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What bishops want.

Today, Cardinal Timothy Dolan released a statement outlining the USCCB's objections to the Obama administration's revision of the revision of the contraception mandate. The new rule scotches the previous iteration's much-maligned four-part definition of "religious employer," and proposes arrangements to make sure religious employers -- including colleges, hospitals, and charities -- won't have to pay for or refer for contraception coverage in their employee health plans. In other words, the Department of Health and Human Services listened to its critics and attempted to allay their concerns.

As the editors ofCommonweal put it, "This will do." The U.S. Conference of Catholic Bishops disagrees.

First, a word of praise for the tone of Cardinal Dolan's statement. It avoids the hyperbolic rhetoric that has characterized this debate for far too long. The cardinal states that the bishops are open to further discussion. He acknowledges that the Obama administration "has heard some previously expressed concerns and that it is open to dialogue," and promises "additional, careful study." He notes that the new proposal does away with the "exceedingly narrow" definition of "religious employer," which, the bishops claimed, "created a 'second class' of citizenship within our religious community" -- subordinating Catholic charities to Catholic parishes. But apparently that's not enough for the bishops.

"The administration's proposal maintains its inaccurate distinction among religious ministries. It appears to offer second-class status to our first-class institutions in Catholic health care, Catholic education, and Catholic Charities." Yet Dolan fails to mention what replaced the four-part definition. The USCCB had called that definition "unprecedented" in federal law. So HHS lifted the revised definition from something with plenty of precedent: the federal tax code. According to the new rule, any religiously affiliated employer that has nonprofit status simply has to self-certify with HHS in order to opt out of the contraception mandate. If the employer pays an insurance company for employee health coverage, it has to notify the insurer that it doesn't want contraception included in the plan, and the insurer in turn automatically enrolls employees in a separate plan at no cost to them or to their employer. If the objecting employer is self-insured, it just has to inform its plan administrator, which will arrange for free contraception coverage for employees.

(This is where it gets complicated. "Self-insurance" is a misnomer. Rather than pay an insurance company premiums, some employers prefer to pay directly for their employees' health care. This requires a lot of cash. Such companies typically pay an insurance company to handle administrative tasks. The administrator generates "insurance cards" for the employees, and every time a worker incurs a medical expense, the administrator handles the paperwork and bills the employer for the service, according to an agreed-upon fee schedule. Administration fees are much lower than insurance premiums, so requiring administrators to cover the upfront costs of contraception would be unfair. They'd be paying for savings that accrue only to the "self-insured" company -- covering people who don't want babies is cheaper than covering those who do. That's the financial incentive for insurers to give away contraception to people they already cover. In order to make it worthwhile for administrators of "self-insured" plans, HHS proposes to reduce fees insurance companies will have to pay in order to sell their plans on the new health-care exchanges. Either way, the idea is that no religiously affiliated employer will have to contract for, pay for, or refer for contraception coverage.)

So why does Cardinal Dolan say, "there remains the possibility that ministries may yet be forced to fund and facilitate such morally illicit activities"? No arrangement proposed by HHS would oblige a Catholic institution to fund contraception coverage. But what about "facilitate"? This is the next line of defense. A bishop might argue: Sure, HHS may say that religiously affiliated employers won't have topay for contraception, but there's no getting around the fact that our employees wouldn't receive that coverage if they didn't have the insurance policy we provide. But the Affordable Care Act mandates that everyone have a health-insurance plan -- regardless of employment status. So even if a scrupulous Catholic employer canceled its employee health-care benefit (likely replacing it with cash payments), its workers would still need to buy health insurance -- insurance that would certainly include contraception coverage. The facilitation argument doesn't withstand scrutiny. What's to keep employees from using their salaries to engage in morally illicit acts? Think of all the illicit acts made possible by gainful employment. This is the slipperiest of slopes.

The Catholic tradition developed categories of "cooperation with evil" to help us think through this kind of problem. Without intending the employee to use contraception, without securing or paying for contraception coverage for its employees, a Catholic institution is not involved in a morally illicit act. If an employee wants to use free contraception provided by a third party, that's on her. There's no way to wall off an employee's moral agency. Yet Cardinal Dolan protests that the new proposed rule "would require all employees in our 'accommodated' ministries to have the illicit coverage -- they may not opt out, nor even opt out for their children -- under a separate policy." Cardinal Dolan seems to say that contraception coverage is itself illicit, but the Catholic moral tradition doesn't hold that things in themselves are licit or illicit. Acts are. So Catholic teaching would say that forcing a bishop to provide contraception coverage may be morally illicit. Just as it would say that using contraception is illicit. But the coverage itself has no moral character. It's like saying a drug store shouldn't be selling contraception in a Catholic neighborhood. The availability isn't the problem. An employee may or may not use the free contraception coverage. Until she does, nothing illicit has happened. And if she does, it's not the employer's fault.Cardinal Dolan also expresses his displeasure with the fact that the revised rule does not address the complaints of for-profit employers who have religious objections to the mandate. They "have no conscience protections at all," Dolan writes. Matt Boudway covered this question earlier this week. Should any employer be able to opt out of federally established basic health-insurance benefits because of religious objections? Matt writes:"It would logically lead to a situation they couldn't possibly wish for. Should an overzealous Jehovahs Witness be able to get a group plan that excludes coverage for emergency blood transfusions, even if none of his employees are coreligionists?" The bishops tend to treat conscience claims as though they outweigh everything. In fact, conscience claims must be balanced against state interests (whether the contraception mandate advances a legitimate state interest is another question).

"Throughout the past year," Cardinal Dolan writes in the concluding paragraph, "we have been assured by the administration that we will not have to refer, pay for, or negotiate for the mandated coverage. We remain eager for the Administration to fulfill that pledge." As the bishops continue to study HHS's new proposals, I hope they come to realize that the Obama administration has done just that.

Follow up: Matthew Franck has responded to this post with something shy of full understanding of health insurance. Here's my reply.

About the Author

Grant Gallicho is an associate editor of Commonweal. You can follow him on Facebook and Twitter.

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What the bishops want is pretty simple -- to impose their archaic view of catholic morality as the law of the land. Make artificial contraception illegal -- after all, it is "intrinsically evil," or so they say. Make homosexual acts illegal -- same rationale. The catholic church -- the people of God -- soundly reject the bishops and their 17th century views. The rest of the country should do the same.

Grant:"so requiring administrators to cover the upfront costs of contraception would be unfair." So the heck what? THAT is none of Dolan's business.Moreover, non-profits and especially religious non-profits and ESPECIALLY Catholic non-profits shouldn't be allowed to self-insure anyway.If you'd like to know why, ask the creditors who got screwed in the San Diego, Portland, OR and Milwaukee (Cardinal Dolan's old see) diocesean bankruptcies because of inadequate or non-existent liability insurance.Clearly, this isn't about "religious liberty" anymore (not that it ever was). It's about the Catholic Church trying to retain their perverted patriarchical control over women's sexuality.BTW, a warning for Dolan and the rest of the USCCB: This is like the FIFTH time Obama has employed this same negotiating strategy and when he whips Dolan it'll be the fifth straight win. Obama gives ground, the left shrieks, the liberals coo, the conservatives reject it and the right-wing smells blood because they think Obama is an easy mark. Obama gives more ground, more shrieking, cooing, rejecting and blood-smelling. He gives even more ground and just when it looks like Obama is about to defeat himself, the right-wingers are flat on the ground smelling their own blood, the conservatives have nothing to reject, the liberals are dumbfounded and the left slinks off to find something else to shriek about.Dolan would have been well-advised to take this deal. Since he didn't, he should brace himself to be destroyed.

"Dolan would have been well-advised to take this deal. Since he didnt, he should brace himself to be destroyed."I don't think he's rejected the deal. i agree with Grant's comment about he tone of the statement.The article on th USCCB website summarizes his issues as follows:

Cardinal Dolan highlighted problems with the proposed "accommodation.""It appears that the government would require all employees in our 'accommodated' ministries to have the illicit coveragethey may not opt out, nor even opt out for their childrenunder a separate policy," he said.He also noted that "because of gaps in the proposed regulations, it is still unclear how directly these separate policies would be funded by objecting ministries, and what precise role those ministries would have in arranging for these separate policies. Thus, there remains the possibility that ministries may yet be forced to fund and facilitate such morally illicit activities."Cardinal Dolan also said the proposal refuses to acknowledge conscience rights of business owners who operate their businesses according to their faith and moral values.

My guess is that the first issue is mostly about Catholic parents being able to block their children (who may be covered until they are 26 years old) from getting free contraceptives. Otherwise, the employee could just not use contraceptives her/himself even if she/he automatically received a policy. They may have a chance of getting this change. This is a new issue that they haven't brought up before. The second issue doesn't object to anything that has been proposed - just says we need to see all the details before we endorse this - to be sure we're not paying or facilitating the coverage. The third point is the Taco Bell/Hobby Lobby proposition. I suppose they felt they had to express solidarity with them but I think there is about zero chance that they will get this. It will be resolved by the Supreme Court , someday.

I may be completely at sea here, but is it possible that the bishops see their fighting the HHS mandate, raising issues about religious freedom, etc. as a way to encourage and show solidarity with those Catholics who use Church-approved NFP techniques? What seems to be happening, though, is that position of the bishops seems to irritate the larger number of Catholics who use contraception counter to Church teaching and apparently hold it as morally neutral for husbands and wives as those in Protestant denominations. NFP may be perfectly effective, but the fact that it is promoted by a Church that bans every form of artificial contraception is enough to make many folks hinky about it.Am I wrong to wonder whether the bishops are just trying to ensure that they aren't cooperating in sin? Or whether they're also sending a message to those Catholics who aren't in line with contraceptive teaching? And, if the latter, is this an effective mode of faith formation? Or does it merely separate those in the small, pure Church from those who try to be Catholic have a harder time reconciling Church teaching to modern practicalities?

John Hayes:"I dont think hes rejected the deal."With all due respect, hogwash: "At the same time, we will continue to stand united with brother bishops, religious institutions, and individual citizens who seek redress in the courts for as long as this is necessary." That means he's continuing his opposition unabated.In fact, Dolan has INCREASED his demands, since he's now thrown in with the secular for-profit employers also trying to impose their personal patriarchial control of women's sexuality. Just like those blood-smelling right-wingers I mentioned above, Dolan is under the mistaken impression that Obama is being rolled. He's not. The Church is about to get rolled--and they won't see it coming anymore than the Republicans saw Heath-Care passage coming, or Hillary or Romney saw defeat coming, or Boehner saw the sequester coming.I hope you're right, but I believe you're wrong. This is a fight the Bishops CANNOT win, and the sooner they realize that, the better for everybody.

Jean Raber:"raising issues about religious freedom, etc. as a way to encourage and show solidarity with those Catholics who use Church-approved NFP techniques"That is an interesting observation, one that I would never have thought of and I have not seen it expressed enywhere else. Cynic that I am, I would say that such a motivation is far down on the totem pole. A more likely motivation might be to save face for all the money put into Ad Hoc Committee on Religious Liberty, Fortnight for Freedom, law suits and lawyers.

The new rule scotches the previous iterations much-maligned four-part definition of religious employer, and proposes arrangements to make sure religious employers including colleges, hospitals, and charities wont have to pay for or refer for contraception coverage in their employee health plans. The proposed new rule limits the exemption to "churches." If colleges, hospitals, and charities can be squeezed into that definition, if they can be characterized as "churches" themselves, then they will be exempt. Problem is that many of these agencies cannot be characterized as "churches," especially when the Notice itself expressly states that it does NOT contemplate that the proposed new rule will expand the number of entities that will be able to claim the exemption.

This is a Becket Fund talking point. The bishops asked that religiously affiliated employers not be forced to contract for, pay for, or refer for contraceptive coverage. The new proposal does that. If the bishops want to argue that no employee of a Catholic hospital should be able to get contraception coverage arranged by the government and paid for by a third party, even though many of those people aren't Catholic, they'll have a tough time winning.

I must be very cynical because I think what the bishops want is to display their power. I read a news article in which some bishops said they would be willing to go to jail rather than comply with the HHS mandate. An empty assertion - they know Obama would never do that - he instead tries again and again to compromise. If only just one of the bishops had the integrity to be willing to go to prison for speaking the truth about the sex abuse cover-ups. But no.

I don't know if it's power the bishops want to display so much as rectitude and firmness. Their moral authority is at at a low point now and still ebbing with every page of documents released in Los Angeles, and who knows where else. They need to show resoluteness about something larger than their own perks and privileges. If they can be seen by some people as scourges of evil and stout defenders of freedom, although as unreasonable and ridiculous by others, it's a victory for them, whether or not they ultimately lose the legal and regulatory cases. Or especially if they lose, if it gives them another chance to rail against overreaching government and the onset of tyranny. What is more satisfying than a bloodless martyrdom?So I don't expect the bishops will ever say, "All right, Mr. President! You've answered all of our concerns."

I wish the bishops would so robustly defend individual conscience protections for taxpayers with moral objections to the wars we're currently financing. That seems a little more important.

The Bishops' selectivity in their defense of individual conscience rights undermines any effort to pose as "stout defenders of freedom." Their wall of silence on abuses of power within their own ranks speaks for itself. History is not likely to be kind to them.

I noted, as well, the more measured tone of Cardinal Dolan's current statement. That's a good thing. But I couldn't help wondering if last year's heated rhetoric wasn't politically motivated--at least in part. "If we can get people angry enough, we just may get him voted out of office." Well, that's no longer an option, so there's no need to sound so angry.

It seems to me that the position of the bishops has shifted from not wanting Catholic organizations (and private businesses) to be responsible in any way for providing their employees with insurance coverage for contraception to wanting Catholic organizations (and private businesses) to be able to prevent their employees from getting insurance coverage for contraception.

"In fact, conscience claims must be balanced against state interests"I don't quite know what "balanced" means here. The way I'd express it, if I could have my druthers regarding religious liberty and conscience protections, is that conscience claims should always prevail over state interests (that seems to be the point of religious liberty protections), unless the state interest is deemed to be sufficiently compelling. Not all state interests are particularly compelling. Free contraception for women of voting age would be one example of a not-very-compelling state interest.

It may be that Cardinal Dolan sees the long game oh how this country is going. It seems by a stroke of the pen, HHS can change wording of a document to make or unmake religious institutions doctrine. By adding more regulations, making the government controller in chief, the ability of this country to compete in the world is slowly dwindling.While all these social "regulations", & entitlements, like SS, Medicare & Affordable Medical Care, may sound great, the country going deeper in debt to other countries. Kind of like the old pusher, "the 1st ones free" mentality. Unfortunately there is no free lunch, & someday History may not be kind to these generations.

"Yet Cardinal Dolan protests that the new proposed rule would require all employees in our accommodated ministries to have the illicit coverage they may not opt out, nor even opt out for their children under a separate policy."This claim confuses me. Is the intent of the proposed rule that all employees will be issued a policy for free contraceptives, and the employee has no right to refuse the policy? I suppose there are all sorts of things that can get issued to a person but never used - people can get driver's licenses but never drive - but I wouldn't want to be bound by an insurance policy - a contract - without my consent.John Hayes' point is astute about the hypothetical employee with a conscientious objection to contraceptives who is also a parent with daughters in their teens or early-mid 20's. It's a fine reason to scrap this whole HHS contraption and replace it with a direct government entitlement. I can't imagine many 25 year old women want mom or dad's permission to have a sex life.

"I dont know if its power the bishops want to display so much as rectitude and firmness."Yes, I guess that's how I see it, too. I'm either not cynical enough about or engaged enough in the Church to see carping about HHS contraceptive mandates as a diversionary tactic from sex abuse cover-ups or church-state wrangles."I wish the bishops would so robustly defend individual conscience protections for taxpayers with moral objections to the wars were currently financing."Yes, agree here, too. The bishops, in their rejection of various accommodations perhaps feel that this is a way to let the faithful know they're dead serious about the "pelvic rules" in the CCC--and they risk making themselves look overly preoccupied with them. Certainly, there was a distinct difference between our old, Vat2 bishop and his current JPII successor. Voter's guides used to cover a wide range of issues with helpful explanations of Catholic doctrine. In this past election, the only non-sexual issue covered was immigration. Explanations were less helpful.

I am most probably going to have to deal with this issue with some parishioners and possibly the RCIA group this Sunday. Grant (and maybe David Gibson), here is a question that if you had an answer I think it would be most helpful to me:Who do you really think is advising Dolan on this which seemingly is leading him to take such an intransigent position? Do you surmise it is the likes of Robby George, George Weigel etc? Is there any evidence that the some bishops may be more amenable to a compromise?

Anthony Andreass:The USCCB can't let go of this. They have too much invested in it. I will eat my hat if they eat crow (agree to the compromise).

Its a fine reason to scrap this whole HHS contraption and replace it with a direct government entitlement. I cant imagine many 25 year old women want mom or dads permission to have a sex life.Jim,If a 25-year-old woman is covered by her parents' insurance, they are paying for it, and if they say she can't use the coverage to pay for contraception, she has to live with that. The parents, as the owners of the policy, will be the ones dealing with the insurance company. They don't need a way to "opt out" of the coverage for their daughter. They just have to tell her not to attempt to use the coverage for contraception. I don't understand the idea that it is so horrible to make people complicit in providing contraceptive coverage for others, that the government just ought to provide it for everybody! Contraception is so damaging and so sinful, and causes cancer, and causes men to lose respect for women, etc., etc., so the solution is for the government to provide it to all women for free!

The bishops of the USCCB are acting like a bunch of Lord Granthams from Downton Abbey. Robert Crawley, the seventh earl of Grantham, the messed up pretty badly. He lost his wifes inheritance with a bad investment and had a significant part in the death of his daughter. Shouldnt he feel a bit of guilt? Not at all. He is seen in last weeks episode ranting about bringing his grandchild up as a Catholic and berating his wife and daughters for being served lunch by a reformed prostitute - all the while living a rather luxurious life.A bit of displacement?Meanwhile his wife and daughters are daring to contradict him.Milord, (which by the way is how the British address bishops) Grantham, methinks you are losing power, authority and credibility.

"I will eat my hat if they eat crow (agree to the compromise)."I'm not sure if it's really for the bishops to agree. The mandate is a fait accompli. I'd think that, according the standard political calculus of the sort used all the time by the White House and Congress, the bishops are basically an interest group, lobbying for more favorable treatment.

"If a 25-year-old woman is covered by her parents insurance, they are paying for it, and if they say she cant use the coverage to pay for contraception, she has to live with that. The parents, as the owners of the policy, will be the ones dealing with the insurance company. They dont need a way to opt out of the coverage for their daughter. They just have to tell her not to attempt to use the coverage for contraception."I'm confusing myself even more here.The question on the table seems to be: would a parent/policy holder of the contraceptive coverage, whether the benefit is part of the employer's group policy or via a special exemption policy issued directly by the insurance company, have the ability to prevent his grown daughter from receiving the benefit?

"I dont understand the idea that it is so horrible to make people complicit in providing contraceptive coverage for others, that the government just ought to provide it for everybody! "Well, my own preference is "none of the above" - consumers can just pay for their own contraceptives, and deal with the consequences, without needing to involve her parents, the parents' employer, the parents' employers' insurance carrier, or the government in the decision But that ship probably has sailed.

Everyone knows what the bishops want. As Abe Rosenthal puts it on his blog today:"From the start, the Church has used the mandate controversy to try to get the government to do what it has failed to do through preaching and dictates from the Pope prevent Catholic women from accessing birth control to manage their reproductive lives so they can bear children when they choose and, equally important, participate in the work force."http://takingnote.blogs.nytimes.com/2013/02/08/the-church-and-the-mandat...

After looking around, i found the exact language of the third-party contraception coverage here, on page 64https://s3.amazonaws.com/public-inspection.federalregister.gov/2013-0242...

(2) A group health insurance issuer that receives a copy of the self-certification described in paragraph (a)(4) of this section with respect to a plan for which the issuer would otherwise provide coverage for any contraceptive services required to be covered under 54.9815- 2713(a)(1)(iv) must automatically provide health insurance coverage for any contraceptive services required to be covered by 54.9815-2713(a)(1)(iv) and identified in the self- certification, through a separate health insurance policy that is excepted under 45 CFR 148.220(b)(7), for each plan participant and beneficiary....An issuer providing contraceptive coverage arranged pursuant to paragraph (b) or (c) of this section must provide to plan participants and beneficiaries written notice of the availability of the contraceptive coverage...."You and any covered dependents will be enrolled in this separate individual health insurance policy at no additional cost to you".

There seems to be an inconsistency between the last sentence, which implies that everyone in the family is included in one policy and the earlier sentences which suggest the each person gets an individual policy and notice (employed mother with three daughters = 4 policies and 4 notices. It seems that what Cardinal Dolan wants is that the notice would allow the employed woman to accept or reject he coverage for herself and for her daughters. I suppose that would lead to a discussion of whether it's "opt-in" or "opt-out" and whether it's all daughters or whether adult daughters could make their own decision to accept or reject.My guess is that the number of people who would reject would be rather small, but the bishops might put on a campaign to urge people to reject.

It is worthwhile to recall that even prior to the Supreme Courts decision in Griswold v. Connecticut, the Catholic Church did not oppose the Massachusetts Legislatures lifting of the ban on the sale of contraceptives. In a submission to the Legislature in 1965, Richard Cardinal Cushing stated that I as a Catholic have absolutely no right in my thinking to foist through legislation or through other means, my doctrine of my church upon others. It is important to note that Catholics do not need the support of the civil law to be faithful to their religious convictions. I devoutly wish that the current USCCB would embrace the spirit of Cardinal Cushings 1965 remarks. Employers compensate employees for their labor. That compensation is paid in the form of salary and benefits. Our civil law permits the sale and purchase of contraceptives. The choice as to whether to purchase contraceptives is left to the individuals conscience. The employer no more facilitates the purchase of contraceptives by providing an insurance benefit to an employee than it does by providing a salary to an employee. The current federal proposal goes even further in removing an employer from the employees decision to purchase or not purchase contraceptives. The USCCB should accept it.

The answer to the inconsistency may be that the "separate health insurance policy" may be just one policy (covering only contraception) that covers all employees of that firm rather than a separate policy for each employee and beneficiary. People would then be enrolled in that plan, just as they are in the employers regular plan

Charles jacobs. Cardinal Cushng asked John Courtney Murray for advice before making his statement Here is Murray's memo to +Cushing.http://woodstock.georgetown.edu/library/Murray/1965F.htm

Find this whole reply to be interesting because it reflects much of the debate in the 4th session of VII over Dignitatis Humanae.From John O'Malley,SJ's book and paraphrasing:"John Courtney Murray,SJ as the council was closing put his finger on a *the issue under the issue* - development of doctrine. In his words, it was the problem of elaborations of church teachings that went beyond, or even contradict, previous teachings. i.e. the problem of change.Murray went on to elucidate the repeated condemnations of *the separation of church and state*; *conscience*; *religious liberty*; etc. as pronounced by popes since the 18th century. And this topic was a bitter struggle and yet, Murray's ideas prevailed.He noted that in this council struggle on *religous liberty* the US bishops came in full force. Yet, this support echoed the American experience - US church did not live in the 19th century European mindset which can be summarized as - if the majority of a state's citizens are Catholic, then the state must profess being Catholic and was duty bound to suppress other religions; even denying their civil rights. If Catholics are a minority, then the state mus tolerate and guarantee free practice of religion.His views prevailed and can be summarized as - religious liberty and the rights of religious bodies in society; as well as the legitimate limits to expression of religious liberty, must be made evident and as appropriate for the good of society.It is interesting to note the change via the current USCCB on this issue. In tone and approach, the USCCB appears to reach back to the 19th century mindset; to echo the fierce objections about Murray's ideas from Rev. Joseph Fenton. Why? Because Dignitatis Humanae lays down two basic foundational principles - the every individual has the right to use conscience to choose and that no government has the right to obstruct this so long as it does not infringe on the right of others or hinder the common good; second, that this human dignity can not be coerced.Realize that terms such as common good and access to contraception can be argued but my point is that the USCCB appears to be operating with a new foundational principle - US government must allow the Catholic Church its preferences and anything less will be a loss of religious liberty. Appears to ignore the foundational principles of Dignitatis Humanae - fact that in a civil society there are diverse and multiple religious bodies or secular views that must be respected and protected. Sorry, USCCB seems to be recycling Fr. Fenton.

"It seems that what Cardinal Dolan wants is that the notice would allow the employed woman to accept or reject he coverage for herself and for her daughters."It's complex.Wearing my dad hat: I view my parental prerogatives in this regard differently with respect to my 15-year-old teenager than I do to my 25-year-old daughter. (I don't really have any children those ages, I'm just speaking hypothetically here). I'd have no problem whatsoever in laying down and enforcing the family law for the 15 year old (the pertinent family law being, No sexual activity, period), and I wouldn't want my employer or its insurance company - or the government - circumventing my parental authority by essentially giving away contraceptives to my 15 year old against my wishes. I think the case for the 25 year old is harder. Frankly, unless she is in medical school or some such, I don't want my 25 year old to be dependent on me for anything. She's an adult, and I want her to be responsible for her life by then. If she comes to me for advice - well, that's no problem, folks around here know I have no trouble telling others how to live their lives. But if she is dependent on me for health care under ACA rules, and she wishes to take advantage of the free-contraceptives benefit, does that make me complicit to her presumably-sinful behavior in some way? There are two possibilities for complicity: (1) she would need my express permission as policyholder to take advantage of the free-contraceptives benefit. If I give her permission, that seems pretty cut-and-dried complicity on my part. Or, (2) she is able to take advantage of the free-contraceptives benefit without needing my permission; essentially, she can fill her prescription, unbeknownst to me, and even against my wishes, because I've arranged for her to have an insurance card (which she would need, not just for contraceptives, but for all sorts of virtuous health care needs). In that scenario, I don't think I'm complicit.

It seems to me that having an opt out option for contraceptive coverage creates a very real danger that a Catholic-associated employer could call a meeting of their staff, pass out the forms to opt out, and tell the staff "you are expected to sign this and turn it in to your supervisor- we will mail them to the insurer". Even if this was in a grey area legally it would be very hard for the employees to prove this wasn't voluntary, and they might reasonably fear their jobs were at risk if they refused to sign. Also, shouldn't the bishops consider that someone who opted out of contraceptive coverage would be taking a huge risk if she (or an adult daughter) developed one of several serious medical conditions which are treated using the pill? I'd be particularly concerned about minimum wage employees where the cost of getting the pill with their own money might be prohibitive.

Evidently The Tim is still keeping his name in the papers on this:http://whispersintheloggia.blogspot.com/2013/02/they-did-or-did-they.htmlHe seems to be emulating Chris Christie these days.

If there ever was an argument for Single Payer healtcare in this country, this entire brouhaha is the sterling argument.

Jim Pauwels, i think it's your (2) but the insurance she automatically got from the third-party (not your employer) as your dependent only covers contraceptives. I think that's what the bishops would like you to be able to opt her out of. The issue of whether a young girl could get a doctor to write a prescription for contraceptives without your knowledge may depend on your state laws. I'm not sure I remember the age correctly, butI think that once she becomes 18, she has a legal right of health privacy and her doctors can't discuss their dealings with her with you without her permission.

Jim Mvrea:Perhaps I was too hasty. It appears Dolan does know that Obama is not the rollee but the roller.In the best sense of the term, the Cardinal is most politic.I was going to try to use the term "Politese" but the association with the Rolling Stones would have been most impolitic of me.

Jim P: as a former benefits manager I know of no circumstances in which an employee duly enrolled her/his dependants under health plan coverage and retained the rights to determine which, if any, of the plan's provisions said dependants could use.I don't think that there would be a practical way for any plan administrator to verify that each and every use of the plan by a dependant has the prior or expressed permission of the employee.

jfxgillis: I think you were addressing your comments to someone other than to "Jim Mvrea" whom I take to mean me.??

"The issue of whether a young girl could get a doctor to write a prescription for contraceptives without your knowledge may depend on your state laws. Im not sure I remember the age correctly, butI think that once she becomes 18, she has a legal right of health privacy and her doctors cant discuss their dealings with her with you without her permission."I'm sure you're right about 18 year olds.Regarding younger teens: I just did a very little roaming around on Google, and it seems that the general rule of thumb is that teens who are mobile without their parents and are sufficiently motivated can get both non-prescription and prescription-only birth control without their parents' consent. This site, which for all I know may know what it's talking about, says the following:"In the United States, some contraceptives are easily available such as male and female condoms and sperimicides, and minors may legally purchase them without a prescription. Other contraceptives require a prescription or are supplied (i.e. Depo-provera injection) by a health care provider. In most states, contraceptive counseling and distribution is confidentially available to minors (i.e. there is no parental notification requirement). Some states do have restrictions which may or may not be enforced."http://www.pediatriceducation.org/2011/01/24/what-are-the-laws-regarding...

"as a former benefits manager I know of no circumstances in which an employee duly enrolled her/his dependants under health plan coverage and retained the rights to determine which, if any, of the plans provisions said dependants could use."Right, Jim McC - you're saying that, once the dependent is enrolled in the benefit, the whole benefit is available to the dependent. But, if I take Dolan's meaning correctly (and I may not be), his scenario is slightly different. His scenario would work like this:* Parent works for an employer, like a Catholic hospital, for which the Obama Administration is now carving out this special exemption.* Parent enrolls dependent children (up to age 26) in employer's group health plan, which does not include contraceptives.* Pursuant to new HHS mandate exemption rules, parent's employer's insurance company proactively issues a special policy that covers only contraceptives, to the policy holder and his dependents.Cardinal Dolan's question is, can the parent refuse this coverage, on his own behalf, and on behalf of his dependents?

The simplest solution to the issues raised by the U.S. Catholics bishops regarding the HHS regulations would be for all Catholic institutions to stop paying for health-care insurance for their employees and instead pay their employees a cash payment equivalent to the employer's share in the insurance coverage.It would then be up to the employees to secure their own health insurance and pay the premiums.

In case you didn't follow the link in Jim McCrea's post of 3:25 pm, here's what +Dolan wrote:"Yesterday, I issued a statement in my role as President of the United States Conference of Catholic Bishops on the Notice of Proposed Rulemaking regarding the HHS mandate. Unfortunately, there were some news reports today that claimed the bishops rejected the White House proposal, ignoring the fact that we bishops said, we welcome and will take seriously the Administrations invitation to submit our concerns through formal comments, and we will do so in the hope that an acceptable solution can be found that respects the consciences of all.I'm glad he clarified that the bishops haven't rejected the proposal. I saw that "rejected" headline in a lot of places yesterday.

Thomas Farrell, it would be the simplest but it would be very expensive ofr the Catholic institutions. To remain competitive with non-Catholic institutions they would have to increase salaries enough to cover what their employees would actually have to pay for the insurance plus the additional taxes the employees would have to pay on their increased salaries. The employer would also have to pay a tax penalty of $2,000 per employee for not providing insurance.And the end result would be that the employees would have insurance covering contraception.

Ow! Ow! No Downton Abbey spoilers without a warning, please!

Jim Pauwels:If that's Dolan's question, he's stupider than I said to the other Jim (and yeah, Jim McRea, I made a typo in my salutation to you), because the way to "refuse" a benefit from an an insurance policy is to NOT CLAIM THAT BENEFIT.Like a whole bunch of this supposedly "complicated" issue, and as I said in a different context above, this is not hard.The only reason this is "complicated" is if the Church hierarchy's hidden agenda is to impose Catholic sexual doctrine on the United States Government's mandated standard benefits package for health insurance.

Lisa Fullam;So Sorry, Milady.

The next person who mentions 'Downton' in one of my threads gets banned.

How about this, Grant? http://www.youtube.com/watch?v=FKCnHWas3HQI realize that the spelling is not quite the same, though.And, yes, I'm old enough to remember when this was in the Top of the Pops.

Raber and I are speculating about how his Amish relatives will handle Obamacare.The Amish pay their taxes ("render unto Caesar") as required by law, but do not register for the draft, serve in the military, apply for Social Security or Medicare, or purchase health care insurance. You get sick, they take up a collection in the community to defray your expenses. His guess is that the Amish will simply pay the opt-out penalty.In the Amish view, we "English" take their money, and they give it up to stay out of jail. But what sins we commit with the money we take from them by force (as far as they're concerned) is no affair of theirs; bishops in many ordnungs, Raber believes, will just counsel the Amish to simply not buy into the latest benefit.Can anyone imagine the Catholic bishops telling the faithful, "Pay your taxes, stay out of jail, but don't accept health care from your employer if it includes contraception coverage. We'll pay for you if you get sick."

Grant:You can't be serious. Sorry I spoiled Season 3 for you.

Addendum:Grant:Note that I did not mention the banned word.

"Raber and I are speculating about how his Amish relatives will handle Obamacare."If you are thinking of the individual mandate, as I undertand it, they are exempt. The exemption applies to people who already qualify not to pay Social Secuity taxes because their religion opposes participating in insurance programs. There is also an exemption for members of religious groups that provide free health care for theirI haven't looked into how this applies to Amih employers. Existing law draws a distinction between Amish employers who employee only Amish workers and those who employee non-Amish okers

Bunch of typos there. Add "members" at the end of the second paragraph. In the last paragraph, fix "Amish", lose four "e"s in the last line, and change the last word to "workers"

Jim McRae is right == this whole kerfufle is the greatest advertisement ever for a single payer system.As I see it, there is an inherent contradiction in the legal system. On the one hand, parents have the general responsibility for their minor (immature) children and therefore may and must make moral decisions for them. BUT on the other hand, because of the recession, parents are also responsible (or may assume responsibility) for their post-adolescent children, BUT those post-adolescent children are ALSO responsible for themselves.Thus some parents are both responsible and not-responsible for their post-adolescent kids.

Grant:What's your position on "Gosford Park"?

Take a look at the National Catholic Reporter editorial on this matter. It distinguishes "traditionalist bishops" such as Dolan from the "culture warrior bishops" (Chaput?) who are given to excessive rhetoric and who ultimtely do the Church not service.http://ncronline.org/news/politics/editorial-hhs-mandate-bishops-fight-t...

John Hayes, thanks for that info about the personal exemption for the Amish.Really, my larger point is that there are religious organizations that get around these problems by simply opting out and doing for themselves. Their communities are very strong, and their adherents are well versed in the faith. I think the Bishops have been so unwilling to accept offered accommodations because they know that most Catholics do not follow Church teaching on contraception. Perhaps they see Obamacare mandates as a "teaching moment," as I noted in an earlier post, to show the faithful that they mean business about these rules. My question--I don't know the answer--is whether their time is well spent debating this issue through press releases and public statements.? Or by trying to build the sense of community some of the more insular denominations (like the Amish or Jehovah's Witnesses) have would set norms and motivate Catholics to follow the rules as a matter of course.If the Seventh Day Adventists can keep their adherents off the cigs, I'm pretty sure Catholics could figure out ways to keep folks off the Pill and out of the condom aisle at the drug store.

Jim Pauwels: what if your daughter were the friend who motivated Sandra Fluke to speak out? Fluke described a friend who was taking a prescription contraceptive to control the growth of an ovarian cyst. When she could no longer get the prescription medication free and could not afford to buy it, the cyst began to grow until her entire ovary had to be removed surgically. If your unmarried daughter were a dependent on your insurance plan, would you be so hardhearted as to forbid her to obtain the Pill for some other purpose than avoiding pregnancy, on the off-chance that she might have sex while taking it?

Re: Culture Warrior ChaputHis family background: father, French Canadian and mother, Native American.Archbishop Chaput is member of the Prairie Band Potawatomi tribe through his mothers Native-American lineage. His Potawatomi name is the wind that rustles the leaves of the tree. His surname, Chaput, a variant of Chapel and a nickname for a habitual wearer of a distinctive cloak or hat.It figures, doesn't It?

Angela Stockton, i think some Catholic institutions say that their healh insurance will pay for contraceptives used to treat medical problems but not if they are used only for birth control. i suppose (but haven't verified) that they could continue to do that. Paying for some uses of contraceptives but not others creates an awkward situation for the employee. Doctors don't write on a prescription why they are prescribing that drug. However, the insurance company would have to know whether to charge the cost to the employer's policy that covers some uses of contraceptives or the separate third-party policy that covers other uses. Sounds as if the employee would have to submit a statement from the doctor as to why the pills were being prescribed.

Some day in the future, bishops will reminisce about Tim Dolan and company and say that they meant well. That they felt they had to protect the church's rights. That they really thought that contraception was wrong. That it was a threat to the infallibility of the church which was held at that time. So apolgies to all those families that they thought they were helping. ..............

Perhaps Cardinal Dolan needs to be reminded that many employees of Catholic hospitals, colleges and social service agencies already are eligible to received government-subsidized contraceptives either through Medicare or Title X of the Public Health Act (1970). Income eligibility for a family of four --in most states-- is $41,319.Doesn't the HHS "mandate" simply remove the salary ceiling on employee eligibility for government subsidized contraceptives? (In the future, the "professional staff" will have access to the same government subsidy that the "housekeeping staff" now has access to.)This raises the question: Aren't Catholic institutions engaged in "material cooperation" by "qualifying" their employees for the "illicit coverage" provided by Medicare and Title X? (The moral solution is simple: pay higher salaries and make their employees ineligible for government-subsidized contraceptives!)

"i think some Catholic institutions say that their health insurance will pay for contraceptives used to treat medical problems but not if they are used only for birth control. i suppose (but havent verified) that they could continue to do that."Would be interesting to know if those who provide "Catholic insurance" have employees with a higher rate of ailments for which b.c. pills are prescribed for "therapeutic" use, say something really vague like "dysmenorrhea." I suppose Catholics providing the insurance would not be complicit in this particular scenario, just as they wouldn't be culpable if women in their 40s take "hormone replacement therapy" for menopausal symptoms (my Lord, how DID our grandmothers deal without hormones!?), which have the effect of preventing an unwanted mid-life pregnancy.Am I wrong to think that all of this smacks of a kind of moral gamesmanship that doesn't fool anybody?

I think it is good to stay aware of what the discussion outside the Catholic bubble is like about Catholic hierarchs and and their anti-feminine contraception campaign.Don't these folks have a point that really the hierarchs are engaged in little more than just "whining"? http://www.dailykos.com/story/2013/02/07/1185380/-Catholic-bishops-still...

I wonder if this is good for the HHS mandate. By keeping the media focused on an issue that, in the view of most people, is a non-issue, the Catholic bishops are preventing people from discussing other potential and perhaps more substantial problems.

I think it is good to stay aware of what the discussion outside the Catholic bubble is like about Catholic hierarchs and and their anti-feminine contraception campaign.The answer is for Church organizations to mind their own business and stay out of people's bedrooms.Oh wait -- that's exactly what they are asking to be able to do, to be kept out of people's private sexual affairs. To not be involved and especially to not have to subsidize the sexual activities of people, especially those activities which operate to suppress that which is feminine. ("anti-feminine contraception" -- that is exactly right, it is contraception which is by its nature anti-feminine. To oppose subsidizing contraception is, in fact, anti-anti-feminine)If anyone should be subsidizing women's contraception, it should be the MEN who have sex with the women.

"I wonder if this is good for the HHS mandate. By keeping the media focused on an issue that, in the view of most people, is a non-issue, the Catholic bishops are preventing people from discussing other potential and perhaps more substantial problems."I'm sure it's not good for the HHS mandate, but not sure I follow your point. Problems like what?"To not be involved and especially to not have to subsidize the sexual activities of people, especially those activities which operate to suppress that which is feminine. ('anti-feminine contraception' that is exactly right, it is contraception which is by its nature anti-feminine. To oppose subsidizing contraception is, in fact, anti-anti-feminine)"So if "feminine" = conception, i.e., that which can conceive, carry, and nurse babies, where does that leave celibate women. Do they become anti-feminine if they choose not to use their procreative powers? What about older women past child-bearing years? Do they turn into drones? You poor guys sometimes you shoot yourselves in the foot when you try to explain the "feminine," and that's gotta hurt. At least I hope it does.

John Hayes, according to Sandra Fluke's testimony, Georgetown does make an exception for women who need the pill to treat serious diseases. Unfortunately, she says they are so concerned to prevent people sneaking in contraception that they don't accept a doctor's letter that the pill is a medical necessity. Rather, they open an inquiry to see if the pill is really necessary- and, academic bureaucrats being what they are, the inquiry takes weeks, even months, and in some cases the disease progressed so much that treatment was no longer possible before the Georgetown officials had made up their minds whether to allow the pill or not.It's a major issue for me that if the bishops win this fight they should address this problem- i.e. make a commitment to accept a doctor's letter immediately even at the risk of somebody sneaking some contraception. It's unacceptable to me that a young woman be unnecessarily sterilized and subjected to premature menopause as the price of making double and triple sure that nobody sneaks a contraceptive through the system.

Ann Evans, in my post I thought that even requiring a woman to get a doctor's letter was bad. What you describe is much worse than I imagined.

Ann Evans --That Georgetown story is so outlandish I find it impossible to believe. (Jesuits may be wrong, but they are not usually so stupid.) Has anybody checked out that testimony carefully?

"If anyone should be subsidizing womens contraception, it should be the MEN who have sex with the women."Bender --This time I half-way agree with you. Surely it makes less sense to have some Jesuit pay for a woman's contraceptives than to have her sexual partner pay.On the other hand, the new rules of the new let's-be-fair feminism require that men and women are supposed to split the check when they share a pleasurable meal. It's downright old-fashioned to expect the guy to pay for both dinners. So it would seem to follow, since sex is a shared pleasure, shouldn't the new women split the cost of contraceptives with their partners? (Georgetown really gets nada from their encounters, so of course it shouldn't have to pay at all.) But that would get complicated if she has more than one partner a month -- should the guys each pay one quarter of the cost? This gets to be a complicated as the HHS mandate problems. See what happens when you expect non-participants to pay for somebody else's jollies?

Ann Olivier, I looked p Sandra Fluke' testimony. Heres what she is reported to have said:"When this exception does exist, these exceptions don't accomplish their well-intended goals, because when you let university administrators or other employers, rather than women and their doctors, dictate whose medical needs are legitimate and whose are not, a woman's health takes a backseat to a bureaucracy focused on policing her body. In 65 percent of the cases at our school, our female students were interrogated by insurance representatives and university medical staff about why they needed prescriptions and whether they were lying about their symptoms. For my friend, and 20 percent of the women in her situation, she never got the insurance company to cover her prescription. Despite verification of her illness from her doctor, her claim was denied repeatedly on the assumption that she really wanted birth control to prevent pregnancy. She's gay -- so clearly, polycystic ovarian syndrome was a much more urgent concern than accidental pregnancy for her.After months of paying over $100 out of pocket, she just couldn't afford her medication anymore, and she had to stop taking it. I learned about all of this when I walked out of a test and got a message from her that, in the middle of the night in her final-exam period, she'd been in the emergency room. She'd been there all night in just terrible, excruciating pain. She wrote to me: "It was so painful I woke up thinking I'd been shot." Without her taking the birth control, a massive cyst the size of a tennis When this exception does exist, these exceptions don't accomplish their well-intended goals, because when you let university administrators or other employers, rather than women and their doctors, dictate whose medical needs are legitimate and whose are not, a woman's health takes a backseat to a bureaucracy focused on policing her body. In 65 percent of the cases at our school, our female students were interrogated by insurance representatives and university medical staff about why they needed prescriptions and whether they were lying about their symptoms. For my friend, and 20 percent of the women in her situation, she never got the insurance company to cover her prescription. Despite verification of her illness from her doctor, her claim was denied repeatedly on the assumption that she really wanted birth control to prevent pregnancy. She's gay -- so clearly, polycystic ovarian syndrome was a much more urgent concern than accidental pregnancy for her."http://www.politifact.com/truth-o-meter/article/2012/mar/06/context-sand...

Sorry, mixed up the copy and paste? Here's the correct second paragraph:"After months of paying over $100 out of pocket, she just couldn't afford her medication anymore, and she had to stop taking it. I learned about all of this when I walked out of a test and got a message from her that, in the middle of the night in her final-exam period, she'd been in the emergency room. She'd been there all night in just terrible, excruciating pain. She wrote to me: "It was so painful I woke up thinking I'd been shot." Without her taking the birth control, a massive cyst the size of a tennis ball had grown on her ovary. She had to have surgery to remove her entire ovary as a result. On the morning I was originally scheduled to give this testimony, she was sitting in a doctor's office trying to cope with the consequences of this medical catastrophe."

Thanks, John Hayes, but I was really asking if Ms. Flacke's purported facts and figures had been checked out by others. In other words, has her testimony been verified by other evidence? I just can't believe the Jesuits would have such a stupid policy. But I could be wrong :-)

I just spent less than a minute on Google and a mapping program, and discovered that there is a Planned Parenthood clinic about two miles away from Georgetown's campus. Did her friend pursue that avenue? If, as has been reported here, she had a note from her doctor, I would find it pretty amazing to learn that Planned Parenthood wouldn't have helped her.http://maps.yahoo.com/directions/?q=3700%20O%20St%20NW%20%20Washington%2...

Google turned up this letter from John DiGioia, president of Georgetown, in response to criticisms of her testimony. Doesn't sound like the kind of letter he would have written if she had invented that story.http://blog.georgetownvoice.com/2012/03/02/degioia-responds-to-attacks-a...

"a womans health takes a backseat to a bureaucracy focused on policing her body."I think is is only half fair: The bureaucracy is focused on policing its determination NOT to collude in contraception."I would find it pretty amazing to learn that Planned Parenthood wouldnt have helped her."I think people need to understand how PP and other family planning clinics work before offering this type of advice.In the first place many such clinics often do not have dispensaries where you can just take a scrip for hormones and have it filled for free. Larger clinics that might offer a dispensary will charge for the pills on a sliding scale. This is unfair if the woman's insurance company covers non-contraceptive hormone therapy treatments.In the second place, PP and similar clinics specialize in contraception and abortions; staff are not very good at diagnosing other gynecological problems, and they generally refer patients elsewhere for treatment for those conditions. In the third place, the patient may have her own moral qualms about PP's mission. Wouldn't a Catholic patient rightfully fear colluding with evil paying for services from such a clinic?The best recourse a woman in this situation has is to pay for her prescription out of pocket ASAP so that her cystic condition doesn't worsen to the point where she needs surgery or, God forbid, a cyst ruptures causing excruciating pain and possibly serious infection. If I were that woman's friend, I would try to help her with the cost of her meds and hope that the employer who is withholding treatment she has paid for and deserves will get sorted out in the Hereafter.

John Hayes --The best DeGioia manages to say about Fluke is tht she is sincere. And neither did he say tht she correctly described Georgetown's policy. Further, given Jim Pawells point about the family planning clinic not far away, I still can't believe that her perception of the whole situation is reliable. if the situation really was so dire for her friend and if she really cared about her friend she would have found a ride for her to that clinic. There are lots of Georgetown students with cars.

Ann, you're ignoring a) that Planned Parenthood or a similar clinic that specializes in contraception is not going to be a fix-it for this, and b) this woman has paid for or earned her insurance benefits and has a bona fide medical condition that could be straightened out with hormone therapy. She does not intend to use the medication to get illicit "jollies." Why should she be denied or jacked around about getting something she has earned? Guess I'll add birth control to my list of things I should stop talking with Catholics about.

Phew! Georgetown was spared the possibility that it might indirectly and unintentionally collude in someone's practice of contraception, and it only cost this woman (and how many others?) significant pain and unnecessary surgery. WAY better that women be cut up than that Georgetown students might get access to contraception on campus, right? After all, if you give women and their doctors control over their medical decisions, well, that can't be good. Women just can't be trusted when it comes to morality, after all. Eve and all that...Does it matter how many women have unnecessary surgery? Or is it enough that this policy led to one woman having unnecessary surgery?The problem here, istm, isn't that the woman could have found a work-around if she'd tried harder. The problem is that she would have had to, while if she'd gone to a secular school she'd likely still have both ovaries. Should the result of choosing Catholic education be mutilation?

OK, my last comment, I promise, then I'm off all pelvic discussions, to the relief of all concerned.But women with polycystic ovarian disease or endometriosis, another condition that hormones are sometimes used to treat, are usually already infertile. So taking hormones that render them sterile is moot. And the spectacle of Catholics on this blog suggesting that women to go to Planned Parenthood for a work-around is truly astounding.

Jean --Why not go to Planned Parenhood to get help if you're desperate? Some of what PP does is quite moral. My purpose in entering this discussion was simply to question whethr the Georgetown studen't's testimony was entirely credible. I didn't find it to be. That does not imply that, had Georgetown given her the run around it would have been right. But on the other hand, franklly Ms. Fluke sounds quite holier-than-thou because she could have gotten her friend to Planned Parenthood or some other agency for the needed help. But obviously she didn't.

Ann Olivier, here is this year's version of the doctor certification form that Georgetown requires if you want their plan to pay for contraceptives for non birth control use:http://studentaffairs.georgetown.edu/insurance/medication-override.pdfAs I understand her testimony, Georgetown makes extensive enquiries before approving the prescription even after reveiving this form. To find this, you have to go here in the student helth plan bookletQ. Are medications to prevent pregnancy or procedures to prevent or terminate pregnancy covered?A. No, medications and procedures for birth control are not covered. The following notice is required by the Patient Protection and Affordable Care Act:NOTICE TO PLAN PARTICIPANTS The organization that sponsors your health plan has certified that it qualifies for a temporary enforcement safe harbor with respect to the Federal requirement to cover contraceptive services without cost sharing. During this one-year period, coverage under your health plan will not include coverage of contraceptive services.Q. Are medications to prevent pregnancy covered when prescribed for treatment of a covered sickness?A. Yes, your health care provider can document the medical necessity and a medical override for non-contraceptive reasons may allow for insurance coverage. To purchase such medications with your Pharmacy Card, ask providers outside of the GU Student Health Center (SHC) to complete the Medication Override Form and fax it to Gallagher Koster Insurance Agency, 617-479-0860. Note: The SHC will submit the Medication Override for you.

<My purpose in entering this discussion was simply to question whethr the Georgetown student's testimony was entirely credible. I didnt find it to be. Rush Limbaugh, of course, agrees. (Also about feminists in general and about who should pay for their "jollies.")http://www.google.com/search?hl=en&tbo=d&site=&source=hp&q=limbaugh+on+s...

Ann Olivier said: My purpose in entering this discussion was simply to question whethr the Georgetown student's testimony was entirely credible. I didnt find it to be.Rush Limbaugh, of course, agrees. (Also about feminists in general and about who should pay for their jollies.)http://www.google.com/search?hl=en&tbo=d&site=&source=hp&q=limbaugh+on+s...

Thanks, John Hayes. It looks like not only will Georgetown make such medication available upon he submission of filled out forms, but will pay for them.

Ann Olivier, it looks like that, but what Sandra Fluke testified was:"In 65 percent of the cases at our school, our female students were interrogated by insurance representatives and university medical staff about why they needed prescriptions and whether they were lying about their symptoms. For my friend, and 20 percent of the women in her situation, she never got the insurance company to cover her prescription. Despite verification of her illness from her doctor, her claim was denied repeatedly on the assumption that she really wanted birth control to prevent pregnancy"

John Hayes --But that is exactly what I think needs verification. Or did she give some source for the figures?

Ann Olivier. She testified representing. Group called Georgetown Law Students or Reproductive Justice. Seems likely that they did a survey on campus and came up with those figures. In my Googling I didn't find anyone who questioned the figures. Nothing from Georgetown saying "it's just not right that we reject 20% of applications - last year we approved 98% of applications. And we don't imply that you are lying about your symptoms to get free contraceptives."Her presentation is a little unclear to me because she may be mixing together people who submit a letter from an outside doctor and people who never get a letter because they went to an internal Georgetown doctor who didn't agree they have a medical condition.Whatever tne numbers, this kind of conflict seems inherent in a situation in which an employer says "we'll pay for this drug but only if you convince us that it's for a non-sinful use."

Thanks for the input, John. You have a point. DiGioia didn't deny her figures. So who knows. I did see some of her testimony on TV, but didn't watch the whole thing since what I did see didn't impress me, but that was just an impression of her body language.

"In 65 percent of the cases at our school, our female students were interrogated by insurance representatives and university medical staff about why they needed prescriptions and whether they were lying about their symptoms."I suppose I'm not the only person to spot the contradiction inherent in this non-testimony.Why would an insurance company "interrogate" a patient about the symptoms for contraceptive medication?After all, we've been told that the entire financial basis of the Obama Administration's accommodation is that birth control saves insurers money. It's always cheaper for the insurer, we're assured, for women to utilize contraception than for them to become pregnant. To carry this notion to its logical conclusion, one would expect that insurance companies would do everything within their legal powers to get their female patients of child-bearing years onto birth control. Insurance companies, one would think, would want women popping them like vitamin supplements with their breakfasts in the morning.

Just one more thought on Fluke and her anecdote. I have no reason to question the essential facts. I can easily believe that bureaucratic mismanagement resulted in this woman becoming much more seriously ill than was necessary. It sounds like a horrible thing, and I hope that she is now healed and did not suffer a financial or an academic-progress setback.I spent a very little time looking for a public statement from DiGioia, the Georgetown President, defending his student heath policy against Fluke's charges. I haven't found one. So it seems possible that Fluke isn't exaggerating to make a point.It strikes me as a solvable problem. I'd like to think that DiGioia, upon learning about this situation, immediately did whatever is in his considerable power to ensure that it never happens again to a member of the Georgetown community. It seems eminently reasonable that a doctor's note should suffice to get a prescription filled on the spot for medication for a serious condition. No additional forms or visits should be necessary. I'd think, given DiGioia's position, he could make that policy change happen. And perhaps he has.Note, though, what isn't necessary to solve this problem. What isn't necessary is a frickin' *federal agency mandate* that binds virtually every employer in the land, misdefines what constitutes a religious organization, creates a firestorm of controversy, requires an "accommodation" that doesn't satisfy the intended recipients, implicates insurance companies and third party administrators, generates lifetime employment for a lot of lawyers, and causses everything else that has come about because of the HHS mandate. A stroke of a college president's pen could solve a local problem. And that could have been the end of it.

She didn't say the "insurance company," she said the "insurance representatives." For information about the university's insurance representatives: http://studentaffairs.georgetown.edu/insurance/index.html(And see the link in John Hayes's 4:17 post above.)

Gerelyn - what does the link you provided illustrate regarding insurers, or insurance representatives?The link that John Hayes provided is to a form belonging to a third party benefits administrator called Gallagher Koster. I'm not sure what that tells us, except that Georgetown uses a third party administrator for certain student health benefits. It may mean that Georgetown is self-insured. Or not.

Jim Pauwels, the booklet Gerelyn linked says:"This Program is underwritten by UnitedHealthcare Insurance Company and serviced by Gallagher Koster."

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