Obama seeks policy ‘balance’
Guiding principle seen in dispute with Catholic leaders
WASHINGTON— Itwas just a few days after the Obama administration announced its groundbreaking decision to require employers providing health insurance to cover contraception, and a controversy was flaring.
Roman Catholic bishops were vowing to fight an “unconscionable” mandate. Catholic hospitals and even some Catholic Democrats were assailing PresidentBarack Obama, saying he was trampling on religious freedom.
Obama, as angry as his senior aides had ever seen him, summoned them to the Oval Office. The debate over the decision had divided top staff members along religious, gender and political lines. Though trusted advisers supported the policy, the president never seemed comfortable with it.
On the day it was announced, he had caught his advisers by surprise when he told New York’s archbishop, Timothy Dolan, the policy was not final and therewas still time to find a compromise.
Now, the president was telling his aides that he had read the legal opinions and policy papers on the issue, and he sawno reason why a more accommodating solution had been ruled out. “Fix this,” he said testily. “He didn’t have the balance he wanted, and he wasn’t happy with us about it,” said a senior administration official, who, like others interviewed, declined to be identified talking about internal discussions.
Obama’s search for “balance” is the defining princi- ple of his decision-making.
Part personal inclination and part political calculation, the president’s sometimes awkward attempts to accommodate views on either side of the political spectrum have driven nearly every major policy move in his first term: his health care law, attempts to cut the national debt and his plans to withdraw troops from Iraq and Afghanistan.
The contraceptives decision, although a smallerscale one, offers a window into this process.
The tussle over the birth control mandate began in the summer of 2011, after the Department of Health and Human Services laid out interim rules for the Affordable Care Act, often known as Obamacare.
The law required all employers to provide coverage for contraceptives to their employees at no additional cost, with an exception for “religious employers.”
The interim rules de- fined religious employers as houses of worship, but not religious universities, hospitals and social service agencies, which serve and employ people of all religions and cultural backgrounds.
Within the WhiteHouse, many top stafferswanted to make the interim rules permanent. But a subset — led by Catholics— sawthe rules as a major blowup in the making.
Vice President Joe Biden and Bill Daley, then chief of staff, set up a meeting between Obama and Dolan.
The two had a rocky relationship. While both made public, personal overtures, theywere far apart on policy. Dolan, the president of the U.S. Conference of Catholic Bishops who has sincebeenelevated to cardinal, is the voice of the conservative wing of the Catholic Church.
When Dolan arrived at the White House, his organization was already in a battle with the administration over a decision to pull grant money from Catholic groups working to combat sex trafficking.
Dolan, who declined to be interviewed, has said he left his Oval Office meeting with Obama encouraged.
The Dolan meeting sent nervous jitters through abortion-rights and women’s groups pushing to keep the interim rule. They intensified their lobbying, relying on White House senior adviser Valerie Jarrett and Kathleen Sebelius, secretary of Health and Human Services, as allies.
They also had a supporter in political adviser David Plouffe, who argued that the bishops were a lost cause and suggested the WhiteHouse focus onmoderate Catholics such as Sister Carol Keehan, head of the Catholic Health Association of the United States, who had backed the administration in the health care fight.
Plouffe also thought the bishops’ complaints could bolster a useful campaign narrative: that supporters of their view, including Republican Mitt Romney, held anachronistic views about women and family planning.
White House lawyer Kathy Ruemmler, meanwhile, concluded the federal government lacked the authority to implement a hybrid solution used in some states because it would place an obligation on insurers.
In Hawaii, for example, employers who object to contraceptives on moral grounds can simply let female employees know where they can get coverage.
On Jan. 20, the president got on the phone. He was planning to inform Dolan and Keehan that they had lost this fight. But onthe call with Dolan, the president indicated he was open to a Hawaii-style modification.
Keehan was somewhat hopeful. “I was profoundly disappointed that we didn’t get the exemption, but Iwas glad that it wasn’t the door slammed in our face,” she said.
A few days later, Obama ordered his aides to fix the problem. The president, a constitutional lawyer by training, challenged Ruemmler’s conclusions andpressed his aides to look again at a hybrid solution.
Over the next twoweeks, the firestorm would intensify. Republicans seized on the issue.
Staffers came up with a hybrid idea with elements borrowed from New York, California andHawaii.
Under the compromise, religious institutions would not be involved at all. The insurers, rather than the religious institutions, would tell employees about the availability of contraceptives. Insurerswould alsobe required to cover the cost— something staffers now concluded would save the companies money.
When the proposal was presented to the president, he nodded. He had the approach hewanted.
On Feb. 10, Obama announced the revised policy. “Religious liberty will be protected, and a law that requires free preventive care will not discriminate againstwomen,” he said.
The bishops still weren’t satisfied. Keehan, although she offered guidance in crafting of the solution, announced in June that she could not support it. A coalition of groups led by the bishops is suing the government.
But the accommodation provided an appearance of moderation and quiet a controversy that endangered the president just before high campaign season.
He “believes very strongly,” said White House spokesman Jay Carney, “in finding the balance that he believes he found.”