This issue was put on hold by the election of U.S. President Donald Trump. “In 2017, the Trump administration issued a ruling letting insurers and employers refuse to provide birth control if doing so went against their ‘religious beliefs’ or ‘moral convictions’.” But it is a near certitude that a democratic will eventually win the presidency, and reinstate the mandate. In addition, it is arguable whether contraception and abortifacients do in fact go against the ‘religious beliefs’ or ‘moral convictions’ of many Catholics.
The contraceptive mandate requires employers, including Catholic employers and Catholic organizations, to pay for health insurance plans for employees, plans that include contraception and abortifacients. Some Catholic commentators opined that employers may morally pay for these types of health plans, under the principle of remote material cooperation. But over time, the prevailing view became a rejection of the requirement to pay, as if it were formal cooperation, not remote or material cooperation. My opinion is that paying for a health care plan, which includes contraception and abortifacients as one small part of the benefits, is remote material cooperation, and would be justified if there were substantial bad consequences to refusal, such as loss of one’s business or incarceration. However, the position of most conservative Catholic leaders has been a rejection of the mandate, on the grounds that it forces Catholic employers to violate their consciences.
I wish that were true. I wish their consciences were so well-formed that they would reject all forms of contraception, abortifacients, and abortion. But that is not the case. What is happening here, sadly, is that Catholic leaders are more concerned about political issues, that overlap with the faith, than they are with correct understanding of doctrine and with good morals.
In truth, Catholic teaching is that all forms of contraception, abortifacient contraception, and abortion — when morally direct — are intrinsically evil and always gravely immoral. Mere contraception, not abortifacients or abortion, is permissible in cases of rape, because it is morally indirect. But otherwise contraception is not moral, regardless of intention or circumstances. And abortifacient contraception is not moral to use, even for a medical purpose or in a difficult circumstance.
If my fellow Catholics believed and lived the above truths, then they could reasonably object to paying for a health care plan that includes contraception and abortifacients. However, many theologians have asserted contrary claims about this topic, claims which conflict with the refusal to comply with the contraceptive mandate.
Common Catholic Theological Opinions
1. That the use of contraception outside of marriage is not intrinsically evil.
In her book, Self-Gift, Catholic theologian Janet E. Smith, a professor of ethics at Sacred Heart Major Seminary, claims that sex outside of marriage is less evil if the couple uses contraception, than if they do not. She is also the leading proponent of a commonly held view that the Church has never condemned the use of contraception outside of a valid marriage.
Janet E. Smith: “Humanae Vitae and all Church documents that treat contraception focus on marital morality and speak only of marital or conjugal intercourse…. The Church has never taught on the morality of the use of contraception by fornicators or adulterers, one way or the other.”
Dr. Ed Peters and other leading Catholic voices in the U.S. adhere to this same opinion.
So, if contraception is not condemned by the Catholic Church outside of a valid marriage — and we are speaking here of the Catholic understanding of valid marriage — then why can’t Catholic employers pay for it? How can it violate their conscience if it is not condemned by the Church?
2. That the use of abortifacient contraception within a valid marriage is moral, for a medical purpose, despite the anticipated deaths of prenatals.
The medical purposes cited by Catholic theologians and apologists include: treatment of acne, regulation of an irregular period, reducing painful periods, excessive bleeding during menstruation, and endometriosis. And they adamantly state that the spouses do not need to refrain from sex while taking the abortifacient, and that the anticipated deaths of prenatals are justified morally. This opinion is widely held by many Catholics and appears to be the majority view.
So, why can’t a Catholic employer pay for abortifacient contraception, if it is justified morally for a medical purpose? The reason given, that unborn children die, contradicts the prevailing opinion among Catholic ethicists (other than myself) that these deaths are morally acceptable. Why can’t health care plans specifically permit abortifacient contraception outside of marriage or for a medical purpose?
Edited to add [10-16-2018]
A 2017 study by Iversen et al., published in American Journal of Obstetrics and Gynecology, found decreased risk of several cancers with OC use. Ever use of oral contraceptives was associated with reduced colorectal [19%], endometrial [34%], ovarian [33%], and lymphatic and hematopoietic cancer [26%]. Another study found that oral contraceptives reduce the risk of Pelvic Inflammatory Disease by 50% to 60% (Burkman 2001). Oral contraceptives are commonly used to treat endometriosis. So the possible medical benefits are substantial. There are also serious medical detriments as well.
3. That a faithful Catholic spouse, who is opposed to the use of contraception, may morally have sexual relations with his spouse who is using contraception or abortifacient contraception.
If it is moral to cooperate with a spouse who is using abortifacient contraception, by having sex, why would it be immoral to cooperate — much more remotely — by merely paying for a health plan that includes contraception as one of many benefits? The former type of cooperation is much more closely related to the use of contraception than the latter.
And when various Catholic authors assert the above views publicly, they are not rebuked by the Bishops, they are not fired from their position teaching Catholicism, and few persons object or disagree.
So the above common opinions morally permit contraception outside of marriage, abortifacient contraception in or outside of a valid marriage for a medical purpose, and cooperation with a spouse using abortifacient contraception.
Also, note that the definition of a valid marriage, in the Catholic view, excludes many legally married persons, such as the divorced and remarried. So already we are talking about a majority of the uses of contraception, including many uses of abortifacient contraception, which are said to be moral by the common theological opinion, in the U.S. especially.
But as soon as the law wishes Catholic employers and organizations to pay for the contraception, only then do they object. And this objection, in my view, has nothing to do with conscience or doctrine or morality. For if the Bishops were concerned with these things, they would do something about the fact that the majority of married Catholics and very many unmarried Catholics use contraception and use abortifacient contraception (even without a medical purpose).
* They rarely preach or teach against contraception or abortifacients.
* They prohibit the divorced and remarried from communion, but they do not prohibit Catholics who use contraception or abortifacient from Communion.
* They do not fire diocesan or parish or school employees who use contraception or abortifacients.
* They do not discipline priests and theologians who teach the above opinions (1, 2, 3 above).
So, then, why to the Bishops object to the contraception mandate? The reason, in my opinion, is that they don’t want to lose a political battle.
Someday soon, some astute attorney is going to realize the above hypocrisy, present it in court, and then there will be no exceptions to the contraceptive mandate.
For my part, I hope the Bishops stop acting like political lobbyists and mere administrators, start teaching the Gospel in its fullness, and finally rebuke the many unfaithful teachers who promote and approve of grave moral error.
You can’t have it both ways. You can’t approve of contraception and abortifacient contraception, by means of multiple comprehensive exceptions which, when put together, constitute the vast majority of uses, and then say it is against your conscience to pay for it. Hypocrites. False teachers. Wolves in sheep’s clothing. Teach true doctrine and condemn every intrinsically evil act, no matter how popular it may be with the laity. Then you will be able to say, honestly, that paying for contraception is against your conscience.
Ronald L. Conte Jr.
Roman Catholic theologian
 Wikipedia, Contraceptive Mandate;
 Smith, Janet E.. Self-Gift: Humanae Vitae and the Thought of John Paul II (Renewal Within Tradition) (Kindle Locations 7638-7639). Emmaus Academic. Kindle Edition.
 Janet E. Smith, “Pope Francis and contraception: A response to Christopher Kaczor”, in Our Sunday Visitor, 3-3-2016;
 Dr. Ed Peters, “Misunderstanding the (alleged) ‘Congo contraception’ case”;