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.”)

Little Sisters and other resisters

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

My mom, God rest her, once quipped that the three biggest lies in the world are “the check is in the mail,” “of course I’ll love you in the morning,” and “I’m from the government and I’m here to help you.” I can add a fourth to the list: “They’re coming for your birth control” – a lie that has gained some currency, as a quick Web search will verify.

Brace yourself for more. A year and a half after the Hobby Lobby cases, the U.S. Supreme Court has announced it is taking up more challenges to the contraceptive mandate of the so-called Patient Protection and Affordable Care Act. (The ghost of George Orwell groans with every repetition of that title. I’ll use “Obamacare,” hardly a slur if the President takes as much pride in the law as he says he does.) The Little Sisters of the Poor, among others, will argue that they should not have to be involved in employees’ decisions to use contraception. The Administration holds an opposing view.

Inconvenient truths


The they’re-coming nonsense ignores a few facts: people who don’t want to pay for someone else’s contraception or abortion-inducing drugs are not “coming to take” them; access does not mean “free”; religious liberty under the First Amendment includes religious practice, not mere freedom to worship – at least until and unless the Supreme Court chooses to eviscerate the First Amendment; Americans with religious objections to contraception (myself, among others) want not to be forced to subsidize or provide it to others.

Recall that in this context, “religious” isn’t limited to Catholic. The Hobby Lobby case was won by evangelical Protestants, and the companion Conestoga Wood Products case involved Mennonites. Recall as well that those cases were decided on extremely narrow grounds, with the Court majority acknowledging that it was not addressing the First Amendment issues raised by the plaintiffs. Instead, the decision rested on a statute, the Religious Freedom Restoration Act (RFRA). It was left to Justice Ginsburg and the other three Justices in the minority to say that the First Amendment didn’t protect the plaintiffs in their claim at issue. One more Justice being swayed to that view could make the Little Sisters’ case what Hobby Lobby was not: a landmark in constitutional law.

At issue

I am indebted to SCOTUSblog.com and Helen Alvare, Esq. of Women Speak for Themselves for their research and reports on the cases to be heard by the Court. I am mentioning only a few of the issues. Any errors in the following summary are my own.

The Little Sisters are arguing that their sincerely-held religious beliefs, no less than those of the Hobby Lobby plaintiffs, are protected by RFRA. In order for the federal government to prevail, if the Court limits itself to the actual issue in question, it would have to show that the Obamacare contraceptive mandate and the Administration’s efforts to “accommodate” religiously-affiliated employers do not amount to a burden on the Little Sisters’ free exercise of their religious beliefs. Further, the government would have to show that it has a compelling interest in forcing the Little Sisters to violate those beliefs. It would have to show that there is no other way to get “free” contraceptives to the Little Sisters’ employees.

The federal government is quite comfortable making all those arguments. The President and his HHS secretaries – first Kathleen Sebelius, Obamacare’s virtual doula, and now Sylvia Burwell – will litigate challenges to the mandate regardless of time or cost required.

About that “accommodation” for religiously-affiliated employers: employers who provide health care for workers are supposed to advise insurers, or the agencies administering health insurance, to cover contraception as a “preventive” health care item. To accommodate employers like the Little Sisters, the Administration crafted a regulation that allows those employers to advise the government of its objections to the contraceptive mandate, but then requires the employers to provide the government with all the information it needs to provide contraceptive coverage to employees.

The Administration calls this an opt-out for employers. Nope, assert the plaintiffs. Under the accommodation, the government simply turns around and does the paperwork that makes contraceptive coverage part of the health insurance plan provided by the employer. The employer is thus forced to be a party to providing something in violation of the employer’s sincerely-held religious beliefs. To compound the burden on the employer, there are financial penalties for failure to cooperate with the mandate.

We’ve met you halfway, say the feds. You don’t get to tell us what constitutes a violation of our religious beliefs, say the plaintiffs.

Back to “They’re coming for your birth control”

Nowadays, when I hear anything about a threat to women’s basic preventive health care, I immediately go on high alert. The currency of language regarding health care has become so debased that no one can or should take it at face value. “Threat to basic preventive care” has become code for “someone’s trying to get out of paying for your contraception” – a far cry from denying “preventive” care.

The Little Sisters of the Poor are nuns, for God’s sake (literally). They care for the elderly poor. Their vision statement sounds like something that ought to be encouraged: “to contribute to the Culture of Life by nurturing communities where each person is valued, the solidarity of the human family and the wisdom of age are celebrated, and the compassionate love of Christ is shared with all.

”

These are the women who are challenging the mandate. Theirs is the ministry that will be crippled if they have to pay fines. These are the people the Administration and other mandate supporters want to force into compliance. The Sisters take a vow of obedience, all right, but in doing so the Sisters in the U.S.A. didn’t surrender their constitutional rights.

Most inconvenient truth of all, in the face of the mandate: women aren’t broken and they don’t need to be fixed. Calling contraception “preventive” health care is the same as saying that women in their childbearing years are defective. Treating contraception as a choice, an option, is far different from treating it as a public health imperative.

It just might take a group of nuns to drive that point home.

March for Life stands up for religious liberty, opposes O’care HHS mandate

banner from 2013 March for Life in DC
banner from 2013 March for Life in DC

The national March for Life is organized by a nonprofit business of the same name, which is one of many groups challenging the Obamacare contraceptive mandate (also known as the HHS mandate) in court. March for Life recently prevailed in federal court. Yesterday, the Obama Administration – specifically, the Secretaries of the Treasury and Health and Human Services – filed an appeal.

And by the way, what’s the Treasury secretary doing signing on to the appeal against March for Life? Is that a heavy-handed way of serving notice that the March’s tax-exempt status is on the line here?

This Administration can’t stand the thought of a business owner not paying for or subsidizing an employee’s contraception insurance coverage (with no co-pay), even if that “contraception” is actually abortifacient. Further, the Administration can’t stand challenges from people who believe in the right to live out religious beliefs seven days a week, not just freedom to worship one hour a week. When the Hobby Lobby decision came down, exempting a narrow group of business owners from the mandate, Obamacare apologists whined that employers were making birth control decisions for employees. “Not my boss’s business,” was the cry.

Here’s a cry right back: Not my boss’s problem – and a co-pay isn’t a war.

CAM00569The Washington Times has a brief story about the Administration’s appeal in the March for Life case. The story quotes the federal judge whose ruling in favor of March for Life – the ruling the Administration seeks to overturn – is at issue: “HHS may be correct that this objection [to the mandate] is common among religiously affiliated employers. Where HHS has erred, however, is in assuming that this trait is unique to such organizations. It is not.”

Hobby Lobby should have settled that question. The company isn’t a religious organization, but its owners have religious beliefs that they refuse to shelve in order to accommodate the mandate.

This all started when “contraception” was classified as a preventive service under Obamacare, with no co-pay for the user, and with coverage required under health insurance policies. Why suppression of women’s fertility should be such a federal priority is an argument the President has never successfully made to me. Our federal government is spending money litigating against not only March for Life but other people as well – Little Sisters of the Poor, for example – in a an effort to get them to buy in, literally, to that misplaced priority.

The federal government can litigate indefinitely if the Chief Executive so chooses. Must be nice. The March for Life and fellow mandate resisters aren’t in that position, many of them relying on public interest law firms which themselves rely on donor support. David vs. Goliath, of course.

A few days before the Hobby Lobby decision, I posted “Why Sue Over the Mandate?”

Why not just go along? Because religious liberty matters. It’s not simply a matter of worship, taking place in a building once a week. The mandate forces the question of how Americans may exercise their beliefs in everyday life. If an American holds the religiously-based belief that contraception and abortion are immoral, can that American be forced to pay for them? How about a business owner who wants to provide employees with health insurance, but on religious grounds wants no part of helping fund contraception and abortion as “preventive care”?

Now, more than a year after the limited but welcome Hobby Lobby victory, those questions are still hanging.

#FITN: how about asking about the mandate?

#FITN: that means First in the Nation, as in first-in-the-nation Presidential primary. We use the hashtag with pride here in New Hampshire. Potential candidates are already swarming, including some Democrats (rumors of Secretary Clinton’s inevitable nomination are a tad premature). I attend candidate events when I can.

At five events recently, during Q&A, I heard the same question asked in almost the same words. A different person asked the question each time; two of them actually read it off a card. Coincidence? Nah. The cards were a giveaway. The well-organized questioners all wanted to know what the candidates would do to stop “the corrupting influence of money in politics” that is wielded by corporations. What that means is “are you willing to overturn the First Amendment in order to get rid of the Citizens United decision?” But this isn’t the forum for that discussion. I’m simply noting the coordinated questioning.

One other thing is brought up at every candidate Q&A I’ve attended, although in a less-scripted manner, and that’s Common Core. The candidates know they have to have some kind of response ready.

So where’s the demand for an answer to any of these question?

  • What are you going to do about the Obamacare contraceptive mandate and its threat to religious liberty?
  • What’s your take on the Hobby Lobby decision?
  • What do you think of last week’s Supreme Court ruling in favor of Notre Dame University, which is seeking exemption from the mandate? As a Catholic institution, the University wants no role in providing benefits like contraception and abortion-inducing drugs through health insurance policies for students and employees.
  • Do you even know what the mandate is? Do you understand it’s not just a Catholic thing? The owners of Hobby Lobby identify as Pentecostals, for example, and the owners of Conestoga Wood Products (whose case was decided with Hobby Lobby) are Mennonites.
  • Must a business owner give up religious liberty rights under the First Amendment in order to offer Obamacare-compliant health insurance?
  • For any candidate who’s a fan of the Obamacare contraceptive mandate, here’s another one: where in the Constitution is there a right for a woman to have birth control paid for by someone else? How does that supercede the First Amendment?

I’m also listening for any candidate who says that by choosing not to be involved in employees’ birth control decisions, an employer is “making health care decisions for employees.” That’ll help me narrow down my list of candidates to consider.

So where are the half-dozen or so voters – that’s all it would take – willing to follow the candidates around New Hampshire and ask about the mandate? Catholics who take Church teaching seriously have the most at stake, given their numbers and the number of health care ministries they administer. Or are we (yes, I’m Catholic) going to stay under the radar and just hope that we’ll get a President who’ll fix the mess?

As the saying goes, hope is not a method.

Will first-in-the-nation voters ask the right questions about the mandate, or will they let candidates get away with avoiding the issue?