Letter to HHS Secretary Kathleen Sebelius

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The Honorable Kathleen Sebelius

Secretary, U.S. Department of Health and Human Services

Center for Medicare and Medicaid Services
Attn: CMS-9992-IFC2

P.O. Box 8010

Baltimore, MD 21244-8010


Dear Secretary Sebelius,

We, the Roman Catholic bishops of Minnesota, express our strong opposition to elements of the recent "preventive services mandate" rule imposed by the Department of Health and Human Services under the Patient Protection and Affordable Care Act (PPACA). While we support providing access to those services which can truly prevent disease or disability for women, such as pap smears and mammograms, we join other persons of good will who strenuously object to mandatory coverage for contraceptives and sterilization procedures.

This Rule raises four serious concerns for us: its treatment of fertility and pregnancy as abnormal states in need of prevention; unprecedented restrictions on employers to act in violation of their informed conscience; a reversal of the long tradition of conscience protections for faith-based providers; and the potential impact of the Rule on the vulnerable populations who have been served well and generously by Catholic providers for mm1y decades in our country.

First, the Rule effectively treats human fertility and pregnancy as abnormal disease processes. On the contrary, fertility is a gift that, exercised responsibly, allows society to prosper. Further, the Rule would also require taxpayers and providers to act against deeply-held convictions regarding the sanctity of life, as the promotion and provision of drugs like "Ella" (ulipristal acetate) and other abortifacient agents are enabled by this mandate. Government has the duty to protect innocent human life, rather than facilitate its destruction.

Second, even if we disagree about the immorality or shortsightedness of abortion and birth control as public policy, the long-standing legislative tradition in our nation has protected the freedom of conscience mid religious beliefs. The Church amendment of 1973, the Federal Employees Health Benefit Program, and other federal laws protecting conscientious objections have worked well to support the provision of necessary services while respecting the legitimate autonomy of providers to act in accord with their commitments and values. Therefore, requiring Catholic individuals and institutions to pay for and provide abortion drugs, sterilizations, and contraceptives contrary to Catholic teaching-all in the name of "reproductive autonomy"-is a serious assault on one of this country's most cherished traditions.

Third, we are concerned that the Rule's "religious exceptions" are far too narrow. By exempting only those who employ and/or serve persons of the same religious tradition from its mandates,

Catholic health care providers-the safety net for many of our marginalized sisters and brothers--cannot enjoy the exception without abandoning our mission, to the significant detriment of those in need. Further, we would be deprived of the important contributions to our mission by those who do not share our Catholic faith but do hold similar fundamental values and greatly enrich our ministries and institutions.

In his executive order of March 24, 2010 clarifying aspects of the PPACA, President Obama assured Americans that federal funds would not be used to pay for abortion and that "longstanding Federal laws to protect conscience remain intact." That promise is broken if this mandate is fully adopted.

For these reasons, we urge you to rescind the mandate and broaden the protection of conscience in the implementation of the PPACA. Catholics, from the time they arrived in the United States, have contributed to the common good by serving the poor and vulnerable-irrespective of their faith-in our many schools, hospitals and charities. America is the richer for this faith-inspired witness. But if the mandate is not eliminated, the vast educational and social service network of the Catholic Church will be imperiled, and with it not only those who are employed and assist us in our works of mercy, but also those who are served: our neighbors in need.

We thank you for your respectful and thoughtful consideration of this matter.



The Most Rev. John C. Nienstedt

Archbishop of Saint Paul and Minneapolis

The Most Rev. John F. Kinney

Bishop of St. Cloud

The Most Rev. John M. LeVoir

Bishop of New Ulm

Most Rev. John M. Quinn

Bishop of Winona

The Most Rev. Paul D. Sirba

Bishop of Duluth

The Most Rev. Lee A. Piche

Auxiliary Bishop of St. Paul and Minneapolis

The Most. Rev. Victor H. Balke

Bishop Emeritus of Crookston

The Most Rev. Michael J. Hoeppner

Bishop of Crookston

The Most Rev. Harry J. Flynn

Archbishop Emeritus of St. Paul and Minneapolis

The Most Rev. Bernard J. Harrington

Bishop Emeritus of Winona

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