After oral arguments over the constitutionality of federal healthcare reform but before the Supreme Court announces its decision, it's difficult to recall all the details of the Catholic Church's opposition to the federal rule on health insurance coverage. Something about religious freedom versus women's reproductive rights? How did that go again?
Last we heard, the United States Conference of Catholic Bishops had rejected President Obama's accommodation for Catholic institutions like hospitals and colleges, the one that effectively relieved them from paying for employee healthcare coverage that included contraception by putting the insurance companies on the hook for contraception coverage. The bishops reasoned that even the compromise infringed on the conscience of the Catholic Church.
Disappointing news for supporters of the Affordable Care Act, but not surprising. Catholic teaching does, after all, prohibit knowingly giving assistance to people involved in activities it considers morally objectionable procuring birth control, in this case.
So, assuming the Supreme Court doesn't throw out the entire legislation, where are the White House and the Catholic Church to go from here?
The answer may lie west, in the fine print that enabled Catholic Healthcare West to become Dignity Health.
In January 2012 (about three weeks before the Conference of Bishops rejected the compromise), the San Francisco-based nonprofit underwent a major restructuring to position the organization to succeed in a changing health care environment, since its growth plans anticipate expanded partnerships, which will include both Catholic and non-Catholic care centers.
In other words, because federal healthcare reform stands to make safety-net hospitals quite profitable in coming years, we don't need the usual questions about Church positions regarding women's reproductive services gumming up our acquisition plans.
Among the 40 hospitals in California, Arizona and Nevada that the health system manages, 25 are Catholic. Under the new structure, these 25 hospitals will follow healthcare directives promulgated by the U.S. Conference of Catholic Bishops. The 15 non-Catholic hospitals, meanwhile, will follow Dignity Health's Statement of Common Values, which differs from the Bishops directives by allowing for such procedures as direct sterilizations.
It remains to be seen on what level these two bodies will intermingle whether the left hand will know what the right hand is doing but San Francisco Archbishop George Niederauer approved the restructuring in January 2012, concluding that it did not conflict with the teachings of the Catholic Church.
Hence, if The Health System Formerly Known As Catholic Healthcare West can figure out a way to pursue its strong growth agenda in a changing healthcare environment, it's not impossible to imagine a similarly inspired structure to cover contraceptives for non-Catholic employees of Catholic institutions, so long as the U.S. Conference of Bishops and the White House work together in good faith.