A firestorm of debate has opened recently about the Obama administration’s handling of an interesting conundrum regarding birth control. The debate purportedly posits the rights of free practice of religion with the rights of women to make choices regarding their health. An interesting by-product of the Patient Protection and Affordable Care Act (PPACA, Obamacare) is a provision which would have forced employers to provide (purchase) health insurance for their employees which covered the costs of contraception, including “emergency contraception” (felt by many to be abortion-inducing pills). Many faith-based employers took umbrage at their being forced to directly subsidize actions which they feel are morally reprehensible; however many of their own employees demand the right to make those choices for themselves rather than have them made by their employer. While the shrill tones of the debate have been amplified by the current election year politics, the crux of the debate is made all the more interesting by the issues and cogent arguments it raises.
Many on the religious right, particularly in the Catholic church, see this issue as one of religious freedom. Their religion takes a strict line on contraception, especially “emergency contraception”; though this strict stance is seldom shared by their adherents. As such, they consider enabling such action through direct subsidy or purchase to be as morally unacceptable as engaging in the practice itself. This is a point that I, for one, can understand. Islam has similar rules regarding paying for, storing, gifting, or otherwise enabling the use of alcohol; and I would be just as dismayed if the federal government mandated that I had to participate in such tasks. Clearly, the people in these institutions have a right to abide by their religion and stay true to their faith.
There is, however, another side to this story. Each employee of each of these institutions (and every person in general) has a right to make personal decisions about their own healthcare, regardless of their faith or the faith of their employer. This right is as close to sacrosanct in American culture as can be. Decisions regarding contraception, even emergency contraception (by virtue of its status as a legal and accepted form of medical practice), should be left to an individual alone and availability of these culturally accepted healthcare options should not be determined by a persons employer, this is a central provision of PPACA (providing guidelines for acceptable basic health coverage). Clearly, these individuals have a right to personal liberty in their healthcare choices.
The challenge of America is to reconcile these rights and freedoms which are seemingly in direct opposition to one another. This has been the root of America’s greatness as well. However, it will be impossible to do so without compromise. Lately, compromise has unfortunately been related in political spheres to weakness, but truly the ability to compromise to find solutions for a such a vastly diverse nation is essential, and is a source of strength. The unwillingness to compromise leads to an unwillingness to tolerate diversity, and this is a trend which leads to various forms of xenophobia which are evident in today’s political culture.
The PPACA was put into place partially to assure that employers were providing a certain degree of basic health insurance for their employees (the merits and drawbacks of the act can be debated ad nauseum, but we will currently consider it as it stands). This basic insurance must include contraceptive care, as oral contraceptives have multiple potential uses besides the prevention of pregnancy (use in dysmenorrhea, endometriosis, and even as chemical castration for sex offenders). So, if we take the PPACA at face value, how shall we endeavor to provide such care for employees of Catholic institutions, regardless of their religious affiliation? A reasonable compromise must be obtained.
In order to prevent these institutions from disturbing their moral sensitivities, a compromise solution was arrived at, whereupon such care would be covered free of charge by the insurance companies (thus nominally not being subsidized or enabled by said employers) for employees of these institutions. Obviously, the costs need to be borne somewhere; the one thing all Americans can agree on is that health insurers are not in the business of charity. This cost would then be spread over the pool of employers, increasing the incremental cost of each customer of that insurance company slightly but equally. Yes, this small increase spread over all customers can be considered indirectly subsidizing (to a much lesser extent) such care. No, it is not perfect. However it is an imminently reasonable attempt to compromise, and to find comfortable ground for both employees/patients and those financing their insurance premiums.
Those shrieking dismay at this latest attempt at compromise by the Obama administration are motivated at least as much by election year politics as by true concern for religious freedom. After all, if freedom was truly their main concern, they would be concerned about freedom of those on both sides of the equation. It is time to remove this issue from the grotesque distortions of the kaleidoscope of election year politics and view it as calm, rational adults. Doing so would soon reveal that while Obama’s compromise is not perfect for all parties, no compromise ever is–by definition. His attempts, however, are laudable and imminently reasonable.