List favorite, which speaks volumes. And in 2013, refusing to vote to weaken the Obamacare HHS/contraceptive mandate, she was willing to let the government shut down instead.

Recall her letter to  me from 2013, which stands up pretty well as a guide to her attitude towards religious liberty and what constitutes health care. The subject was the potential government “shutdown,” her support for Obamacare, and her insistence on defending its provision that women are broken and need to be fixed via “preventive” contraceptive converage. She had (has?) no problem forcing employers who provide health insurance to employees to be involved in those employees’ decisions regarding contraception.


From the 2013 post, with excerpts from Shea-Porter’s letter set off in quotation marks:

Here’s the relevant portion of her message. I’ve added some bold-face emphasis.

“Last weekend, the House of Representatives voted on a Continuing Resolution that contained multiple provisions that had nothing to do with keeping the government operational. That version of the bill, which I voted against on September 29th, included a provision that would allow any employer or insurer to refuse to cover any health care services they might object to.  This would give unprecedented control over personal healthcare decisions to employers and insurers, allowing them to deny coverage for important women’s preventive health services, including HPV testing to prevent cervical cancer, domestic violence screening and counseling, and birth control.”

Like the president whose water she’s carrying, she conceded no good will to people like me who see the down side of the “Affordable” Care Act. That makes her next sentence a punch line, albeit a lousy one.

“I stand ready to work with my Republican and Democratic colleagues on finding common ground and getting things moving here in Washington.” 

I guess the First Amendment doesn’t qualify as common ground.

…In Shea-Porter’s view, it’s imperative that employers with religious objections to contraception be forced to subsidize it anyway. She thinks that affording such people freedom of conscience would amount to “unprecedented control” over a woman’s health care decisions.

Forcing an employer to pay for birth control pills is an “unprecedented control” of its own.

I take from this that Shea-Porter believes free pills must somehow trump religious liberty. Perhaps I take too dim a view.  HHS Secretary Sebelius, when asked about the HHS mandate last year, couldn’t square it with religious liberty beyond saying, “I’m not a lawyer and I don’t pretend to understand the nuances of the constitutional balancing tests.” Madam Secretary is apparently not the only Washington denizen who has trouble with nuance. The difference between health care and health coverage, between choice and mandate, between cancer screening and fertility suppression: all are lost on my congressional representative.

One more thing: if Carol Shea-Porter wins in 2016, she’ll be entitled to a lifetime Congressional pension at her own option once she’s halfway through her term. That seems odd recompense for her support of the HHS mandate.

(Photo credit: visitthecapitol.gov)

What the Democratic party sent out on primary day

The New Hampshire primary election for state and federal offices is over. More about that later this week. Today, though, just one day after the primary, I’ve received a letter paid for by the New Hampshire Democratic Party. (That’s one of the questionable pleasures of being an independent voter. I get  mail from all sides.) That means it was sent before the votes were counted. It’s an attack on incumbent Senator Kelly Ayotte, who is being challenged in November by Governor Maggie Hassan.

I think it’s worth sharing in full.

The signature on the letter is that of Oglesby Young, M.D. A quick online check of the name tells me that he is a practicing OB/GYN in Concord. He’s also a Clinical Assistant Professor at the Geisel Medical School at Dartmouth.

Will Senator Ayotte be willing to confront challenges like this? Or will she take refuge in the jobs-and-the-economy mantra that has served GOP candidates so poorly?

And will pro-life health care providers be willing to speak up? Are their jobs in jeopardy if they do?

Dear Ellen,

As a practicing medical doctor, I care very much about policies that affect the well-being of my patients, but I tend to stay out of politics. This election is different. I’ve watched with disbelief as Senator Kelly Ayotte and her special interest allies have attempted to completely rewrite her record of voting to undermine women’s access to critical health services – and so I feel the need to set the record straight and add my voice to the chorus of medical professionals who oppose Senator Kelly Ayotte’s reelection to the Senate.

First, I am personally offended by the positions taken and claims made by Senator Ayotte, who insinuates that my patients and I are somehow less qualified to make private medical decisions than she is.

Abortion is a difficult topic for a lot of people. I know that because I have had thousands of conversations about it with women and couples who depend on me for factual, rational, objective information about what’s best for their personal health. Doctors and nurses are trained – very well, I would add – to understand the implications, necessity, and repercussions of abortion. We are the front lines. We are the ones giving careful advice and performing the procedures. Does Senator Ayotte think so little of our training, our judgment, and our character – and that of our patients, of New Hampshire women – that she must impose her own partisan beliefs on us?

I also take issue with Ayotte and her colleagues who want to overturn Roe v. Wade and continue to fight so vigorously to shut down Planned Parenthood and women’s health clinics, here at home and nationwide, because they provide abortion care. This crusade against a legal, constitutionally protected, legitimate, safe medical procedure actively hurts women.

Too many women of lesser privilege have a tough time finding and paying for standard medical care, let alone preventive care like cancer screenings and mammograms. Senator Ayotte is even pushing a bill that would increase costs of and limit access to birth control – forcing women to pay up to $600 more per year in out-of-pocket costs. When women aren’t allowed to make their own health decisions or have equal coverage for their prescription medications, it violates their freedom, and it also creates a huge economic strain on the entire family.

Ayotte and her partisan cohorts could succeed in revoking women’s health care options – but only if we let them.

I hope that this letter moves you to consider the effects of this election on the women and medical professionals of New Hampshire and our nation as a whole. I strongly urge you to vote to unseat Senator Kelly Ayotte on Election Day.

Sincerely,

Dr. Oglesby Young, MD, Obstetrician/Gynecologist

“Game-changer”: Supreme Court helps the Little Sisters, though mandate stands

For now, the Little Sisters of the Poor and the numerous other faith-based agencies fighting the HHS contraceptive mandate will NOT be subject to federal penalties for refusing to be a party (via employer-provided health insurance) to provision of goods and services that violate their faith. A unanimous U.S. Supreme Court decision today made that clear, while sending thirteen challenges to the mandate back to lower courts.


“This is a game-changer,” said Mark Rienzi of the Becket Fund, representing the Little Sisters. “The Court has accepted the government’s concession that it can get drugs to people without using the Little Sisters. The Court has eliminated all of the bad decisions from the lower courts. And the Court has forbidden the government from fining the Little Sisters even though they are refusing to bow to the government’s will. It is only a matter of time before the lower courts make this victory permanent.”

I admire Mr. Rienzi’s optimism. I hope he’s right.

The eight Justices declined to rule on the legality of the mandate, which is a regulation that followed the federal Obamacare fiat that contraception for women is a basic “preventive” health service. This federal policy that women are basically broken and in need of fixing is left untouched by today’s Court action.

The federal government can go ahead and provide the coverage for contraceptives and abortion-inducing drugs and devices, under today’s Court action.

The bad news is that this means no majority could be mustered in the Court to reject the mandate altogether. That was the “decision” of the day: the mandate is still legal, despite numerous carve-outs and exemptions. From SCOTUSblog:

“The two issues that the Court had agreed to rule on, and then left hanging at least for now, were whether the [Affordable Care Act] mandate violates the federal Religious Freedom Restoration Act by requiring religious non-profits that object to contraceptives to notify the government of that position, and whether the move by the government to go ahead and arrange access to those benefits for those non-profits’ employees and students was the ‘least restrictive means’ to carry out the mandate.”

“A decision not to make a decision is still a decision.” Those words were drummed into my head by my public-policy professor more than three decades ago as I studied landmark Supreme Court cases. An important non-decision was made today: the mandate stands. So do at least thirteen challenges to it, though, and that’s good news.

(See earlier Leaven coverage at “Religious Liberty and the HHS/Obamacare mandate.”)