The NCBC Cautions Catholic Agencies Considering Assuming Position of ACA Navigator and Other Roles

There has been an increasing amount of coverage regarding the role that local people (and in many cases, sponsoring corporations) can or will play in the orchestration of the Patient Protection and Affordable Care Act (ACA)  and and enrollment of persons in the insurance program at the individual level. Referred to generally as Navigators, these local people and corporations will be assistants and are claimed to be available to act an unbiased aides who can help individuals as they make decisions about enrolling in Obamacare.

The National Catholic Bioethics Center has taken ample time to review the status and the roles of these so-called Navigators and the NCBC is urging Catholic individuals and agencies not to participate in these enrollment programs lest they cooperate with evil in the role of a Navigator.

Please read the NCBC's full assessment of the matter below:

The National Catholic Bioethics Center (NCBC) has reviewed the various enrollee registration roles developed to implement the Patient Protection and Affordable Care Act (ACA) and is advising Catholic agencies to exercise caution in assuming such roles.

 There are three specific roles to assist consumers in enrolling for health coverage under the ACA:

           

Navigator: All exchanges (also known as marketplaces)—whether state-based, partnership, or federally facilitated—are required to establish a navigator program. Each exchange will designate entities as navigators and provide them with grants for helping individuals and small employers with the application and enrollment process. Navigators will also conduct public education activities to raise awareness about the exchange and provide referrals to other consumer assistance resources.

In-Person Assisters (IPAs):  In the final exchange blueprint, the Center for Consumer Information and Insurance Oversight (CCIIO) outlined in-person assisters (IPAs) as a second type of assister that is distinct from navigators and other application assistance programs.

Certified Application Counselors (CACs):  Being certified as CACs enables organizations that would likely be engaged in application assistance anyway to help consumers in a more formal capacity. For example, although not all community health centers and community-based organizations will be chosen to serve as navigators or IPAs, they are well-positioned to provide application assistance because they are trusted messengers.

The CAC designation will help expand the network of trained assistance that is available to consumers.

[Excerpted from Enroll America Fact Sheet: http://files.www.enrollamerica.org/best-practices-institute/enroll-america-publications/Enrollment_Assisters_Fact_Sheet.pdf.]

There is a significant possibility of scandal, which is to be judged by the diocesan bishop, when a Catholic agency participates not only as a Navigator but also in providing In-Person Assisters or Certified Application Counselors for enrollment in coverage by the Exchanges.  This is not just because of the morally illicit drugs and procedures which will be facilitated by implementing the ACA, but also because of the violation of religious liberty occurring pursuant to the U.S. Department of Health and Human Services contraceptive and abortifacient mandate in the implementation of the ACA.

There are also additional concerns, especially for states that have not banned abortion coverage in the Exchanges.  Pursuant to the ACA, only one plan per Exchange must omit such coverage.  Therefore, those enrolling persons that select a plan that includes abortion coverage are cooperating in a manner that would be hard to justify, even if it was mediate material cooperation with evil (which at times can be justified, as addressed, below).  This becomes especially problematic when the enrollee specifically requests abortion coverage (speaking to intent, which constitutes what is always morally illicit formal cooperation).  

Explicit formal cooperation in evil occurs when the cooperator (e.g., enroller) has the same evil intent as the principal agent (enrollee who desires insurance coverage of abortion for its potential use). Even if the enroller of an enrollee would prefer that the coverage not include abortion coverage, but acts to assure that the enrollee has such coverage as an In-Person Assister, Certified Application Counselor, or contracted Navigator, this could constitute implicit formal cooperation.  Even in the absence of direct abortion coverage, the enrollee may be a person who intends to use the abortifacient drugs and contraceptive coverage, facilitated by the enroller, presenting a similar moral dilemma as outlined above. 

This is unlike a person accepting a health care insurance plan for his/her family that does include the morally illicit coverage, which cannot be refused, but at the same time knowing that coverage will not be used.  This represents remote mediate material cooperation by which material assistance (payment of premiums) is given, which neither causes another person to commit an evil, nor intends evil.  It may make the evil possible by contributing to the overall financing of the plan, not dissimilar to paying taxes.  For such an enrollee, for the proportionate good of the family’s health care coverage, the remote mediate material cooperation could be justified, with the understanding that the family makes known its objections to such public policy and works in a prudentially appropriate manner to effectuate change.

This is the NCBC opinion on the matter, in which we urge that Catholic agencies not sponsor or assume the roles of Navigator, In-Person Assister, or Certified Application Counselors for the Exchanges because of the implications of these actions for cooperation with evil.  Of course, the final decision rests with the diocesan bishop.

Who is Free to Exercise Religion? An NCBC Ethicist Weighs In

John A. Di Camillo, Staff Ethicist at the National Catholic Bioethics Center, has just completed an article that targets and addresses conflicting opinions that have arisen in the United States courts as the Judiciary continues in attempting to delineate and interpret the "identity, purpose, and scope of business entities and the relationship of those entities to their owners and to religious exercise" in light of the HHS mandates and government enforcement of the unjust laws.

John Di Camillo provides a deeper look into the ongoing battle for religious freedom as:

"Two federal courts of appeal have come to opposite conclusions regarding whether for-profit companies can claim religious liberty protections. All for-profit and most non-profit organizations in the United States continue to be impacted by the legal requirement that was established by a provision of the Patient Protection and Affordable Care Act of 2010, and incrementally clarified by regulations from the Department of Health and Human Services, which has come to be known as the HHS Mandate. The HHS Mandate requires that employers who offer health insurance include, at no cost to employees, the full range of FDA-approved contraceptive drugs and devices, including surgical sterilizations as well as abortion-inducing drugs and devices such as ellaOne, Plan B, and IUDs. Providing this sort of insurance coverage is at odds with the moral values and religious convictions of many U.S. citizens and business owners, especially Catholics."

Read the full article HERE.

Read it Before it's Printed! - Dr. Marie Hilliard Talks Surrogacy With OSV

The NCBC's Director of Bioethics and Public Policy, Dr. Marie Hilliard, recently spoke to Our Sunday Visitor about the ethical issues surrounding surrogate motherhood. 

Dr. Marie Hilliard

This Interview will be printed in the May 26th Edition of the weekly news publication Our Sunday Visitor; be sure to pick up a copy!

Below is an excerpt of the interview. For the full interview, click HERE. To read more news, click HERE

Our Sunday Visitor: Please discuss the ethical-moral issues of surrogate motherhood first, and then the peripheral issues such as the psychological and legal. 

Marie Hilliard: If you look at the ethical, moral and legal issues, they are not separate. What the Church teaches is based on what we call natural, moral law: that we can know the good by what we can know by reason. We do not have a distinction between how the good should be expressed in the public arena and what is the good in terms of the moral arena. My mother had a great saying about her version of what Paul, in Romans 2:15, has told us about how certain things are written on the hearts of women and men and can be known by reason: “Sanctity is sanity.” 

OSV: What does Church teaching say about surrogate motherhood? 

Hilliard: The Church has such great scholarship on this and other issues. For example, natural moral law, as it pertains to assisted reproductive technologies, is extremely well addressed in the document Donum Vitae (“The Gift of Life”) from the Congregation for the Doctrine of the Faith (1987). In 2008, the same congregation issued further instruction on such matters in Dignitas Personae. Such documents are an invaluable resource to couples struggling with infertility.

The Church teaches that the child should be conceived as an act of love in the fruitfulness of a marriage. Further, the child has a right to be conceived through that natural act of love that demonstrates the ultimate source of love — the Creator who establishes the laws of nature pertaining to how human life is to be engendered and life is to be lived.

Parents don’t produce: They engender new life through an act of love, which is a sacred act; and they are called, as responsible parents, to love and raise that child. For this reason, we really can’t separate the psychological from the legal, the moral, the physical and the spiritual. The child has every right to be engendered through that natural act of love, and the child actually becomes the fruitfulness of the love of the parents. That triune relationship between the mom, the dad and the Creator is fractured with a surrogate pregnancy.

Click HERE to read more

For those interested, the OSV article included some excellent excerpts from the Catechism on this subject. Enjoy! Have a blessed and thankful Memorial Day.

Church Teaching on Surrogacy

Catechism of the Catholic Church: “Techniques that entail the dissociation of husband and wife, by the intrusion of a person other than the couple (donation of sperm or ovum, surrogate uterus), are gravely immoral. These techniques (heterologous artificial insemination and fertilization) infringe the child’s right to be born of a father and mother known to him and bound to each other by marriage. They betray the spouses’ ‘right to become a father and a mother only through each other’” (No. 2376). “A child is not something owed to one, but is a gift. The ‘supreme gift of marriage’ is a human person. A child may not be considered a piece of property, an idea to which an alleged ‘right to a child’ would lead. In this area, only the child possesses genuine rights: the right ‘to be the fruit of the specific act of the conjugal love of his parents,’ and ‘the right to be respected as a person from the moment of his conception’” (No. 2378). Donum Vitae, the 1987 Congregation for the Doctrine of the Faith Instruction on Respect for Human Life in Its Origin and on the Dignity of Procreation: “[Surrogate motherhood] is contrary to the unity of marriage and to the dignity of the procreation of the human person. Surrogate motherhood represents an objective failure to meet the obligations of maternal love, of conjugal fidelity and of responsible motherhood; it offends the dignity and the right of the child to be conceived, carried in the womb, brought into the world and brought up by his own parents; it sets up, to the detriment of families, a division between the physical, psychological and moral elements which constitute those families” (No. II-A-3). Dignitas Personae, the 2008 Congregation for the Doctrine of the Faith Instruction on Certain Bioethical Questions: “With regard to the treatment of infertility, new medical techniques must respect three fundamental goods: a) the right to life and to physical integrity of every human being from conception to natural death; b) the unity of marriage, which means reciprocal respect for the right within marriage to become a father or mother only together with the other spouse; c) the specifically human values of sexuality which require ‘that the procreation of a human person be brought about as the fruit of the conjugal act specific to the love between spouses’” (No. 12).