New York City, USA - The recent dispute over contraceptive coverage under the Affordable Care Act for employes of Roman Catholic hospitals offers a window into the larger issue of whether religious institutions may impose their own doctrines as a condition for participating in taxpayer-funded programs.
The political left has treated the policy controversy mainly as an argument over contraception and the right has framed the issue as one of “religious freedom.” The real issue is freedom for whom. It raises the fundamental question of the degree to which religious institutions should be exempt from equal protection requirements that apply to all other organizations that spend government money.
Are institutional church hierarchies like the U.S. Conference of Bishops the arbiters of religious freedom? Why does their freedom matter more than that of the majority of American Catholics, who, according to every public opinion poll, disagree overwhelmingly with their church’s prohibitions of contraception, in vitro fertilization, abortion for rape and incest victims, and voluntary sterilization? What about non-Catholic patients and employes? What, for that matter, about the nuns who often run these hospitals and have incurred the wrath of the Vatican for defying the bishops on a number of health care issues ?
In 2010, for example, the Catholic Diocese of Phoenix stripped St. Joseph’s Hospital and Medical Center of its affiliation with the church because the hospital performed an abortion on a mother who whose life was threated by primary pulmonary hypertension. That decision is a dispute for Catholics but if the hospital had denied the mother a procedure recommended by her doctors—one that would have been routine at a secular institution—it would be the business of every taxpayer.
The potential for serious trouble extends far beyond either the Catholic Church or health care. Disputes over public funding for religious purposes have arisen across the country in charter schools linked to evangelical Protestant, Jewish and Muslim institutions.
There is nothing new about this basic tension. When the federal School Lunch Progrm was established in 1946, it was decided that school lunches could be provided in Catholic institutions because the program was intended to help individuals and it would be wrong to deny children a hot lunch simply because they were attending religious schools.
But the battles over public funding in religious institutions today have stood the older church-state issue on its head. When a child received a federally subsidized lunch in 1950, the government was saying that this service could be provided to any student in any school as an individual benefit. But when the government allows a Catholic hospital not only to refuse the morning-after pill to a rape victim but to withhold information about the pill’s existence, it is denying standard medical care to an individual who may have no choice, particularly in small towns, about where she receives treatment.
As an atheist, I believe in reasonable compromise on such church-state issues—the key word being reasonable. It may be reasonable for a Catholic doctor who agrees with the Vatican to tell me, were I a rape victim, that his conscience forbids him to prescribe the morning-after pill and to then refer me to another doctor or hospital. It is not reasonable for me to be deprived of knowledge and choice or required to pay extra because the police took me to a Catholic hospital.
In cases involving freedom of conscience, government policy—like the Bill of Rights—should always be on the side of the individual. If churches don’t like the strings attached to public money, they are free to refuse taxpayer subsidies. The First Amendment was not written for an America in which religion claimed the right to have it both ways.