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Insurance claims.

Last week, in a tour de force of intellectual humility, Matthew J. Franck treated First Things readers to a catalogue of my confusions. He didn't take kindly to my analysis of Cardinal Timothy Dolan's response to HHS's new proposals for the contraception mandate. First, Franck claims that I am "confused...about what the government actually announced." Second, he says that my analysis of the moral culpability of religious employers is unreliable because I am "confused about the economic reality of insurance." This confusion, Franck informed me via Twitter, is profound: He sees "no sign from you either of an argument, an ability to read, or an understanding of arithmetic." Given those impairments, I may not be able to formulate a successful response to Franck's confident critique, but I beg your indulgence as I give it a shot.

Let's start with the Franck's first complaint. Do I have the foggiest idea of what HHS actually announced? Here's how I summarized the latest proposals: "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." Later in the post, I wrote that "any religiously affiliated employer that has nonprofit status simply has to self-certify with HHS in order to opt out of the contraception mandate."

Franck alleges that I conflated the categories of religious employers proposed by HHS: "Gallicho fails to understand that the new, tax code-derived definition of 'religious employer' is perfectly irrelevant when it comes to the new second category, and insists, quite wrongly, that 'any religiously affiliated employer that has nonprofit status simply has to self-certify with HHS in order to opt out of the contraception mandate.'" But that isn't my only error, according to Franck. No, I've made "several mistakes at once":

First, the tax codes borrowed language does not apply to "any religiously affiliated employer that has nonprofit status,' but to a much tighter category of churches and their 'integrated auxiliaries." Second, the employers in the new second category who are nonprofits that 'hold themselves out as religious' do not get to 'opt out' at all, if by that is meant that their employees are not covered by the mandate; they get the new (essentially fake) "accommodation."

What is he talking about? When HHS floated its initial proposal for the contraception mandate, it counted as "exempt" only those employers that had religious inculcation as their purpose, that employed and served "primarily" co-religionists, and that operated as a nonprofit. I joined the bishops and many others in criticizing that definition of "religious employer."

A few weeks later, the Obama administration announced a new proposed rule that would "accommodate" religiously affiliated employers that failed to qualify for the narrowly defined exemption by allowing them not to include contraception coverage in employee health plans. Instead, the insurance company would offer employees of such institutions separate contraception coverage at no cost. (At the same time, the administration floated a series of complex arrangements that might address the situation of "self-insured" companies that pay directly for employees' medical care; those have been distilled in the latest HHS proposals.)

So, on the one hand there were "exempt" employers (dioceses, parishes, parish schools) -- their employees would not be eligible for the proposed free contraception coverage. And on the other hand there were "accommodated" institutions (hospitals, colleges, charities) -- they wouldn't have to contract for, pay for, or refer for contraception coverage, but their employees would be able to receive it at no cost from a third party. That difference is preserved -- but clarified in such a way that could expand the range of exempt employers -- in the most recent proposed rule, and that's what upsets Franck. He believes that there is a significant moral difference between a religious employer whose employees will not receive contraception coverage at all and a religious employer whose employees will receive contraception coverage from a third party. He thinks the only true "opt out" is available to fully exempt employers, whereas I see a moral significance in an "accommodated" employer's ability to choose not to contract for contraception coverage. I could have been clearer about this in my post, but in the final analysis, it makes little difference to the moral calculus because neither exempt nor accommodated institutions will have to include contraception coverage in their employee health plans. I agree with Bishop Robert Lynch that this arrangement amounts to "a distinction without difference." More on that in a moment.

Back to Franck: "When the Obama administration claims that employers will not 'fund' the contraceptive coverage provided by insurers," he alleges, "it speaks falsely." He continues:

When it [the Obama administration] claims that the free contraceptive coverage can be afforded by the insurer because cost-savings will result from improvements in womens health and fewer childbirths, the administration is admitting that the contraception is already being paid for by the employer, if its policy covers childbirth and womens health in general. The insurer is not being told to lower its premiums because of the cost-savings on procedures and ailments already covered; it is being told that it can put the cost-savings toward the expense of providing contraception. The existing premiums, paid by the employer, will be the funding source.

Leave aside, for the moment, the fact that actuarial studies have already shown that adding contraception coverage doesn't end up costing insurers extra -- it's not relevant to the moral question. What matters is who pays for it and why. Franck says that "the existing premiums, paid by the employer, will be the funding source." Unfortunately for his argument, that's not how health insurance works.

When a group like, say, EWTN pays monthly premiums to its insurance provider, the insurer does not take the money, deposit it in an account used only for the TV network's premiums, and then pay EWTN employees' medical bills out of that account. Rather, the insurer pools EWTN's payments with those from other customers. So when an EWTN employee gets an X-ray, the money that pays the bill may or may not come from EWTN. It may come from a company whose insurance coverage includes abortion. The insurer's risk assessment of its policyholders determines whose monies fill the pools. If the same insurer covers EWTN and NARAL, the two organization's monies will be mingled. Indeed, it's the pooling of premiums that provides the incentive for insurers to offer contraception at no cost to their customers. (In 2002, the Kaiser Family Foundation published a useful primer on health insurance [.pdf]. If you have trouble getting your head around our strange health-insurance system, it's well worth reading.)

So, pace Franck, when it comes to determining who's really funding contraception for employees of accommodated organizations, "the existing premiums, paid by the employer" will not "be the funding source." It may be one of the funding sources. It may not. The point is, there's really no way to know, because insurance companies are in the business of spreading risk. It would be like trying to determine whether any of Matthew Franck's federal tax dollars ended up paying for an abortion for a rape victim. Once he's paid taxes, that money is no longer his. It's collected with other people's money and dispensed by someone else. He's not on the hook for what's done with that money unless he's willed something evil. That is, of course, the point of money. Did the change I got from Starbucks this afternoon come from a drug dealer? I don't know. Was the banana I had this morning picked by a child? I hope not, but did I try hard enough to find out? Did the money I saved by not buying organic cover life-saving medical treatment for a loved one? An electric bill? An iPad mini? The Catholic tradition accounts for the complexity of moral agency in a fallen world. We are never disentangled from sin. So the tradition helps us think through these difficult questions: What did I intend? What was the effect? Could it have happened without me?

Franck doesn't give those questions their due. He seems to suggest that every time someone pays an insurance company he has illicitly cooperated with evil, regardless of intent. After all, major insurers cover abortion for at least some of their customers. (Would he also say "self-insured" religious employers that engage the services of an insurance company to administer their health plans are morally culpable [most do]?) Franck says the latest contraception-mandate proposals are no good because they still involve religious employers in morally illicit arrangements. But everything the Obama administration has proposed is designed to distance the religious employer from the coverage it objects to. It frees religious employers from having to say, "Yes, I want to include contraception coverage in my employee health plan." It allows "self-insured" religious employers to say, "No, we won't pay for contraception out of the monies we've saved to cover our employees' medical care." It transfers responsibility to a third party. If an employee of an "accommodated" religious institution avails herself of the contraception provided by a third party, her employer is no more responsible than it would be were she to use her wages to purchase condoms. In the United States, benefits are considered part of an employee's compensation.

Franck is hung up on whether the HHS proposals will actually work, whether insurers will recoup the upfront costs of providing contraception, even to people who aren't in their risk pools. But who cares? For "self-insured" companies, not a dime from their health-care kitties will pay for contraception. For companies that pay insurance premiums, they won't have to contract or refer for contraception coverage. Might their premiums end up paying for services to which they have religious objections? Yes. But they already are. That they don't intend to fund such services is what frees them from moral culpability.

And that's precisely why I believe the latest proposals for the contraception mandate pass moral muster. If Franck wants to counter my moral argument, he'll have to acquire a clearer understanding of how insurance works.



Commenting Guidelines

The CHA (Catholic Health Association) has issued a pretty favorable statement about the HHS proposals. Thy say "CHA is also aware that the issues that we have as a ministry are narrower than the broader concerns of the Bishops' Conference."

Who is Matthew FrancK? I googled and found a lawyer. Is that him? Does he have any expertise in insurance?

The First Things/USCCB position, as it evolves, is a disgrace to serious moral reasoning. It is a result of the same pathology that afflicts the political right, a commitment to a contrary worldview so all-encompassing that every intrusive fact, any inconvenient complexity must avidly be ignored. I could laugh if it weren't so damn sad.

There are some further misunderstandings detailed in the Public Discourse piece Franck links to. Same very certain tone, though.

Well, Grant, I think you've more than adequately answered the first two deficiencies he charged you with. But you didn't directly address the claim that you lack an understanding of arithmetic. So let's see, shall we?2 + 5 = ?8 - 6 = ?4 x 4 = ?9 3 = ?Then we should be able to move on.

Is this guy associated with The Becket Fund - my guess is that by the time a few of these cases wind up at SCOTUS, the Becket Fund will lose. (know that is different from a moral question but he seems to have failed high school morality class in double effect and the various levels of cooperation. But, it is par for First Things these days.

To repeat a part of a Krugman quote from an earlier thread: "One side believes, at least in principle, in letting its policy views be shaped by facts; the other believes in suppressing the facts if they contradict its fixed beliefs.

OK, lets try it this way:I cant say Im an expert on actuarial studies, but I would bet such studies do not incorporate the costs of there being fewer children in our society, even considering only the mere economic value they add.I do indeed think it is a moral question whether we want to support a government program the encourages Americans to be barren and divide, just so insurance companies can amass greater profit.

I'm not persuaded the mention of fewer children is germane. The regulation of births, itself, is permitted. The moral question pertains to method. For whatever reason there are fewer children, to account for the difference between those absent by licit versus illicit means is so difficult, so remote a question I cannot imagine how it would bear on a meaningful analysis of these problems. Better to keep the focus on health effects and more measurable costs.

StevenI see the issue is much larger than mere method. Consider a hypothetical 1% couple that religiously practices NFP and has no children, so that the husband can, say, take an annual vacation golfing in Florida and the wife can, say, take an annual vacation in skiing in Colorado. Do you think there is no question of morality here, in a Catholic sense? Doesnt it contravene the first commandment in the Bible?

Weak as I am on this topic, it seems to me mathematics is a grand, remarkably lucid adventure until one runs into that darn infinity thing. At which point, it seems to me even the best of us can only say "well, seems likely".

Mark --Your argument doesn't hold. If the insurance companies encourage people not to have children, then there will be no money from those children to pay the old-age insurance bills of their parents. it is to the advantage of the ins. cos. to at least have a stable population.

The first commandment in the Bible? Be fruitful and multiply? That was a commandment? Now you tell me! I thought it was a blessing, a counsel, an exhortation, or maybe a wish, like "have a nice day."But I think, Mark, that you've hit on an insuperable argument against a celibate clergy. So there's that.

AnnI cant tell if your comment was tongue in cheek or not. Do you really think most insurance companies, most any kind of companies, think as long term as that? Not more interested in the quarterly numbers?John--It was in the imperative mood, no? Doesn't that make it a command? Though I can accept blessing/counsel/exhortation. But never, ever, could I liken it to "have a nice day."Live long and prosper.

Wouldn't say it encourages Americans to be barren and divide. When I was on the pill, it wasn't in order to never have children, it was just so I could time my family so I could be in a position to care for those children and support them financially.To be honest, there is something very, very skewed about our views on birth control being driven by a group of elderly male virgins. I don't mean that disrespectfully, but I just think birth control is an issue completely outside the expertise of our church leadership.

"Is this guy associated with The Becket Fund my guess is that by the time a few of these cases wind up at SCOTUS, the Becket Fund will lose."Weren't a bunch of these suits just dismissed in the lower courts?

I'm not really interested in getting sidetracked by a contraception argument. Grant's treatment of the First Things/USCCB line is more interesting. I would say though that HV says that the regulation of births is permitted and that nowhere does the Theology of the Body worry about a hypothetical like Mark's. So long as his hypothetical couple is 'open to life' while practicing NFP faithfully there is no moral problem. So far as that couple's INTENT is no different from a couple practicing artificial contraception, it seems to me we've found the problem with HV's, JPII's, and Christopher West's argument, and I don't begrudge Mark's worrying about that. But as long as we're here discussing the complex intricacies of intent, we ought to notice Grant's good point. Even when my insurer pays for someone else's contraception or abortifacient, I don't intend that outcome when I simply pay a premium. If we can handle the complexity of worrying about that hypotheical couple's intent, we ought not to worry too much about the HHS mandate.

Kevin Drum of Mother Jones on the claim that insurance carriers would be required to provide contraceptive riders at no cost:"And, let's be honest, it is a kludge. There's no such thing as 'no cost.' If an insurance carrier covers contraceptives, that's a cost they're going to make up somewhere else. And that somewhere else is in the premiums for the main policy. There's really no way around that."In other words, money is fungible, a subject that liberals and conservatives alike treat with abandon depending on whether they happen to like the consequences. In this case, liberals are willing to accept the fiction that the money for contraceptive coverage is somehow 'segregated,' and conservatives aren't. When bailed-out bankers pay themselves big bonuses and swear that not one dime is coming from bailout funds, the roles are reversed. All good fun." also examines the alleged cost savings from free contraception. Coming from a leftist his skepticism cannot be dismissed as an anti-Obama rant.

...nowhere does the Theology of the Body worry about a hypothetical like Marks. So long as his hypothetical couple is open to life while practicing NFP faithfully there is no moral problem.StevenIm certainly no expert on the TotB, but Im quite certain you are incorrect that it does not address, and head-on, the contraceptive mentality. It is a constrained view of the TotB to think its focus is on method, and to think what we do with our bodies does not influence, for good or bad, our intent. JPII wrote quite eloquently on the inseparability of the body and the spirit, and how they are inextricably linked. My understanding is that one of the reasons NFP is considered by the Church to be morally superior to artificial contraception is that it is much better at helping couples avoid the trap of the contraceptive mentality, though of course no method is foolproof.I understand that Grants thread is focused only on the narrow issues of who pays for it, but I think the Churchs view is that we all will pay for it.Where have all the flowers gone? Long time passing...

Grant - when you wrote this: 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 - you were doing some pretty condensed summarizing: everything before the "and" refers to exempt organizations, and everything after the "and" refers to accommodated organizations. I think Franck honestly misread your meaning in this sentence, and thought that the entire sentence referred only to exempt organizations. (To be really tedious about it: I believe the antecedent of "proposes arrangements" is "new rule", but Franck interpreted the antecedent to be "four-part definition". If this combox allowed one to put diagrams in it, and if I knew how to diagram a sentence, I'd illustrate it.)He then used that misunderstanding as a club to try to beat your credibility to a pulp, and I don't blame you for being sore about it.

At Mass, in the bulletin literature, and at parish missions, I'm told NFP is "just as effective." That's why we should trust it! TotB does address the contraceptive mentality. Thus the emphasis on 'openness to life' even while practicing natural contraception. The NFP argument is trapped in HV's provision for the legitimate reasons to regulate births. And here comes the real point.There are no flowers here. They haven't gone anywhere. They never were here. This is public policy--prose, not poetry. This is about feeding and caring for a family you can manage. This is about the affordability of basic, life-saving (life-affirming) healthcare. A poetic understanding of the lillies of the field quickly becomes an extravagance amid preventable suffering, deprivation, and death. That's why we institute governments to deal in the dirty, prosaic business of solving problems that the idealized thinking of some theology and philosophy cannot handle. It is why, for all its compromising and compromisedness, the Tradition has taught that government is an honorable, noble, holy thing. That's why we sanction double-effects. That is the strength of Grant's argument.

While I agree talking about the merits of contraception sidetracks the discussion of "who pays for it", aren't we missing the forest for the trees? We only care about who pays for it, because we're ducking the issue of whether its essentially a good thing that it be paid for. The institutional Church is wasting all kinds of time, money, credibility and political capital opposing something most of us actually support. And this time and treasure could be better spent on much more critical issues. Or at least on issues American Catholics support.

For the political scientist, there may be no flowers, but at the root of politics is culture, and at the root of culture is cult...religion, or poetry, as one might call it. I actually agree with Irene on a point.

Mark ==You're changing the subject. The subject is not whether the ins. cos. are most interested in profits, the subject is whether or not it is to there advantage to have fewer people in following generations. Obviously it is to there disadvantage because that would reduce their possible profits per capita.As Krugman has notably put it, you are ignoring evidence to fit your ideology.

There is a place for the poetry, and more than you know I depend on the cultural argument. The question is of priority when we address a particular question, the very problem with TotB and much of the USCCB political engagement. Flowers aren't food for a child. Our beautiful arguments cannot be permitted to become the enemy of the good because they are perfect. Or, to paraphrase Justice Jackson, the Magisterium was never intended to be a suicide pact.

AnneI do not see how your 10:31 am comment responds to mine of 7:06 am. Your comment assumes that insurance companies always act in their long term best interests. I disagree. Disagreement is not changing the subject. As they say in certain circles, the first person who resorts to citing Krugman loses the argument.StevenWell, if you are saying the Churchs argument is perfect, lets stand on that. ;-) Seriously, though, I sense your comments are motivated by the immediate concern of feeding hungry mouths. A more than legitimate concern, but in a fallen world it is impossible to avoid contingency, or the need for faith.

BIG Ooops -- Should be: Obviously it is NOT to their disadvantage because that would reduce their possible profits per capita.

Mark --Merely disagreeing does not address the subject. Further you have made an assumption -- that insurance companies don't think 30 years ahead. but that does not describe what I've seen of ins. cos. Smart companies think 50 years ahead at least.And I didn't say the ins. co. *always* act in their own interest. Wht I said is tht they think at least a generation ahead in order to make profits.Where is ungidon when we need him :)

I'm motivated by a concern that the political order be an order of prudence. I reject all perverse outcomes most especially when they follow perfectly realized, ideal philosophical or theological arguments.

StevenBy perverse, I assume you mean parents having more children than they can afford to raise? Do you have any support for your conclusion that those who currently strive to follow Church teaching are more prone to that than the rest of us?

A short piece in our local, not terribly reliable, newspaper reported that Archbishop Lori has written to Congress urging that an exemption for the "Taco Bell" owners of this world be made part of the deliberations concerning the debt ceiling issue. Does anyone know more about this? If this report is accurate, then Archbishop Lori's attempt to clutter this very important, and very contentious matter with this fundamentally extraneous "contraception" issue is outrageous. Either he is hopelessly naive about our political situation, which I doubt, or he is playing a cynical game.

Mark, this back-and-forth already has gone far past any hope of illumination. I'm no more interested in being drawn into a debate on the merits of contraception than I was this morning. I'm trying to maintain a discussion of what makes good public policy--policy that is as moral and effective as is possible. But let me thrash the straw man. Perversity here is an argument about contraception thwarting the extension of healthcare. I would be the first to agree that a single-payer system would be the best solution, far better than the ACA and its suite of weird compromises. Unfortunately, political leaders who also happen largely to be identified as "pro-life," leaders whom my bishops tell me I should support, have rejected the single-payer option as the unacceptable path toward socialism. In this political climate. the ACA is what we can get. And despite the suite of weird compromises that are packaged together under its aegis, it still just might reduce the cost of healthcare and make its advantages more widely available. I would prefer the perfect solution. I will accept the good one. What I won't do is sit idly by and watch the same bishops who support those political leaders who keep us from a single-payer system now peel apart the ACA based on concerns about contraception and abortion that grow increasingly remote from our actions and intentions. I see no good in it at all.

Regarding insurance premiums of accommodated religious institutions, and whether they are really paying for the insurer-direct-to-customer contraception policies: Franck's argument, in whatever tone it is presented, is logical. On the other hand, I agree with Grant that insurance premiums go into a general "bucket" of money that the insurer uses to pay claims, run the business, etc. But on the third hand, insurers do (or should do) account-by-account profit and loss analysis to determine whether a client institution is profitable (or maximally profitable) and we can be sure that these analyses are used in pricing policies. That suggests that the "one giant bucket of money" concept has limits; for certain of the insurer's purposes, the premiums coming in from a specific account are expected to "match up" with the claims and other expenses going out to that account.I agree, too, with Grant's consistent point that, even if Franck's argument is valid, it constitutes remote material cooperation. Finally, I continue to agree with a point I've made in the past in these discussions: employers should be free to make their own determination as to whether or not this arrangement constitutes remote material cooperation or something more culpable, and the HHS mandate puts substantial burdens on that freedom.

SteveYes, I sense some exasperation. But, for the record, its not me youd be agreeing with that a single payer system would be the best solution. Until your last post, I did not realize how important to you more government control of healthcare in America is, and why youre taking such a negative view of attempts to resist that.Thanks for exchange, I regret it was more illuminating for me than it was for you.

Glad to oblige.

Jim Pauwels says: "[E]mployers should be free to make their won determination as to whether or not this arrangement constitutes remote material cooperation or something more culpable, and the HHS mandate puts substantial burdens on that freedom."I ask: Does every claim that some law 'burdens" my freedom have to be a legally accepted claim? If not, then what is so special about this particular "burden" that necessitates its legal acceptance?

"Where is ungidon when we need him :)"Ditto Peter Nixon who works for one of THE most successful health agencies, Kaiser Permanente (my insurer).

"I ask: Does every claim that some law burdens my freedom have to be a legally accepted claim?"No, I don't think so. Why do you ask?

Jim, I ask because of your remark about the the "substantial burdens" that the HHS mandate supposedly puts on the employers freedom. Is this burden morally, or legally, defensible? Perhaps I misunderstand what you are saying about this burden.

Bernard Dauenhauer wrote "A short piece in our local, not terribly reliable, newspaper reported that Archbishop Lori has written to Congress urging that an exemption for the Taco Bell owners of this world be made part of the deliberations concerning the debt ceiling issue. Does anyone know more about this?"Here is Bishop Lori's February 15 letter to members of Congress:"The 112th Congresss inability to enact appropriations bills for Fiscal Year 2013 left many tasks unfinished. One of the most vitally important of these tasks is to restore a tradition on rights of conscience in health care that has long enjoyed bipartisan consensus, but is now under greatly increased pressure. I urge Congress to address this problem when it considers proposals for continued funding of the federal government in the weeks to come."He urges Congress to include two provisions that were proposed for a House bill in December.At the end of the letter, he summarizes the USCCB objections to the latest HHS proposal:"What seems to be at issue instead is a new, more grudging attitude in recent years toward citizens whose faith or moral principles are not in accord with the views of the current governing power."it permits no free choice by a female employee to decline such coverage for herself or her minor children, even if it violates her moral and religious convictions.""if a religious organization is not exempt, its insurance company or third-party administrator will impose the full mandate automatically on the organizations employees and their female children, using the personal information that the employer had entrusted to them solely to provide a plan consistent with the organizations faith""individuals and families, nonprofit or for-profit organizations that are not explicitly religious, insurers, third-party administrators will have the mandate imposed on them without any recourse

That's my abridgment of Bishop Lori's three-page letter. I have provided a link to he full letter.

it permits no free choice by a female employee to decline such coverage for herself or her minor children, even if it violates her moral and religious convictions.

Is this true? The insurance company is obliged to extend (er, "impose") the extra coverage at no cost to all employees, but does that mean the employees can't call and opt out of it if they should want to? To keep it from their kids, as Lori suggests? I can't think of any other reason someone would bother to do so, since a Catholic's "moral and religious convictions" would not be "violated" simply by having coverage for services no one is forcing her to take advantage of.

Mollie Wilson O'Reilly. as I recall, the language of the proposed regulations says that if the employer doesn't provide contraceptive coverage in its policy, the insurance company will "automatically" enroll all "employees and dependents" in a separate policy that will cover contraception only.I don't recall ever hearing about this issue from the USCCB before the latest draft regulations were issued. Now that the issue has been raised, it may be that HHS would be willing to let a female employee opt out for herself. Whether or not an employee could reject contraception coverage for dependents may raise more complicated issues.AB Lori has clarified that he is now talking about "minor" children. If that means daughters aged 18 to 26 could accept or reject for themselves, that would reduce the issue to whether a parent could reject contraception coverage for daughters under 18.

Cardinal Dolan's News Release of February 7 didn't have he "minor""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."

Here's HHS's explanation of the proposed regulations. Sounds as if each person (employee and dependents/beneficiaries) gets a separate notice. Seems as if this notice could have a section that says "If you don't want his coverage, sign here and mail this notice back to us". The question would be which dependents the parent could sitgn for. "The issuer would automatically enroll plan participants and beneficiaries in a separate individual health insurance policy that covers recommended contraceptive services.""The proposed rules would direct a health insurance issuer providing separate individual health insurance policies for contraceptive coverage at no additional cost to participants and beneficiaries in plans of eligible organizations to provide a written notice to plan participants and beneficiaries regarding the availability of the separate contraceptive coverage. Issuers providing such contraceptive coverage would be responsible for providing the notice of availability of such coverage to participants and beneficiaries in both insured and self-insured group health plans of eligible organizations. The notice would be provided directly to plan participants and beneficiaries by the issuer..."For more details, see

, her employer is no more responsible than it would be were she to use her wages to purchase condoms. In the United States, benefits are considered part of an employees compensation,,This statement is false. The employer is providing and controlling the insurance benefits, once the wages are paid, control and moral responsibility transfers to the employee. The fact that both are compensation is not the deciding factor; their forms are different and that is the crucial factor affecting moral culpability

Mark, I think your observation about encouraging barrenness is the critical point. It is a prescription for the slow death of humanity

BruceThanks. From Father Imbellis thread, the Popes homily warns:[The Tempter] does not spur directly toward evil, but toward an illusory good. He would have us believe that the true realities are power and what satisfies our primary needs. In this way God becomes secondary, a mere means; God no longer counts and thus disappears. In the last analysis, what is at stake in the temptations is faith itself: God is at stake.So while we carefully nuance the double effects regarding the HHS mandate, lets be mindful that the Tempter has his own version of double effect.

I'm sorry. What? Obamacare is a temptation from the devil? Did I connect the dots correctly? Because I try to be a kind person, one who would find it difficult to believe that I have. But the code here seems pretty clear.It seems to me that we ought to return to the point of this thread and the original post, that the contraception debate is a sideshow that grows more and more distantly remote from any substantive debate over the merits of the ACA. That is, despite the increasing volume of those who object. If we want to litigate whether artificial (or, natural) contraception is good or bad, it seems to me that debate belongs elsewhere. Arguably, in 1968.

Did I connect the dots correctly?StevenNo, not exactly, it runs a bit deeper than that. I thank you for trying to be a kind person, but Im afraid I must agree with you now that our exchange has gone beyond the point of illumination.