My dear brothers and sisters in Christ:

Last November, President Barack Obama assured Archbishop Timothy Dolan of New York, president of the United States Conference of Catholic Bishops, that he would rein in his administration's attempts to require virtually all private health plans to include coverage for all FDA-approved prescription contraceptives, abortion pills and female sterilization procedures. These requirements were included in an "interim final rule" issued on Aug. 1, 2011 by the U.S. Department of Health and Human Services (HHS). These were listed among "preventive services for women" that all health plans would have to include without co-pays or other cost-sharing — even if the insurer, the employer or other plan sponsor, or the woman herself object to such coverage. There have been many protests, including formal comments filed with HHS by many organizations and a petition signed by over 430 Catholic leaders. The president sought to assure Archbishop Dolan and all the bishops of the United States that our concerns were unfounded.

Well, the president was being either dishonest or delusional or he is incompetent, because last week President Obama called now Cardinal-designate Timothy Dolan to break the news that this rule was being adopted after all. The only accommodation was that it would be delayed for a year. So if President Obama didn't mean what he said last November, he was being dishonest. If he thought he could change the objectionable stance of members of his Cabinet, he was being delusional, and if he is not able to overrule the morally problematic decisions of his own administration, he is incompetent.

So it was that his Secretary of Health and Human Services and pro-abortion Catholic Kathleen Sebelius announced on Jan. 20, 2012 that the proposed mandate requiring all insurance plans to pay for contraception, sterilization and some abortion drugs is now official — and Catholics cannot escape. The ridiculously narrow exemption for a handful of religious groups will not be expanded, apart from allowing some groups an additional year to comply. Cardinal-designate Dolan responded by saying, "In effect, the president is saying we have a year to figure out how to violate our consciences."

These are some important points to keep in mind:

1. The mandate treats a healthy pregnancy as a disease in need of "prevention," like breast cancer or AIDS (which other "preventive services" on HHS's list do legitimately seek to prevent). In reality, some of the mandated contraceptives are associated with an increased risk of AIDS, blood clots leading to stroke, and other ailments. Inclusion of these drugs places HHS's effort to prevent disease at war with itself. The claim that greater access to contraceptives will reduce abortions is not supported by the facts. Everyone deserves access to basic life-affirming health care, and health care reform is supposed to serve that goal. The effect of this mandate is just the opposite, as it pressures organizations to drop their health coverage for employees and others altogether if they have a moral or religious objection to these particular items.

2. By requiring coverage for all drugs approved for contraception and "emergency contraception" by the FDA, the mandate includes abortifacient drugs that can interfere with implantation in the womb and therefore destroy the early human embryo. One such drug already approved, "Ella" (ulipristal), is very similar to the abortion drug RU-486 in its formula and its ability to cause an abortion in the first weeks of pregnancy. The new health care reform law forbids HHS to mandate coverage of abortion, but it is doing so here.

3. The mandate imposed on health plans violates religious freedom and rights of conscience, which are guaranteed by the First Amendment and several federal laws. The Bill of Rights says we are free to live by our religious beliefs. Forcing all of us to buy coverage for sterilization and contraceptives, including drugs that induce abortion, is a radical incursion into freedom of conscience. Never before in U.S. history has the federal government forced citizens to directly purchase what violates their beliefs. The Supreme Court recently declared in the Hosanna-Tabor case that the Constitution gives a priority place to freedom of religion.

Many federal laws exempt individuals and institutions from having to take part in health services against their moral or religious convictions; some of these laws specifically protect from forced involvement in contraception or sterilization. HHS is violating this long federal tradition, and needs to return to it. Congress should also approve the Respect for Rights of Conscience Act (H.R. 1179, S. 1467) to ensure that this happens.

The rule has an incredibly narrow religious exemption for "religious employers" (not insurers, schools with student health plans, or families purchasing insurance). Even religious employers are exempt only if their purpose is to inculcate religious doctrine, they hire and serve mainly people of their own faith, and they qualify as a church or religious order in a very narrow part of the tax code. Most religious institutions providing health, educational or charitable services to others have no protection. Jesus himself would not qualify as "religious enough," since he healed the needy regardless of religious affiliation and taught followers to do the same (see the parable of the Good Samaritan).

HHS says this exemption is like those enacted by most states that have a contraceptive coverage mandate, but that is false. None of the state mandates covers as wide an array of health plans, and the great majority have broader protection for religious freedom. Even states with similar mandates have a broader conscience exemption, or at least allow employers to self-insure or to choose a plan without prescription drug coverage if they have a conscientious objection to underwriting abortion, contraceptive and sterilization. This mandate forces virtually all insurance plans to offer such services. If the administration will not rescind this violation of the First Amendment, Congress must do so.

May God give us this grace. Amen.