Blurred Lines at the Border

AP Images/Matt Rourke

Last year, during the height of the “religious freedom” fracas over the Affordable Care Act’s (ACA) contraception-coverage requirement, three Catholic laywomen made the church’s case to an audience at the Catholic Information Center (CIC) in downtown Washington, D.C. Housed in an unassuming bookstore on K Street and operated by the controversial Opus Dei order, the CIC claims to cater to the spiritual needs of Washington’s political elites with daily mass as well as lectures and panels featuring prominent conservative pundits and activists. The “Women for Freedom” panel aimed to teach lay Catholics to “convince rather than antagonize” the public about the church’s stances on divisive issues, and, in the words of one panelist, “share and show love.”

“Our goal,” said Kim Daniels, then the head of the organization Catholic Voices and now the spokesperson for the president of the United States Conference of Catholic Bishops (USCCB), “is to make the church’s case in the public square as lay people who know and love our faith. Our job is to be authoritative but not official.”

The ACA’s contraception-coverage requirement was not their only target, and the goal was not simply to defend the church’s argument about religious freedom. The women emphasized the role of the Church as an essential, life-sustaining part of the fabric of American life. The Church and its social-service auxiliaries, they argued, provide indispensible services to the poor and vulnerable. As a consequence, they contended, the Church and Catholic social-services agencies should not be forced to participate in what they consider to be immoral activity, because that would force them to abandon their services to the poor.  

The USCCB has deployed this argument in the context of its work with victims of human trafficking, immigrants, and refugees, insisting that when it receives federal funding to provide these services, it should be exempt from having to refer clients for contraception and abortion care. This stance has put the USCCB in conflict with civil liberties, church-state separation, and reproductive-rights advocates, who say the church should not be using taxpayer dollars to impose its religious beliefs on its clients’ health-care choices.

This debate—balancing the free-exercise rights of a religious institution and its employees with those of its clients, and with the establishment clause’s prohibition on government imposition of religion—has occupied policymakers, legislators, lawyers, and activists since the USCCB launched its religious-freedom campaign in 2011. Republican lawmakers have held hearings accusing the Obama administration of “anti-Catholic” bias. They have introduced legislation to broaden the scope of exemptions for religious objectors, and have attempted to attach it as an amendment to a continuing resolution in the government-shutdown standoff. Conservative activists have registered their support of the Church’s cause with “Stand Up for Religious Freedom” rallies. Think tanks and universities have hosted conferences at which experts dissect the minutiae of law and theology.

For immigrant advocates and health-care providers at the Texas-Mexico border, though, the ferocity of the bishops’ insistence on religious exemptions as a condition for serving this vulnerable population is a misguided sideshow. Seventeen hundred miles away from Washington, in McAllen and Brownsville, the two poorest metropolitan areas in the country, many residents and undocumented immigrants struggle just to access life’s basic necessities. “It makes the whole thing about the exemption, just kind of like, wow,” says Michael Seifert, a former priest in the Brownsville diocese who is now the network coordinator for the Rio Grande Equal Voice Network, a community organizing coalition. “That’s like chapter 15 in this book.”

Religious Conflicts over Reproductive Health Services

Two years ago, conservative activists started a firestorm over the Department of Health and Human Services’ decision not to renew a contract with the USCCB to provide services to victims of trafficking. The contract, which was funded under the Trafficking Victims Protection Act (TVPA), was not renewed because the bishops would not permit referrals for victims of trafficking to a full range of gynecological and obstetric care, specifically abortion, contraception, and sterilization. Many trafficking victims have been raped, and many of them are minors. While under the Hyde Amendment, which prohibits the use of Medicaid funds for abortion, federal funds cannot be used to pay for abortion, the controversy was over referrals, rather than payment.

At a House Oversight and Government Reform Committee hearing on the $2 million contract in 2011, Representative Chris Smith, a Republican from New Jersey, railed against “the Obama administration's bias against Catholics,” declaring it “an affront to religious freedom and a threat to all people of faith." Smith painted the USCCB as the victim of discrimination "solely because it fundamentally respects the innate value and preciousness of an unborn child and refuses to be complicit in procuring his or her violent death by abortion.”

Despite the charges that the administration discriminated against Catholics, during Obama’s tenure, federal grants to the USCCB have increased, according to a federal government database. In 2012, the USCCB received $62.8 million in federal grants, and other Catholic organizations, including Catholic Charities and Catholic Relief Services, also received millions in federal funding. And although the Health and Human Services Department (HHS) ended its contract to aid trafficking victims with the USCCB, the department’s Office of Refugee Resettlement (ORR) still contracts with it and other Catholic organizations to provide services to immigrants, including undocumented unaccompanied children (known as UACs, or unaccompanied alien children) and adult and minor refugees (known as URMs, or unaccompanied refugee minors). All of these populations could potentially qualify for trafficking services, according to an HHS spokesperson.

UACs are undocumented minors who enter the United States illegally, are detained (usually at the U.S.-Mexico border), and placed in the custody of federal authorities. The USCCB, as well as other religious and secular organizations, provide them with transitional housing, foster care, and other services, often to help UACs reunite with family members located in the U.S. Many of these undocumented minors, though, can face deportation when they turn 18.

Shrinking economic opportunities, political persecution, and drug- and gang-related violence have all contributed to a surge in UACs coming across the Mexico border from Central America. In 2012, 14,000 children were in ORR custody, double the number in previous years, says Michelle Brané, director of the Migrant Rights and Justice Program at the Women’s Refugee Commission, a nonprofit advocacy group for women and children refugees. Authorities anticipate that number to reach 20,000 for 2013, she said.

Unaccompanied minors, Brané says, “are a pretty vulnerable group, if you can imagine,” particularly girls, who “are very often exposed to sexual assault and gender-based violence en route and even before they come [to the U.S.].” A 2012 USCCB report on UACs in need of foster care noted that “children migrating to the United States are at risk of experiencing physical and sexual assault, robbery, kidnapping, and death while on the migration journey.” Several health and immigrant advocates in the Rio Grande Valley said many girls start birth-control pills a few months before they leave their home country, anticipating they will be raped during their journey. Others arrive in the U.S. pregnant.

Five years ago, four Catholic Charities workers in Virginia were fired for helping an undocumented, unaccompanied teenager in their care to obtain an abortion. Since the Virginia case, Brané says, “we haven’t had cases come forward, but that doesn’t mean they’re not out there.” Whether girls are being deprived of any services “is really difficult to find out.”

In a January 2013 report on civil liberties, the American Civil Liberties Union (ACLU) charged that HHS “has failed to meet the reproductive health care needs” of immigrants and refugees it serves, “in part because ORR contracts with religious entities that refuse to provide referrals to this type of health care.” In particular, the ACLU argued, the USCCB’s refusal to refer UACs for reproductive health services violates a court-ordered settlement agreement that requires HHS to provide or arrange for family-planning services for UACs.

An HHS spokesperson, when asked to comment on the ACLU’s non-compliance charge, said, “In providing care to unaccompanied alien children, ORR fully adheres to the principles and provisions established by the Flores Agreement in 1997, the Trafficking Victims Protection Act of 2000 and its reauthorizations, and the Homeland Security Act of 2002.”

“USCCB is incredibly powerful in Congress and nobody wants to go against it,” says one immigrant advocate who didn’t want to be identified but whose organization contracts with HHS. “It’s a huge, huge, very powerful institution. So even the NGOs [that also receive HHS funding], I think, are afraid of offending the USCCB.”

 

Exemptions Routinely Granted

In a lawsuit brought by the ACLU challenging HHS’s prior policy of allowing religious exemptions in the trafficking contract, the USCCB argued that it is routinely granted exemptions in contracts with HHS and the Department of State to serve migrants and refugees. (A federal court ruled the exemption in the trafficking contract to be unconstitutional, but an appellate court vacated the decision as moot, since HHS changed the policy and didn’t renew the USCCB’s contract.)

In a sworn affidavit in the ACLU case, Beth Englander, director of the Division of Special Programs for the USCCB’s Office of Migration and Refugee Services (MRS), said that in negotiating a contract to provide services to UACs under HHS’s Safe Passages Program, “at USCCB/MRS’s insistence the government agreed to remove language that would have required USCCB/MRS to provide referrals for abortion and contraception services.” HHS did not respond to a request for comment.

Requiring the USCCB “to provide services to refugee minors that are inconsistent with Catholic moral and religious teachings,” Englander added, would likely result in USCCB being “unable to continue our collaboration” with HHS, producing “a severe impact on a large population of vulnerable children and teens,” because USCCB provides about 50 percent of transitional foster-care services nationwide.

Anastasia Brown, director of MRS, similarly said in an affidavit that in a contract to serve refugees with the Department of State, the USCCB included specific language in its proposal: “The U.S. Conference of Catholic Bishops must ensure that services provided to those served under this proposal are not contrary to the authentic teaching of the Catholic Church, its moral convictions, and religious beliefs.” A State Department spokesperson said the contract did not contain any provisions regarding reproductive health and would not confirm or deny whether the language about Catholic teaching was part of the contract.  The State Department contract with the USCCB was $39,609,977 for fiscal year 2013.

Brown added in her affidavit that in its proposals for contracts with ORR, including contracts to serve UACs, the USCCB included language, which it believed to be incorporated into the contracts, that the services would be provided in accordance with Catholic teaching. An HHS spokesperson said the contracts contained no such provisions.

A spokesperson for the USCCB did not respond to several requests for comment. Maggie Garrett, legislative director at Americans United for Separation of Church and State, said such a provision would “certainly be a constitutional problem” for contractors to “have their own religious litmus test for what services they will or will not perform.”

Brigitte Amiri, senior staff attorney at the ACLU’s Reproductive Freedom Project, says that “it’s fair to say it raises constitutional concerns” but added it is hard to know “in the abstract” whether there is a withholding of services due to a provision requiring compliance with a religious belief. She noted a concrete example of a constitutional concern was the trafficking contract, under which the USCCB was refusing to refer clients for certain services.

On its website, HHS says the administration “is committed to providing the full range of legally permissible services to people who need them” and is also “committed to finding ways for organizations to partner with us even if they object to providing specific services on religious grounds.”

Of the HHS policy, American United’s Garrett said, “The big question is how that’s being implemented,” adding that monitoring how such faith-based policies play out in practice has been an ongoing difficulty.

 

Uncomfortable Truths

Seifert, the former priest, described the dire conditions that the undocumented and the poor face in the Rio Grande Valley and criticized the church for failing to address the panoply of social-services deficits in the area or the draconian effects of stepped-up border federal enforcement. “They certainly are not a prophetic voice in every sense of the word prophetic, in the sense of just speaking an uncomfortable truth,” he says.

The Texas Catholic Conference, the church’s policy arm in the state, lists “protecting human life” first on its legislative agenda in Austin but also identifies justice for immigrants and the poor and vulnerable as issues it advocates.

There’s no public hospital in the valley, Seifert says, and not enough public clinics or doctors to serve the population. He says that because of the absence of clinical psychologists in the area, such providers must travel in from Corpus Christi or Galveston, and securing an appointment with one can take up to three months. Should a patient require medical care not available in the valley, she must drive north to San Antonio—and pass through a second checkpoint along the way, making the trip an impossibility for the undocumented.

ORR’s principal goal—reuniting unaccompanied undocumented minors with family in the United States—does not happen as much as it should, Seifert says. “There are simply no services. You’re talking about children who have come through a war zone. In that instance, in which the Catholic Church or any other church group could do something actually interesting and innovative like bring in those social services,” he says, “it’s not even a discussable point.”

Access to reproductive health care, in particular, has been gutted by the Texas Legislature, which has “impacted us tremendously,” says Patricio Gonzales, CEO of Planned Parenthood of Hidalgo County. “Many of the women we serve are poor and uninsured, and we are their only doctor, and many of them are undocumented.” Many women are forgoing physicals, pap smears, and birth control. Because of the new law in Texas requiring clinics to meet heightened requirements in order to stay open, the two remaining abortion providers in the valley are at risk. And an undocumented woman would be unable to travel to San Antonio because of an additional border checkpoint.

Planned Parenthood’s promotoras, or health educators, discover that many young women living in colonias—poverty-stricken and desperately underserved communities along the border—are “very clueless about birth control,” says Gonzales. “They’ve heard of it, but they’re not sure about it. They don’t understand how it works or what methods are out there for them.”

The bishops, Gonzales says, “manage with their lobbying groups and with this Texas Legislature, to knock out all the available resources for women.”

The church does provide some services to immigrants in the valley, but they are limited by lack of funding and staffing. Sister Norma Pimentel, executive director of Catholic Charities of the Rio Grande Valley, provides legal help to immigrants and emergency food, school supplies, and accommodation to undocumented people in need.

Pimentel says that she handles three or four cases a year of UACs, and her services involve helping them make the transition to reunification with family members. She says that the cases are referred by the USCCB and that questions about referrals for contraceptive or abortion care have never come up. If they did, she says, “I think we would have a problem, because I’m sure the bishop would not want us participating in something like this.”

Father Jerry Frank, pastor of St. John the Baptist Church in San Juan, Texas, praises the diocese’s role in pushing for immigration reform. But, he adds, the U.S. bishops are “focused on one issue [reproductive health], and it makes them come across as very partisan. I’d like to see a broader vision re-established,” one focused on “Catholic social justice principles.” In a recent interview published in the Jesuit magazine America, Pope Francis called for a more expansive treatment of the church's teachings, saying, "we cannot insist only on issues related to abortion, gay marriage and the use of contraceptive methods." Francis later amplified that message, telling the Italian newspaper La Repubblica that "youth unemployment" and "loneliness of the old" are "most serious of the evils that afflict the world these days," and emphasizing that the church must deal with both "bodies and souls." 

Ann Williams Cass, a self-described “recovered Catholic” who worked for the church for 25 years, including as a pastoral administrator, is now the executive director of Proyecto Azteca, a community-development corporation in San Juan, Texas, that helps migrants and colonia residents finance and build affordable homes. She says the church has “definitely lost sight of the mission.” But “when you get people in a small group, and you start asking them questions, you find out that most people don’t have a problem with gay and lesbian people. Most people don’t have a problem with birth control. They’re on birth control.” The problem with the bishops, says Cass, is that they are “far right wing.”

Cass has criticized the Church for its unwillingness to “rattle the people in the pews.” Many people, she says, want to leave church “feeling good. And I would say, ‘well, no, we come to church on Sunday because we want to have our hearts broken to be more generous and hospitable and justice-oriented, to become more like the body of Christ.”

In Brownsville, Seifert of the Rio Grande Equal Voice Network took me for a tour of the border fence, built two years ago over the objections of local activists. It is common knowledge in the valley that the fence doesn’t stop the undocumented from crossing the border, and people chafe at the cost of the border-control efforts and the armed border patrol agents cruising around Brownsville in their white SUVs. As we drove down a residential street, Seifert pointed to a yard where there once was a tree that people used to visit because they believed it contained a vision of the Virgin Mary. “Then the tree fell down,” Seifert said. “I don’t know what that does to your faith, when your miracle tree falls down.”

This report was supported by a 2012 Knight Grant for Reporting on Religion and American Public Life. The Knight Grants are a program of the University of Southern California’s Knight Program in Media and Religion.

Comments

The general rule on taxes and spending in America is that, although individual taxpayers may object to specific policies, they do not have a "right" to VETO the use of "their" tax money for certain policies. They may protest, as Thoreau did during the Mexican War, or as some peace advocates did during the Vietnam war, but as in any civil disobedience, they must be willing to accept the LEGAL punishment as a sign of martyrdom in order to change FUTURE laws. All of our taxes are mixed together and spent on what the MAJORITY of us approve, despite objections from a minority. of people over a minority of the expenditures.

In addition to this rebuttal to religious objections to contraceptives, there is a more serious issue. Since the health insurance of the majority of Americans is controlled by their employers, AND most important medical services are out of reach for all but the fortunate wealthy, without insurance coverage, employer insurance plans have a virtual VETO POWER over whatever medical services their policyholders may need. One reason for creating and passing Obamacare was to ease the harm caused by such rules as pre-existing coverage, lifetime or annual coverage limits, and no coverage for certain "disapproved" procedures or drugs because of the insurance company's medical opinions.

Now, in addition to the INSURANCE company's veto power over employee health care, some employers are claiming that THEIR money should not be used to cover certain medical procedures because of THEIR religious objections. This is a VERY SLIPPERY SLOPE. For example, Jehovah's Witness believers do not accept blood transfusions (and obviously, by extension, organ transplants). Christian Scientists believe in spiritual healing, not medical manipulation (although they make allowances for those who are weaker in faith). Certain evangelical sects are even stricter than Christian Scientists. Should an employer who happens to be a Jehovah's Witness be able to VETO BLOOD TRANSFUSIONS for his EMPLOYEES if they should need them? Should an employer who belongs to the Church of Scientology be able to VETO PSYCHIATRIC TREATMENT AND MEDICATION for his employees? Should an employer who disapproves of medicine in general be able to VETO ALL BUT SPIRITUAL HEALING for employees?

The First Amendment protects the right of those employers, like any other citizens, to refuse medical treatment against their religions, even at the cost of their lives, for THEMSELVES. However, employees who do not share the religious beliefs of their boss have their OWN First Amendment right to religious freedom, which involves the right to accept or refuse care based upon THEIR OWN religion, and the right NOT TO BE DETERRED because of the religious beliefs of SOMEONE ELSE. And since out-of-pocket payment for "anything against the boss's religion" is not a practical alternative, withholding insurance coverage essentially means the patient WILL NOT BE TREATED, possibly resulting in DEATH or PERMANENT DISABILITY.

For this reason, I am TOTALLY OPPOSED to a "conscience clause" that allows an employer to control the medical options available to an employee. However, if the employees belong to the SAME faith, and that faith has an organized internal legal system (excommunication, penance, shunning, etc.), THAT system could certainly be invoked AFTER a religious violation.

This article mostly talks about Texas. In Southern Arizona Carondelet (catholic) Hospitals have been acquiring most of the hospitals they didn't already control near the border; Nogales Douglas, two in Tucson and now Sierra Vista, Yuma? This not only affects abortion rights but also end of life/Living Will rights. They are the only hospital in these towns except Tucson.

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