8:29 PM, Feb 29, 2012
• By JOHN MCCORMACK
Democrats stormed the Senate floor today, warning that the Respect for Rights of Conscience Act, which is up for a vote on Thursday, would lead to employers and insurers denying all sorts of vital health care coverage--mammograms, blood transfusions, etc. Here's a memo being circulated around Capitol Hill that debunks the claims:
The Respect for Rights of Conscience Act (S. 1467, H.R. 1179), now proposed as Blunt amendment No. 1520 to the Transportation bill, has been subjected to irresponsible accusations that it would greatly expand the ability of employers and others to delete beneficial services from the health plans they now sponsor. Not only could Catholics be exempt from birth control, but Jehovah's Witnesses could exclude blood transfusions, Scientologists could reject psychiatric care, etc. Hence, runs the argument, the amendment is overbroad.
The Senate Democratic steering committee has even issued a preposterous claim that "20.4 million" women now receiving coverage for preventive services could lose that coverage under the Blunt amendment.
All these claims forget one simple fact. The Blunt amendment does not modify state or federal laws that are now in effect. It only amends the new mandated benefits provisions in Title I of the health care reform act of 2010 (PPACA), supplying the respect for religious beliefs and moral convictions that is already part of other federal health programs but is woefully missing from PPACA. And the mandated benefits lists of PPACA have not yet gone into effect. So it is impossible for the Blunt amendment to take away any coverage people have now.
Among the many laws affecting health coverage that will continue to have full effect after passage of the Blunt amendment: any state mandates (for contraceptives or anything else); Title VII of the Civil Rights Act of 1964, forbidding discrimination on the basis of race, color, religion, sex, or national origin in employment benefits; the Pregnancy Discrimination Act (made part of Title VII in 1979), requiring health plans to cover pregnancy, childbirth and related conditions; the Americans with Disabilities Act, prohibiting discriminatory withholding of health care and other benefits from people with HIV or other disabilities; the Mental Health Parity Act of 2008, requiring equitable coverage of mental illness; etc.; etc.
Regarding any health service one may be worried about, we need to ask one question:
Are people allowed to exclude this service from their health plan under current state or federal laws, or not?
If they are not allowed to exclude it, then they are still not allowed to do so under the Blunt amendment -- because that amendment does not affect any other state or federal law, only the future mandates of PPACA.
If they are allowed to exclude such a service, why haven't these critics been protesting before now? Probably because almost no one actually makes these exclusions, for a religious or any other reason. In any case, under PPACA as modified by the Blunt amendment, it will be more difficult to exclude such services than it is now - because they can be excluded only on the basis of a violation of religious or moral convictions. That will be a big change from the present situation, in which people can exclude these items for any reason or no reason. And under the Blunt amendment, even those who get a religious or moral exemption can be required to show that their health plan without this item is "actuarially equivalent," that is, has the same value as the same plan without that item. They will have to provide more generous coverage in one area, to make up for an exclusion in another.
So the Blunt amendment leaves all these situations alone, or makes them better. There is no situation in which, after PPACA and this amendment take effect, there will be broader freedom to make these exclusions than exists now.
There is an "overbroad" agenda at work in this debate that endangers many Americans' access to health coverage: The overbroad agenda of opposing religious diversity and rights of conscience in health care.
To cite just the HHS contraceptive mandate: That rule will force many, perhaps most, religious organizations (especially those that serve the general public) to choose between their religious convictions and their commitment to health coverage for employees. If they try to offer a plan without the objectionable services, they will be slapped with heavy financial penalties - perhaps greater penalties than if they offered no coverage at all - or the decision simply taken away from them by an insurer. Many may feel forced to discontinue their coverage altogether, pay the government's fine, and drop their employees on the individual market, where the employees may be unable to find a comparable plan that is within their means. So it is a failure to pass the Blunt amendment that will threaten women's and men's access to health care, at the same time that it threatens fundamental rights of conscience and religious freedom.
Remember the promise that if you like the plan you have now, you can keep it? Only the Blunt amendment, not its opponents, can claim to keep that promise.
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