A Call to Action on Health Care: Protect our Religious Freedom

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Congress and the new administration are devising policies that would be direct attacks on our religious freedom. The dangers come in the form of health care proposals that are inimical to the religious beliefs of many, as we detail below.  Should any one of these policies be implemented, it would be a direct attack on the religious freedom and values of Catholics and those of many other faiths.

Religious institutions are the backbone of health care delivery in our nation, and the health care system would collapse without them.  These institutions have long understood that the inherent dignity of every human person compels a just society to make necessary health care accessible for all.  They were providing health care, especially to the poor and most vulnerable, long before government programs were even created. 

But now, government is threatening to compel physicians, nurses, and pharmacists to provide, in the name of health care, services which violate their consciences.  This government coercion is a violation of the separation of church and state. 

By challenging the religious freedom of Americans, these proposals would undermine the foundational principle of freedom of religion upon which this nation was built. This country’s founders framed the Constitution on these freedoms, and they are explicitly protected by the First Amendment.  We urge all leaders to call these attacks what they are and to call on legislators and citizens to take action to defend religious freedom. 

In America, the family is the core of society where we teach our children about truth and morals.  Many of the initiatives that are being proposed would directly curtail the freedom of parents to direct the moral upbringing of their children, especially in matters pertaining to their sexuality.  This would be done by using the authority of the state to replace parental authority in guiding the health care of their children.

We call on all Americans to work together to defend our religious and parental freedoms because an attack by government on the liberty of one is an attack on the liberty of all.  No government has the right to force a citizen to directly violate his or her conscience or religious beliefs.  While one citizen may not agree with the religious beliefs of another, we all need to honor and protect each other’s fundamental right to hold and exercise these beliefs. 

We ask all Americans to join together to guard our precious Constitutional right to exercise our religious beliefs freely without government intrusion and coercion.



Many provisions in current law that protect life and religious freedom are being reviewed and could be reversed.  Some examples:

•    The Freedom of Choice Act would invalidate all state laws, including bans on partial-birth abortion, which have been enacted over the last several decades to protect the life of the unborn. 

•    Rules in the State Children’s Health Insurance Program (SCHIP) could be overturned which currently leave decisions regarding coverage of contraception and parental consent to the states.  Such decisions should be left to elected officials closest to the people and not pre-empted by the federal government.  

•    The Conscience Clause, which permits pharmacists, physicians, and other health care providers not to provide certain medical services for reasons of religion or conscience, could be overturned.

•    The Centers for Medicare and Medicaid Services (CMS) has included “conscience clause” protections in numerous family planning waivers which could simply be discontinued.

•    The Conscience Clause protection in the Oregon Medicaid waiver was added through administrative action and could simply be discontinued.

•    A Medicaid rule involving the Average Manufacturer’s Price (AMP) for pharmaceuticals restricts the types of providers that are eligible to receive lower-priced drugs.  The new administration and Congress want to extend the rule to cover university clinics and more Planned Parenthood facilities.  This would be a means of providing indirect subsidies to clinics, many of which provide abortion services.

•    The SCHIP regulation on the unborn child provides federal recognition of an unborn child as a person from the moment of conception. This regulation provides an important opportunity to states to expand prenatal care to unborn children and their mothers and presents a special opportunity to states to engage in the life debate.  In 2002, the ACLU said the proposed regulation “…would unnecessarily and dangerously undermine the foundation of the right to choose abortion …” Accordingly, the new Administration may seek to repeal this regulation.

•    Congress has blocked rules from going into effect that would impose restrictions on paying for administrative costs in school settings.  The new administration is likely to expand support for school-based clinics through sub-regulatory measures such as policy guidance, approval of state plan amendments, and discretion in enforcement.  Because administrative claiming is not restricted to a specific medical service to a specific child, it has been used to pay for administrative overhead, infrastructure, and outreach activities – which are indirect ways to support activities that cannot be directly funded. 

•    Medicaid coverage of the abortion pill, RU-486, is restricted because of the Hyde Amendment limitations in 2001 that prohibit federal taxpayer dollars from being spent on abortion.  This protection could be altered or rescinded through a policy guidance letter that the new administration could issue.

•    The Medicaid statute requires the federal government to pay 90 percent of the cost of family planning services.  The Bush administration narrowed the list of services that could be claimed as family planning services, but a new administration could expand the definition.

Future Areas to Watch

•    Congress likely will attempt to reinstate family planning as a mandatory benefit in Medicaid.

•    Medicaid managed care regulations provide protection for health plans to not refer patients for abortion services (counseling and referral).  The new administration will likely seek to amend the regulation.

•    Conditions of Participation (CoP) apply to hospitals, physicians, nursing homes and other providers, stipulating the requirements that they must adhere to in order to receive federal funds.  Medicare Conditions of Participation and various payment rules regarding “end-of-life” issues could be amended in a manner that would erode protections of the elderly and disabled.

•    The new national health plan that President-elect Obama has proposed will likely seek to mandate coverage of contraceptives with language that requires counseling and referral for abortion. 

•    Faith-based plans that are available in the Federal Employees’ Health Benefits Program likely would be eliminated.

•    Abortion training could be required in medical schools to ensure ongoing federal funding and accreditation (including through Medicare CoP).

•    Back-door government rationing of care through various means is a real threat, including directing a government bureaucracy to study and implement medical “effectiveness” and make reimbursement for medical professionals contingent on compliance.