In a case that could have implications for ministries across the country, a Catonsville-based group of nuns who care for the elderly poor are awaiting a federal judge's decision on whether it must comply with the federal health care law's requirement to provide free contraceptive coverage for lay employees.
While the federal health care law exempts churches, the Little Sisters of the Poor don't fall under the government's definition of a religious employer — and providing free access to birth control violates their religious vows, they say. The Catholic Church teaches that artificial contraception is immoral.
"Simply put, as a matter of religious faith, the Little Sisters Home may not participate in any way in the government's program to provide access to these services," states the class-action federal lawsuit filed in U.S. District Court in Denver, where one of the Little Sisters' homes operates.
The Little Sisters, founded in the 1800s, operate about 30 homes for the elderly across the country, including St. Martin's Home in Catonsville. Their lawsuit was filed by the Becket Fund for Religious Liberty, a nonprofit public-interest law firm that is also representing Hobby Lobby — an Oklahoma-based retail chain of craft stores that is also challenging the contraceptive coverage mandate — in a high-profile case that the U.S. Supreme Court is scheduled to hear next year.
The Little Sisters of the Poor's homes in Denver and in Catonsville are plaintiffs in the lawsuit, as is the Christian Brothers Services, which provides their employee health benefits. Each home employs more than 50 lay employees, according to the lawsuit.
A number of court decisions have recently been made on the religious employer issue. Just last week, a federal judge in New York ruled that several Catholic schools and other Catholic organizations should be exempt from the requirement. In the same week, Priests for Life saw its similar lawsuit dismissed by the U.S. District Court for the District of Columbia.
Although dozens of for-profit and nonprofit employers have filed lawsuits over the requirement, the Becket Fund says the Little Sisters' lawsuit was the first of its kind because it could potentially affect hundreds of nonprofit Catholic ministries.
Baltimore Archbishop William E. Lori said the Little Sisters' service is "unmistakably a work of religion" and said the issue is one of religious liberty that could affect all religious people, not just Catholics.
"The government is drawing lines where the church does not draw them," said Lori, chairman of the U.S. Conference of Catholic Bishops' Ad Hoc Committee for Religious Liberty. "We see serving the poor, educating the young, healing the sick, as a natural outgrowth from what we believe and how we worship. And so we believe that all of these ministries should be exempt."
Women's health groups lobbied for the contraception requirement and say it ensures crucial preventive care for American women. According to the Guttmacher Institute, 99 percent of women ages 15 to 44 who are sexually active have used birth control. And nearly 60 percent of those who take birth control pills use it at least in part for health benefits, such as to treat endometriosis and regulate their menstrual cycle.
"Birth control is tremendously important to women for all kinds of reasons, including to control certain medical conditions and to plan our families," said Jenny Black, Planned Parenthood of Maryland President and CEO, in a statement to The Baltimore Sun.
Planned Parenthood characterizes the law's religious exemption as expansive and says it will allow 350,000 churches, religious schools and houses of worship to get out of the requirement. At issue in this Little Sisters of the Poor case is whether groups that don't fall under that exemption should be counted as "religious employers."
The Obama administration has been struggling to find a delicate balance, said the Rev. Thomas J. Reese, a Jesuit priest and a senior analyst for the National Catholic Reporter. Making the exemption too narrow could violate religious freedoms, but extending it to large Catholic institutions such as hospitals and universities would affect a huge number of employees.
"Basically what they tried to do was draw the line somewhere in between," Reese said.
But some say it's clear the nuns are religious employers. The lawsuit claims that complying with the government's rule would violate their beliefs. Daniel Blomberg, an attorney for the Becket Fund, said the religious-employer exemption is so narrow that it's "stunning."
"You have a ministry that started in the 1800s and was run entirely by nuns, and it doesn't count as a religious organization," Blomberg said. "The Little Sisters take a vow. ... Part of this vow is that they treat all of the people that they minister to as if that person were Jesus Christ."
The lawsuit seeks an injunction before IRS fines could potentially be imposed in January. While it's unclear what the fines could be, Blomberg said it could be "millions."
In weighing these issues, the federal government is caught between two values, Reese said — the rights of women to have access to contraception and the rights of religious employers to act upon their conscience.
"This is what life in America's about," he said. "How do you live in a pluralistic society where people have different values and different goals?"
Reese said he thought the initial definition of a religious employer — which has since been broadened — was too narrow. Still, he said, the government must find a balance in granting exemptions.
"Once you allow a person to say, 'My religious conscience says I don't have to obey this law,' if that become an absolute principle, then you've got chaos," Reese said.
Representatives from the Little Sisters declined to comment through a spokeswoman for the Becket Fund. The group explains on its website that the nuns dedicate themselves exclusively to serving the elderly poor at its homes, such as the one on Maiden Choice Lane in Catonsville.
"We welcome them into our homes, form one family with them, accompany them from day to day and care for them with love and respect until God calls them home," states the website.
A spokesman for Planned Parenthood Maryland declined to comment on the Little Sisters' lawsuit. But the organization is keeping a close eye on lawsuits by for-profit employers who object to the contraceptive rule, saying they could have huge implications for women's health.
"If upheld, these claims could deny millions of women access to affordable birth control and set a dangerous precedent allowing businesses to deny their employees a whole host of other medical procedures and treatments to which they are legally entitled, based on the employer's personal beliefs," Black said.
"What the courts will finally say, God only knows," Reese said.