www.baltimoresun.com/news/opinion/editorial/bs-ed-obrien-20120208,0,5736173.story

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O'Brien's quixotic fight

Our view: Why would Baltimore's Catholic leader pick a fight with a federal regulation supported by his followers and endorsed by medical experts that leaves it up to each individual to decide whether to buy or use contraceptives?

5:35 PM EST, February 8, 2012

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Recently, Cardinal-designateEdwin F. O'Brienwrote a stirring letter to all those who worship in the Baltimore Archdiocese, calling on their help to "regain our religious freedom." The impassioned call to arms suggests the federal government has dealt a "heavy blow" to Catholics and has "cast aside" the First Amendment.

What could have so angered the 72-year-old soon-to-be advisor to the pope to justify his call for prayer and fasting until "religious liberty" is restored? Remarkably, it was the recent decision of the U.S. Department of Health and Human Servicesthat requires future health insurance policies, including those administered by religious hospitals and charities, to cover contraception and sterilization.

The hierarchy of the Catholic Church opposes contraception as a tenet of faith, and that is its right. Nothing in the HHS regulations requires anyone to purchase or use a condom, ingest a single birth control pill, or submit to a vasectomy under any circumstances. Nor would it require Catholic medical facilities or institutions to provide them.

But as part of President Barack Obama's health care reform law, the agency did have to set some minimum standards for insurance policies, balancing cost against public health benefit. As it happens, reducing the number of unwanted pregnancies is a highly effective policy for improving the health of women and the outcomes for children. Ask any doctor; this is a medical fact.

So what appears to haveArchbishop O'Brienand others in Catholic leadership upset is that their employee health plans would now have to provide this benefit. The church would be paying — as part of its worker benefits package — for insurance coverage that includes contraception.

With all due respect, the problem with the clergy's outrage is that it's absurdly selective. Catholic dollars have already been used for these same services through something that's known as "salary." Under existing U.S. law, a person can use money from his or her paycheck to buy contraceptives, and one suspects that church employees have done so for generations.

Indeed, a poll released last month by the Public Religion Research Institute found that a greater majority of Catholics support contraception at no out-of-pocket cost than do other Americans. According to the poll, 58 percent of self-identified Catholics took this position, and when asked if the church should be exempted from the Obama administration's insurance-must-include-contraception rules, 52 percent of Catholic respondents said no.

Is paying for an insurance policy administered through a private company morally different from paying an employee directly? In both instances, whether to obtain or use contraception is still the decision of the employee and his or her beneficiaries.

Certainly,Archbishop O'Briencan argue that the benefit facilitates, perhaps even encourages, the purchase of contraception. That is, of course, the point. But in Maryland, the same services are financed through Medicaid, another program church dollars support through payroll taxes. And make no mistake, mandated health insurance coverage, or more specifically, the penalties for failing to comply with that requirement, amount to a tax — a point administration lawyers have made repeatedly, and successfully, in federal court.

Nevertheless,Archbishop O'Brienhas vowed that the archdiocese will not comply with the law. That's a pretty extraordinary level of protest considering that over the years, tax dollars originating from the church have been used for any number of purposes deemed morally wrong, from the death penalty to "enhanced interrogation" of terrorism suspects, without raising a similar ruckus.

What purpose will the church's action serve? If carried out to its logical conclusion, it means employees will have to buy health insurance on their own. And under the federal regulations, the policies will have to include contraception. To pay for it, they'll no doubt draw from their church-provided paychecks. The church, in turn, would be subject to a penalty to help offset the insurance cost.

In other words, it changes absolutely nothing — aside, perhaps, from fueling protests against what some deride as "Obamacare" and potentially endangering the health of millions of uninsured Americans if Congress or the courts reverse the president's groundbreaking health care reform law. Is there not a moral hazard in this, too?

Administration officials say they are looking to provide some compromise. Republicans, particularly all those men running for president on the reject-family-planning bandwagon, have seized the moment to portray Mr. Obama as anti-Catholic. Impassioned letters from U.S. Catholic bishops, including Archbishop O'Brien, have clearly reinforced that outrageous claim.

What's needed is some less inflammatory language and confrontation and some more dialogue and quiet reflection. The federal government has an important role to play in promoting public health and the greater good. The church leadership has a right to its beliefs.

In the meantime, Catholics ought to reply to the O'Brien letter and express their true feelings about contraception to their church. That growing chasm between the practices of U.S. Catholics and the doctrine of church hierarchy would seem a far greater threat to the institution's future than any health insurance policy or federal regulation.