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Prominent Catholic groups are once again are finding themselves on opposite sides of a key issue which came out of the Affordable Care Act. Three years ago, the Catholic Health Association backed that health law, even as the U.S. Conference of Catholic Bishops opposed it. Now the groups are divided again, this time over the law's requirement that most employer health insurance plans provide women with birth control.
As NPR's Julie Rovner finds, this fight may be different.
JULIE ROVNER, BYLINE: Sister Carol Keehan, head of the Catholic Health Association, said the administration's final birth control rule wasn't what her organization would have preferred for the hospitals and other health facilities it oversees.
SISTER CAROL KEEHAN: But it was a solution that we could make work, because it allows our members not to have to buy, contract for, refer or arrange for contraceptive services.
ROVNER: Under the rule, churches and other houses of worship are exempt. Women who work for Catholic or other religious hospitals, universities and social service agencies will still get the no-cost birth control, but the religious entity won't have to be involved in providing it. The insurance company or insurance administrator will instead.
But while that's good enough for Keehan, it's not good enough for the U.S. Conference of Catholic Bishops. Last week, it hosted what it called a religious liberty press conference with representatives of several other faith groups to decry the rules.
Archbishop William Lori read from the letter the group sent to Congress and the Obama administration urging their overturn.
ARCHBISHOP WILLIAM LORI: We stand united in protest to this mandate, recognizing the encroachment on the conscience of our fellow citizens.
ROVNER: Lori said later in the news conference that if women want to have birth control as part of their health insurance plans, they shouldn't go to work for religious employers.
LORI: And I think those employers are pretty upfront about that right at the beginning. And so it's always a person's choice, whether he or she wants to sign on to such a thing.
ROVNER: That outrages people like James Salt. He's executive director of Catholics United, a liberal Catholic group.
JAMES SALT: The bishops have staked out a fairly extreme position which we refer to as the Taco Bell exemption. And they want every Taco Bell in America to be exempted from this mandate.
ROVNER: Not Taco Bell, actually. He means any for-profit company headed by someone with a religious objection to the mandate.
SALT: They want those for-profit entities to have the right to exempt themselves.
ROVNER: But unlike the fight over passage of the health law in 2010, when Keehan said it didn't provide new federal funding for abortion and the bishops said it did, both sides are trying to play down this split. The bishops noted that the Catholic Health Association had informed them of its decision before going public, and Keehan said she understands that the bishops have a larger agenda to pursue than she does.
KEEHAN: The religious freedom questions that they are focused on now, that is a much bigger question.
ROVNER: And the Catholic Health Association's endorsement of the rules wasn't really much of a surprise, particularly given its longstanding support of the law.
Mark Rienzi is senior counsel with the Becket Fund, which is representing many of those suing over the rules.
MARK RIENZI: The CHA thinks it's OK, and God bless them. It's a free country. They're allowed to do that. Other people don't think it's OK, and that's why there are 60-some lawsuits out there that are out there and will continue.
ROVNER: In fact, one thing that just about everyone agrees on, says Rienzi, is that this is an issue likely to be resolved only when it gets to the Supreme Court.
RIENZI: Maybe the administration will back down, but they've shown no signs of it yet. So I think the bottom line is the relief will have to be through the courts, where it's been for all the businesses. And the fact of the matter is the businesses are doing outstandingly well.
ROVNER: By that he means that many of the for-profit firms that have sued have at least had the birth control mandate put on hold while their cases are heard. But like the health law itself, this issue still has a long way to play out.
Julie Rovner, NPR News, Washington.
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