When Central New York Catholics left church last Sunday, many took along a letter from Bishop Robert J. Cunningham that threatened to do something unprecedented for the Roman Catholic Diocese of Syracuse.
Cunningham said the Syracuse Diocese would defy the federal government — refusing to comply with a mandate that all employers, including church-affiliated organizations, include coverage for birth control in their health insurance plans.
“We cannot — we will not — comply with this unjust law,” Cunningham wrote to parishioners. The Catholic Church says all forms of artificial birth control are against its teachings.
He said the church will be “compelled either to violate our consciences, or to drop health coverage for our employees (and suffer the penalties for doing so).”
With the letter, the bishop thrust Central New York into the middle of a national debate about religious freedom and the limits to federal authority to pass laws that give all citizens access to basic health care.
The controversy stems from a Jan. 20 decision by President Barack Obama’s administration that requires all health insurance providers to cover birth control as a preventive service, covering the full cost of contraceptives without co-pays or deductibles for the patient.
The U.S. Department of Health and Human Services exempted churches and other institutions that employ and serve people with the same religious beliefs. So the new federal rules do not apply to the church itself.
But the ruling does not exempt church-affiliated organizations that employ or serve people from a wide range of beliefs.
In Central New York, that means Catholic Charities, St. Joseph’s Hospital Health Center and Le Moyne College, a Jesuit school, will likely have to offer birth-control services on employee health insurance plans.
Federal officials and supporters say Catholic leaders are exaggerating the impact, that the federal law for the most part matches existing New York law.
And, supporters say, the Catholic groups are overlooking the harmful health effects of unplanned pregnancies and births.
The ruling gave church-related institutions an extra year to comply, until Aug. 1, 2013.
Federal officials said exemptions to the mandate will be decided on a case-by-case basis. Otherwise, the law takes effect Aug. 1 for all other employers.
Cunningham, in an interview, said the mandate will likely affect most of the 1,487 people the Syracuse Diocese employs across seven counties in Upstate New York.
He said the policy violates the church’s First Amendment protections for religious freedom.
“It goes against our conscience,” Cunningham said. “It’s wrong. Obviously we believe these services which are offered could all be something that is not in accordance with the teaching of the church. So we don’t wish to cooperate with that.”
Cunningham spoke Wednesday with U.S. Rep. Ann Marie Buerkle, R-Onondaga Hill, who offered to sponsor a House bill to repeal the mandate.
Buerkle said she offered to work with Sen. Marco Rubio, R-Fla., who proposed a similar bill in the Senate. Buerkle, a critic of Obama’s health care law, said the new mandate on birth control should concern all Americans.
“This issue is not just a Catholic Church issue,” she said. “This is really a war on all religions. If they can make this rule with the Catholic Church, all religions should be very concerned about this.”
Buerkle added, “This is the government saying, ‘Set your beliefs aside, and we know what is best for you.’ It has a chilling effect on all religions. It’s an overreach of the federal government. And it’s a dangerous precedent.”
Any legislation will likely have a tough time passing through Congress, especially in the Democratic-controlled Senate where the expansion of women’s health care has strong support.
Among those supporting the new federal mandate is U.S. Sen. Kirsten Gillibrand, who said in a statement, “The use of birth control is a personal decision that should not be affected by your workplace. It should be up to a woman and her family to decide to use it or not, not her boss.”
Cunningham’s letter was inserted into Syracuse-area church bulletins last Sunday and distributed via email to 133 parishes.
It was intended to reach the 274,500 Catholics living in the Syracuse Diocese, whom the bishop encouraged to contact Congress.
The letter is similar to those distributed by the U.S. Conference of Catholic Bishops, which has lobbied against the birth-control mandate since it was proposed in August.
Among those leading the opposition is Cardinal-designate Timothy Dolan, of New York City, president of the U.S. Conference of Catholic Bishops.
He met with Obama in November.
It was widely reported after the meeting that Dolan left with the understanding that the church would not have to adopt the new policies.
Federal officials emphasize that a panel of doctors and scientists from the Independent Institute of Medicine made the decision to include birth control as one of nine areas of women’s preventive health care that should be covered by insurance with no co-pays or deductibles.
HHS Secretary Kathleen Sebelius said scientists “have abundant evidence that birth control has significant health benefits for women and their families.”
She said birth control, the most commonly taken drug in America by young and middle-aged women, is also documented to significantly reduce health costs.
The letter from the bishops suggested that Catholic employers could be forced to provide insurance that includes health coverage for sterilization and abortion-inducing drugs.
Erin Shields, speaking for the U.S. Department of Health and Human Services, said no drugs that cause abortion, such as RU-486, or abortion-related services would have to be covered.
Only FDA-approved drugs to prevent fertilization, such as emergency contraceptives Plan B and Ella (sometimes called morning-after pills) would be offered on the health insurance plans.
Federal officials also argue that the new mandate is not much different than those already in place in 28 states, including New York.
“Similar regulations exist in multiple states that have had contraception coverage laws for over a decade,” Shields said. “And this final rule will have no impact on the protections that existing conscience laws and regulations have given to health care providers for more than three decades.”
Indeed, New York passed the Women’s Health and Wellness Act in 2002, requiring health plans to cover contraception and other services aimed at women, including mammography, cervical cancer screenings and bone density exams.
The New York law, which has its own religious exemption, was upheld after several court challenges.
In 2007, the U.S. Supreme Court declined to hear the case. At the time, church-related institutions were considering whether to drop prescription drug benefits as a way to circumvent the law.
The Syracuse diocese and its related schools and charities are also exempt from the New York law because the diocese uses self-insurance for its prescription drug coverage, said Danielle Cummings, speaking for the Diocese.
But Cummings said the federal mandate has no similar exemption for the self-insured.
Le Moyne College was among the Jesuit institutions that decided to comply with the New York law in 2003.
About 300 faculty and staff, as well about 2,500 full-time students, are eligible for birth control and contraceptive prescription drug coverage.
Birth control is provided free to employees and students through the insurance, as required by the state law, said Jack Matson, the college’s associate vice president of human resources.
“We are in compliance with the law, and our intention is to continue complying with the law,” Matson said, noting the college does not distribute condoms as part of its health service.
Officials at St. Joseph’s Hospital Health Center were not available to comment about the federal mandate or what services the hospital covers.
Michael Melara, executive director of Catholic Charities of Onondaga County, said his organization’s 250 employees receive their health insurance through the Syracuse diocese.
So those workers don’t get birth-control coverage.
The bishops are raising the issue as a series of polls have shown most Catholics in the United States support the use of contraception.
A poll of Catholic women last year found 98 percent had used a form of birth control banned by the Vatican, according to the Guttmacher Institute, a research group that advocates for reproductive rights.
A Le Moyne College/Zogby International national poll in 2007 found 67 percent of American Catholics disagree with the church teaching that artificial birth control is wrong.
The Catholic Church has also run into opposition on the issue from groups who support religious freedom, women’s health care and abortion rights.
Lynda Fuchs, of the Syracuse-area affiliate of the Religious Coalition for Reproductive Choice, said Cunningham and other Catholic leaders are making an old argument about religious freedom.
“I respect the Catholic Church’s right to preach to other Catholics about contraception.
"However, we are not all Catholics,” Fuchs said. “For example, Catholic Charities and other Catholic-affiliated institutions do serve and employ people from a diverse number of religious groups.”
Fuchs, part of a national organization that represents more than 40 denominations and faith groups who support the mandate, said the rule is a victory for women and families from all religious faiths.
“We all are always free to practice our conscience,” she said. “I guess I would tell the bishop this is the price of living in a democracy.”
More than 60 religious leaders sent a December letter to Obama to support the Catholic Church on the issue.
The supporters are mainly from evangelical and Orthodox Jewish groups.
Cunningham said he and other Catholic leaders believe that people of all faiths will join them in seeking the law’s repeal.
“It’s a sensitive issue, and we certainly think while we’re not imposing our teaching on others, we’re trying to uphold our own teachings and our own conscience rights,” Cunningham said.
“We don’t think this is a mandate that is a victory for freedom,” the bishop said. “They are trying to coerce us into a behavior that we find objectionable. And we should be able to heal and help people of any religion.”