Richard John Neuhaus once commented that the “philosophes” of the French Revolution would turn over in their graves to discover how the Catholic Church had become the chief defender of the place of reason in the public square in the late 20th century. Today in the 21st century it is the feminist revolutionaries of the 1960s who are squirming in their rocking chairs as the Catholic Church dares to defy “the establishment” to stand for the freedom of women and of conscientious objection to federal mandates.
The greatest attack on women’s freedom is last week’s recommendation by the Institute of Medicine (IOM) that the new health care law should mandate “the full range of FDA-approved contraceptive methods [and] sterilization procedures” as “preventive services.” This means that every health insurance plan must provide these services without co-pays or deductibles. “Grandfathered” employer plans are exempted, but these lose their “grandfathered” status if the plans are significantly changed; HHS estimates that by 2013, about 88 million Americans’ preventive services coverage will be affected by federal decisions. The Secretary of Health and Human Services has solicited IOM’s recommendations and will render a final decision August 1.
Cardinal Daniel DiNardo of the U.S. Conference of Catholic Bishops responded immediately that the new threat to religious conscience posed by this recommendation fails women. He noted further that the “FDA-approved” category includes even abortion-inducing methods (such as Ella), and that IOM’s report appeared to be driven by ideology, not science or care for women’s health.
If you want to give new meaning to the word “outsider” in Washington today, identify yourself prominently as a conscientious objector to birth control as a tool in the “war against unintended pregnancy.” A giant federal health care bureaucracy becomes your enemy. So does one of its closest collaborators, the self-described champion of all things female, the Planned Parenthood Federation of America. The IOM’s report gave Planned Parenthood everything it lobbied for—even the opinion that abortion, too, is a form of preventive health care, but one that the IOM believed it could not recommend in light of extant law.
The underlying reason that the Church opposes the IOM’s recommendations is its opposition to the trivialization of sex. At bottom, the Church seeks to preserve the idea that “sex makes babies.” Such a formulation indicates on its face that there is something unique, even sacred, about sex, and that sex is intrinsically associated with committed adult relationships. The state’s competing mantra—that only “unprotected sex makes babies,” while protected sex is consequence-free—implies rather that children are the unfortunate results of technological failure. It renders invisible the sacred, unifying, and procreative attributes of a sexual relationship. By this means, the state’s approach hurts women in particular. As I argue below, it “immiserates” them. On these grounds, and on the grounds of conscience protection, the Church opposes the latest federal attempt to force citizens and institutions, including religious ones, to participate in its war against unintended pregnancy.
Women’s well-being suffers under a system operating according to the maxim “unprotected sex makes babies.” The Church predicted as far back as 1968 in the encyclical Humanae Vitae that such an ideology would lead to the devaluation of sexual intimacy and of women’s sexual dignity, in particular. For decades, and to the present day, a robust literature—economic, sociological, and psychiatric—indicates that the complete separation of the idea of sex from the idea of procreation does not in fact favor women’s preferences about sex, dating, or marriage.
Economists have pointed out how this leads to a market in which sex becomes the price women pay for even casual relationships with men; women are drawn into this market against their preferences, feeling they have no choice. This is the classic “prisoner's dilemma.” Women would be better off if they joined together to set their own terms, but instead, they are persuaded to make less than optimal decisions for themselves on a one-by-one basis.
It is no surprise, then, that the rates of every outcome harmful to women—uncommitted sexual encounters, sexually transmitted infections, nonmarital births, and abortion—have climbed precipitously during the decades that the federal government has escalated both public and private support for contraception. Yet the IOM report—a report on women’s health—makes no reference to this substantial body of literature. Americans are likely to support its conclusions generally. They assume, understandably, that widespread distribution of contraception successfully reduces pregnancy rates. Four decades of history and empirical data, however, demonstrate otherwise. Women’s reproductive lives are more, not less, outside their control in a sex and mating market dominated by the notion that it is not sex but “unprotected sex” that makes babies.
Even if its warning about women’s health goes unheeded, however, conscientious health care providers, especially religious ones, ought not to be forced to participate in HHS’s plan to heighten the profile of contraception in women’s health care. Catholic medical institutions are the largest providers of health care to women and men in the United States. Catholic employers serve vast numbers of poor and immigrant and other vulnerable populations. In fact, their social services, health care, and educational facilities regularly pick up the pieces of lives injured by the prevailing sexual marketplace, a marketplace that the federal government is preparing not only to affirm but to exacerbate. At the very least, religious entities ought not to be forced to become complicit in such a plan.
Helen Alvaré is associate professor at George Mason University School of Law and a senior fellow of the Witherspoon Institute.