[Congressional Record Volume 158, Number 21 (Wednesday, February 8, 2012)]
[House]
[Pages H625-H629]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
CONTRACEPTION
The SPEAKER pro tempore. Under the Speaker's announced policy of
January 5, 2011, the gentlewoman from New York (Mrs. Lowey) will
control the remainder of the hour.
Mrs. LOWEY. Mr. Speaker, some decisions are just too important to be
based on fear of political repercussions. That is why it is gratifying
that President Obama heeded the advice of the Institute of Medicine and
concluded that given its importance to women's health, contraception
should be covered by health insurance as a free, preventative service
for all American women.
To accommodate religious institutions, the administration
appropriately exempted places of worship from requirements to cover
contraceptives in their health plans. The rule strikes a delicate
balance respecting the rights of both religions ideologically opposed
to birth control and American women.
Let me be clear: No one will be required to use contraceptives. The
rule simply allows women to exercise their own conscience when it comes
to their health, and the vast majority of American women already do.
It would be a grave mistake to make it more difficult to access
medically recommended services for the 99 percent of all women who have
used contraception in their lifetime.
The administration was absolutely right to stand up for women's
health by protecting access to contraception.
I yield to Congresswoman Slaughter from New York.
Ms. SLAUGHTER. I thank the gentlelady for yielding.
Mr. Speaker, I want to commend President Obama and Health and Human
Secretary Sebelius for including contraception as a preventive service
that health insurance plans are required to cover at no cost.
This decision, based on the recommendation of the Institute of
Medicine, is the right decision for women. It affirms the individual
freedom of women to make choices about their health and their future.
Following the administration's decision, there has been an uproar
from the religious community. While some claim it is in violation of
First Amendment rights, the simple truth is that this decision upholds
the First Amendment rights of millions of women to not have their
reproductive health managed by religiously affiliated organizations who
may not share their own beliefs.
This decision stands up for women's freedom, as it is a woman's right
to decide when and how she wants to have a family, whether or not she
chooses to use birth control, as 98 percent of Catholics do. If she
subscribes to a religion that teaches against the use of birth control,
then she is free to choose not to use it either.
[[Page H626]]
If she would rather use birth control for the many health protections
and benefits that it provides, such as the fibroid tumors, migraine
headaches, and bleeding that cannot be controlled, she should also be
free to do so. Either way, the choice should belong to her and to her
alone.
It is also important to note the details of the administration's
decision.
We're not talking about churches or organizations that exist for the
sole purpose of teaching their religion.
{time} 1750
These organizations are totally exempt from providing coverage for
contraception.
What we are talking about is religiously affiliated organizations,
such as hospitals, schools and universities. Millions of women are
employed by these types of organizations, and those women do not
necessarily share the beliefs of their employers. In fact, I think one
of the most egregious things felt by many women is that whatever their
own religions teach, they are not going to be allowed to go by that.
Catholic hospitals can and do--and we want them to--employ Baptists,
Methodists, Protestants, Muslims, Jews, Buddhists, agnostics, and
atheists. Teachers, cafeteria workers, administrative staff members at
religious schools and universities are not necessarily members of that
religion. Those employers should not have the right to decide whether
or not the women on their insurance plans can access birth control.
They still have separation of church and state.
Many religions that teach against the use of birth control also teach
against divorce, but institutions affiliated with those religions are
not allowed to discriminate against employees based on their marital
status. They do not have an exemption from labor laws because of their
religious beliefs. This is no different.
A recent decision by the administration shows that they are standing
with women and supporting their freedom to make the choices that impact
themselves and their families. Surveys have repeatedly shown that women
and men across this country support providing access to contraception
at no cost and that that support is equally strong among members of the
very religious who are fighting this decision.
I applaud the President and Secretary Sebelius for supporting the
health and freedom of women, and I support their decision to put
women's personal health and freedom first.
I yield to the gentleman from Illinois.
Mr. QUIGLEY. Mr. Speaker, when it comes to religious exemptions, a
balance must be struck. The rights of religious followers must be
protected while also respecting the beliefs of others who may be
impacted by a religious exemption.
Take, for example, a Catholic university where Jews, Hindus, Muslims,
and non-religious followers work. Should these individuals be denied
access to contraception even though their faiths do not oppose it?
If we expand the religious exemption too far and allow religiously
affiliated institutions to deny contraception to their employees
regardless of their religious beliefs, we begin to see the beliefs and
rights of those who support and require contraception infringed upon.
As policymakers, we have to stand up for the rights of all of our
constituents regardless of their faiths. This means making policies
that walk the line between protecting the rights of primarily religious
institutions while also protecting the rights of individuals employed
by religiously affiliated institutions. The administration's exemption
strikes that balance.
I yield to the gentlewoman from California.
Mrs. DAVIS of California. Mr. Speaker, I rise to applaud the final
ruling issued by the Department of Health and Human Services to include
birth control at no cost.
The pill changed the world. As some have said, it was one small pill,
but one giant leap for womankind. It improved women's health. It
reduced infant mortality. It increased a woman's earning potential. It
empowered families to chart their own courses. Yet, currently, one in
three American women struggles to afford birth control. A woman's right
to decide when to start a family is meaningless if she does not have
the means to make a choice. All of these benefits could be denied
because of a relatively small amount of money, and that is simply
unacceptable.
I am pleased that we are living up to the promises made in the
Affordable Care Act, and I urge my colleagues to join me in protecting
and increasing access to health care for every woman in America.
I yield to the gentlewoman from New York.
Mrs. MALONEY. Thank you.
I rise in support of the President's action and Secretary Sebelius'
action in the Department of Health and Human Services to allow the
birth control benefit for working women across this country.
This birth control benefit increases access to preventative health
care while respecting religious freedom. This is accepted practice in
28 States--28 States that require insurers that cover prescription
drugs to provide coverage of the full range of FDA-approved
contraception drugs.
Taking this benefit away would be devastating for millions of
workers. Women's access to care is absolutely on the line, and they
have turned it into a religious versus reproductive freedom debate.
Birth control is medication prescribed for women's health, plain and
simple. It is not radical. As I said, 28 States already supply it, and
roughly 99 percent of women use birth control at some point in their
lives; but the only way they can use it is if they can get it, so the
right to choose is absolutely meaningless without the means and access
to choice.
The President's thoughtful decision allows insurance companies to
cover contraceptives. It does not in any way interfere with one's
religious beliefs or the beliefs of the church. It does not force
anyone to use them, and it certainly does not require anyone--churches
or anyone else--to cover them. Yet, if it is a university, if it is a
major employer that is employing many people and not people of one
faith but of many different faiths, then it is required to follow the
law of this country.
So let's end this assault on women's health, and let's listen to the
millions of Americans who rely on birth control each and every day.
It's important for their health, and I applaud the President and
Secretary Sebelius.
I yield to the great Congresswoman from the great State of
California.
Ms. LEE of California. I want to thank the gentlelady for yielding
and also for standing up for women's health, not only today and during
these very difficult times, but each and every day of her life.
As a former devout practicing Catholic, I fully understand and
respect the Church's doctrine on contraceptives. Even though I disagree
with it, I fully respect it and I understand it. Also, I know that the
separation of church and state is a fundamental principle that we must
maintain.
Mr. Speaker, the administration's decision to provide choices to
access quality, affordable health care, family planning services,
including contraceptives, are vital for women's health and well-being.
This is really not about a mandate. The rule would not force anyone
with a religious objection to use or prescribe FDA-approved
contraception. The fact is that Catholic bishops know that the 335,000
religious institutions and organizations and churches and places of
worship are exempt. In fact, no woman will be required to use
contraceptives or to even access contraceptives if she does not want to
do that. This ruling is about women making their own decisions as to
whether to use contraceptives or not. It's about access.
Religion must not force discrimination and discriminatory policies
against, for example, an employee who works in the cafeteria of a
hospital who chooses to plan her family. She should not be denied this
coverage because of where she works. Low-income women finally--
finally--will have equal access to contraceptive services if they
choose.
So we want to make sure tonight that the facts are presented
appropriately. Yes, we've witnessed this war against women
systematically come against women's health for the last year now, and
it's about time we start really being truthful to the public and
[[Page H627]]
get the facts out there and not allow the misinformation to really put
women, once again, in a position of not having access to contraceptive
care.
{time} 1800
So I believe that this decision was right. I know that it allows for
religious exemptions. And this rule should now allow for employees, for
nurses, for health care workers to access contraception when they want
to, and if they choose not to. They don't have to. But we should not
allow discrimination to take place anymore.
I yield now to the gentlelady from California, Congresswoman Lois
Capps.
Mrs. CAPPS. I thank my colleague, Barbara Lee from California, for
yielding to me. And I also want to thank our colleague from New York,
Nita Lowey, for her leadership in organizing this opportunity for us to
speak, to speak with one voice, we who are Members of Congress, women
Members of Congress. And speaking for myself, some of us are mothers,
are grandmothers. And my career in public health greatly informs what
I'm about to say.
Mr. Speaker, I rise today in support of the Obama administration's
decision to include contraception in their very, very important list of
preventive services which will make women's health care more
affordable. Let us be clear: This was not a political decision on the
part of the administration, on the part of our President, nor was it
intended to attack any religious institution. It was a decision based
on extensive science and the expert recommendations made by these
scientists with the goal in mind of keeping women and their children
healthy.
However, a great deal of misinformation has been spread about this
rule, and some have decided to, again, use women's health as a
political football. But the truth is that this issue is not as divisive
as many would like it to be. Almost all women use a form of an FDA-
approved birth control at one point or another in their lifetime. This
includes 98 percent of Catholic women as well. And most Americans, men
and women, believe that women--not their bosses--that women should have
the choice of which health care services they can and want to access.
But, you know, some would have us believe that the administration's
rule is in some way radical. It is not. Twenty-eight States already
require the coverage of contraception in their insurance plans, and the
new Federal standard is based on the one that has worked in my home
State of California for many years. It has done so without any
religious hospitals dropping coverage or firing employees. It's worked
perfectly well. The administration now has made the right call, and I
speak on behalf of women in this country urging the administration to
stay the course.
Now it is my honor and pleasure to yield to our colleague from
Maryland, Donna Edwards, a very appropriate person to speak on this
topic.
Ms. EDWARDS. I thank the gentlelady for yielding.
Mr. Speaker, I just want to express my support for the
administration's ruling that provides women and families across this
country, no matter their faith, the opportunity to take control of
their own reproductive health and to gain access to contraceptive
services.
The opposition we are hearing--although very vocal, from very few
voices--does not adequately reflect the voices of the millions of women
across this country who rely on contraception.
Mr. Speaker, 99 percent of women in the United States and 98 percent
of Catholic women already use birth control; and it's estimated that,
on average, women use birth control for 30 years. Polls conducted
across the country over the last week also have found that more than
half of the United States population believes that employers should
provide health care plans that cover contraception and birth control at
no cost.
Unfortunately, over the last week, since the administration's ruling,
I believe religious leaders have misinterpreted and misled the American
people on the rule's implications. The exemption in the ruling actually
very carefully protects the rights of churches and church associations.
The administration justly limits the exemption of institutions whose
main purpose is for spreading religion and employ and serve people of
the same faith. Clearly, the opposition doesn't express this. Extending
this exemption beyond these churches to other religious institutions
would directly undermine the intent of the health care reform law for
the more than 640,000 individuals employed, in particular, by Catholic
hospitals.
And let's be clear: Contrary to what some have said, this ruling has
absolutely nothing to do with abortion. In fact, the ruling will save
women up to $600 per year and keep their employers from absorbing a 15
to 17 percent increase in health care costs simply not to provide women
with contraceptive coverage.
Women and families across the country deserve the option to receive
comprehensive contraception coverage if they desire. The rule doesn't
prescribe contraception to women. If a woman chooses to exercise her
faith and not use contraception, she's free to do so under this ruling.
However, limiting access to contraception to any subset of the
population would be a direct affront to the scientific and medical
recommendations of the Institute of Medicine.
Catholic institutions are in an untenable position. After all, where
is it that we would draw the line? Should those institutions exercise
their role as employers rather than their role in their faith
tradition? I would argue that of course this is about their role as an
employer.
What, for example, would the government do if these institutions also
believed that they should exempt themselves from paying payroll taxes
because they believe that under their faith tradition people's
responsibility is to tithe instead? Would we allow them to self-exempt
from payroll taxes? I don't think so.
Contraception and maternal health is all a part of a woman's
comprehensive health care, just like breast exams, screenings, and
well-woman visits. Fifty percent of pregnancies in this country are
unplanned, and it's widely understood that these unplanned pregnancies
are not as healthy as planned pregnancies. This can cost taxpayers up
to $11 billion a year. And at a time when the other side is slashing
budgets and proposing reforms to shift costs to States, this ruling is
about as smart as we get for our health care system, for women and
families, for babies, and for American taxpayers.
Making certain women and families have the opportunity to plan
pregnancy is critical for our society. The administration's ruling
protects women, families, and babies, eliminates discrimination of one
group of women over another, and it's important for us. The ruling
respects the religious beliefs and freedoms of all Americans and health
care providers while it ensures that women have the full option to
pursue contraception.
I stand with my colleagues in support of the administration's rule
and look forward to working to expand health care coverage and women's
health care coverage.
At this time, I would like to yield to my colleague from Connecticut,
the Honorable Rosa DeLauro, who is a true leader for women's health
care, and I appreciate her leadership.
Ms. DeLAURO. As both a Catholic and an advocate of women's health, I
believe that these guidelines strike the necessary balance between
increasing access to health care services for women while respecting
the religious beliefs of all Americans.
These guidelines are based on recommendations from the Institute of
Medicine, a nonprofit, independent organization that is grounded and
rooted in science. They have recommended that women have access to a
wide range of services, such as screening and counseling for domestic
violence, that pregnant women have access to services such as a
screening for gestational diabetes, that women have access to at least
one well-woman preventive care visit a year, and that all women have
access to a range of contraceptive services, counseling, and methods.
Let me be clear: The Catholic Church and its employees are exempt
from these guidelines. They apply only to church institutions that
serve the larger community, employ people of different faiths on a
nonreligious basis, and do not meet the clear requirements for a
religious exemption. There are thousands of non-Catholics who work
[[Page H628]]
in Catholic hospitals and in Catholic universities.
Improved access to birth control is directly linked to declines in
maternal and infant mortality and helps to reduce unintended
pregnancies.
{time} 1810
That is why 28 States, including Connecticut, already mandate the
coverage of contraceptive service and why many private employers
already cover these services.
I'm proud to support what I believe to be a moral decision by the
administration and a well-drafted compromise that maintains the
existing Federal conscience protections and at the same time allows
women access to contraceptive service and other preventive health care
services without mandating in terms of contraceptive services that one
use it or be required to dispense it.
I would like now to yield to my colleague from Washington, DC, the
Honorable Eleanor Holmes Norton.
Ms. NORTON. I thank the gentlelady for yielding. And I think, Mr.
Speaker, in the next several days and weeks you're going to see people
come forward to speak up for the silent majority in this controversy
about contraception and what institutions should and should not
provide. Whoever has been a silent majority, today it is the women of
America, particularly women who may happen to work for Catholic
hospitals, for a Catholic university as I did, for example, when as a
Protestant I worked as a tenured professor of law at Georgetown
University here in Washington, DC.
The Catholic Church has long accepted the laws against discrimination
except as to the Church itself and the Church's own activities. And so
you'll find in a Catholic hospital or Catholic university you must hire
people regardless of their race or religion and the like.
Now, the Church seems to be seeking a different rule on how you
accommodate religion. We have accommodated the Catholic Church when it
comes to hiring its own employees, for example. And the administration
has accommodated the Catholic Church when it comes to the provision of
contraceptives for its own church employees.
However, there are hundreds of thousands of women and men who work
for hospitals, for universities, and other institutions that hold
themselves out as nondiscriminatory and as accepting all people. For
that reason the Church, of course, qualifies for Federal funds because
it is accepted, as acting as a public institution in the place of a
public institution.
We have a long and treasured history, Mr. Speaker, of religious
accommodation. When I chaired the Equal Employment Opportunity
Commission, I recall the many cases in which we tried to err on the
side of religious accommodation, but the accommodation must never be so
broad as to trample on the rights of others. To accommodate the
institution and not accommodate the people whose conscience is being
trampled, of course, is precisely what the Constitution does not allow.
A broad accommodation to the Church that would relieve it of offering
a health care service that is essential would penalize the rights of
thousands of non-Catholics. So whatever the right of the Church is, it
does not have the right to trample on the rights of others. That's how
accommodation works.
The administration's own exemption is patterned on identical
religious exemptions that have been tested in the courts and found to
be constitutional.
I think the administration was looking at two things when it
fashioned a very, very generous exemption for the Church in the health
care law. First, it was looking for what was necessary to do as vital
to the health care of women, but it was also looking to what was
constitutional.
Mr. Speaker, if I may say so, I believe the broad exemption which the
Catholic Church seeks which would penalize the rights of thousands of
women who work for catholic-affiliated institutions who are not
Catholic who do not share their views, whether or not they are
Catholic, on this issue, if such an exemption were to be granted, then
the administration, it seems to me, would find itself engaging in an
unconstitutional exemption.
The administration has accommodated the Church. It has fulfilled its
obligation to see to it that women have a vital health care service,
and it has prevented an unconstitutional violation.
I am pleased to yield now to the gentleman from New York.
Mr. NADLER. I thank the gentlelady for yielding, and I thank her for
her excellent exposition as to the law and the constitutionality, with
which I am in full agreement.
As we all know, the administration recently announced that a popular
and critically important component of the health care reform law would
guarantee that most women have access to contraceptives paid for by
their health insurance. This decision was based on the sound science of
the impartial and independent Institute of Medicine, which recognized
that contraceptives are an essential health service fundamental to
improving the lives of women and their families.
This decision is a major victory for women. Eighty-nine percent of
American women, including a similar percentage of Catholic women, use
contraceptives at some point in their lives. Particularly at this time
of economic uncertainty, women will have one less cost to worry about
that can be a substantial cost. Make no mistake about it, freeing up
$600 or $800 a year will have significant effects on working families.
The decision also recognizes and supports religious freedom by
providing certain limited exemptions for places of worship, as well as
for those organization that hire and predominantly care for those who
share the same religious beliefs. They were protected against being
required to violate their religious teachings.
I am proud to stand shoulder to shoulder with President Obama and his
administration for helping to strike this important balance between
religious rights and the rights of women to protect their health.
Yet to hear some people talk about this decision, you'd have no idea
that the religious organizations and the religiously devout have their
liberties protected. Amid all the hyperbole, the truth is that the
administration's decision, while significant and important, is hardly
new. This measured approach that balances religious rights on the one
hand and the rights of women on the other is already the standard in 28
States, including my home State of New York.
Because it is not just employers and corporations that have rights at
stake, hardworking people and their families also have rights.
Under the approach adopted by the administration, universities and
hospitals which serve and employ people from a multitude of faiths and
cultures are not exempt from the requirement that health insurance
provide coverage for contraceptives, nor should they be. Women should
not be denied a basic health service merely because they work or study
at a university or hospital affiliated with a religious organization.
The difference here is that churches are and should be protected in
their religious role, protected against having to violate their
religious views, but they must not be protected in their role as
employers. We permit a church, for example, to discriminate in
religious practice. No one asks the Catholic Church how come you do not
permit women priests? That's their business.
But we do not permit them to discriminate as employers. We do not
permit a church-affiliated hospital or university to say we will not
permit the hiring of female doctors or female professors or black
doctors or nurses because that would impinge on liberty. If a church
has a doctrine against hiring female priests, that's fine. But hiring
female professors in the university, unless it was a solely
ecclesiastical university, only for religious purposes, if it is a
regular university, then they cannot be permitted to have that kind of
discrimination.
We protect religious liberty, but we cannot permit a church to impose
its views on others who may not share those views.
{time} 1820
The church can preach its views, it can seek to persuade people, but
it cannot coerce people who may work for a church-affiliated university
or hospital that they cannot use contraceptives if they want to. The
liberty here is the
[[Page H629]]
liberty of the employee that must be protected. The liberty of the
church must be protected in its churchly function and in its function
as a religious institution. In its function as an employer, the liberty
belongs to the employees. And that is the distinction that is made
here. It is the proper distinction.
Imagine if some other church that thinks that it is wrong to give
transfusions to people, blood transfusions, ran a hospital. We would
not permit them to let people die in that hospital for lack of
transfusions because it's not up to them to decide medical practice by
their religious doctrine. If the person wants to refuse treatment
because his religious doctrine says, I don't want a transfusion, that's
his liberty. But we must not confuse the religious liberty of the
church to propagate its views and to conduct its religious affairs as
it sees fit with the liberty of employees in a secular institution
affiliated with the church to have the normal protections against
discrimination and the normal rights that we afford all people.
That is why the administration's decision to say that contraceptives
are scientifically a necessary health care service which must be
provided by health insurance is right, and any attempt by a religious
institution to say that they should be exempt from having employees
allowed to get contraceptives paid for is wrong, and I applaud the
administration for making the proper distinction to protect the liberty
of the employees and the religious liberty of the church both.
I yield to the distinguished gentleman from New Jersey.
Mr. HOLT. I thank my friend from New York.
This is an important subject. As previous speakers have made clear,
birth control is fundamental to women's health, just like cholesterol
testing and any number of other things. And decades of evidence show
that planned births produce healthier babies and healthier mothers.
Anyone who is working as a health care aide or a nurse or working in a
religiously affiliated social service agency would want health care
provided to them that is not discriminatory, and that includes the
range of services that provide for good health.
Purely religious organizations would be, are, have been and will be
exempt. But when an institution, even if affiliated with religion,
chooses to provide public services and accept public money, they must
follow public fair employment practices and not discriminate in hiring
or salary or benefits. And now, under the Affordable Care Act, they
also may not discriminate against women and women's services in
providing health care benefits.
That's what we're talking about here. It's really quite
straightforward. Expanding the religious exemption to religious
institutions that employ people of all faiths would take preventive
services away from millions of Americans, would result in substandard
health care for far too many women in our country, and it would allow
religious institutions to be able to discriminate against employees of
different faiths.
It's only fair. It's only what has become recognized by the courts,
by the public, and by general public mores as the right thing to do.
And now under the health care act, it would be institutionalized for
all agencies except purely religious agencies that hire only in one
faith.
So, Mr. Speaker, I think there's been a lot of misinformation about
this. I hope tonight's discussion has helped to clarify the matter.
With that, I am pleased to yield back to my friend from New York.
Mrs. LOWEY. I thank my colleague from New Jersey.
In conclusion, I want to emphasize, again, that the Institute of
Medicine found that contraceptives save lives. There are numerous
studies that have shown that contraceptives lower the risk of
developing ovarian cancer, help prevent unintended pregnancies, improve
outcomes for children, and reduce abortions. So, my friends, it's hard
to believe that in the year 2012, we are having a debate about whether
or not insurance plans should cover contraceptives.
Let's remember that for many women in this country, of the 98 percent
of women that are using contraception at some point in their lives,
let's remember that for many women, $1,000 a year is money that they
can't afford. So let's support the administrative position recommended
by the Institute of Medicine.
Mr. Speaker, I yield back the balance of my time.
____________________