A religious order of nuns is concerned about its future presence in the United States because of Obamacare’s impact on its charitable operations. The Little Sisters of the Poor told The Daily Caller that it may not qualify for a long-term exemption from Obamacare’s healthcare mandate. The law requires the order to provide government-approved health insurance to its 300 sisters who tend to the elderly in 30 U.S. cities.
The exception is needed, said Sister Constance Carolyn Veit, the Little Sisters’ communications director, because Catholic teaching opposes contraception and medical treatments that cause sterility or can cause abortions.
President Barack Obama’s health-care overhaul law requires employers to include those services in qualifying health care plans they provide for their employees. Failure to comply will bring hefty fines — even for religious orders whose members have taken vows of poverty.
“[I]t could be a serious threat to our mission in the U.S.,” Constance told TheDC, “because we would never be able to afford to pay the fines involved. We have difficulty making ends meet just on a regular basis; we have no extra funding that would cover these fines.”
The crux of the matter is a religious exemption that the federal government is expected to make available to Catholic churches, but not to other Catholic institutions.
That’s because unlike Catholic parishes and dioceses, the church’s many affiliated schools, charities, religious orders and hospitals don’t discriminate in their hiring or service, often employing staff — and serving people in need — who come from other Christian denominations or from other faiths entirely.
“We are not exempt from the [Obamacare] mandate because we neither serve nor employ a predominantly Catholic population,” Constance added. “We hire employees and serve/house the elderly regardless of race and religion, so that makes us ineligible for the exemption being granted churches.”
Those employees, she said, number in the thousands.
“We employ about 100 employees per home; many of them receive their health insurance through us,” Constance explained. “So the financial burden with fines is not primarily for our own insurance coverage, but for theirs, a much bigger dollar amount.”
The one concession the Obama administration made to religious groups like hers was a one-year extension of time before they would be expected to provide their staff with health insurance that met with the White House’s approval. That extension will expire at the end of 2013, but the sisters have only a few weeks left to make their case for an exemption beyond the end of next year.
“We just cannot not say what will happen,” Constance told TheDC. “We are continuing to pray that our backs will not be up against the wall in 2014. If we are forced to make a decision, we will seek concrete direction from the U.S. bishops.”
The Little Sisters of the Poor take care of elderly patients in 31 countries, but on Dec. 16 a representative told the congregation of Saint Raymond of Peñafort Church in Springfield, Va., that her order could conceivably be forced to pull out of the United States if paying fines and penalties is the only alternative to compromising on the doctrines of their religion.
Asked about that Sunday Mass message, Constance responded, “Essentially it sounds like what sister said was accurate.”
In a June 2012 essay appearing in The Tablet, a Catholic newspaper in Brooklyn, N.Y., she said leaving the United States entirely wouldn’t be without precedent.
“[A]s Little Sisters of the Poor, we are not strangers to religious intolerance,” she wrote. “Our foundress was born at the height of the French Revolution and established our congregation in its aftermath. Our sisters have been forced to leave numerous countries, including China, Myanmar and Hungary, because of religious intolerance. We pray that the United States will not be added to this list.”
“[I]f we were to stop offering health insurance rather than comply with the mandate,” she told the National Catholic Register in October, “we would have to pay a $2,000 penalty per employee. This penalty aside, it just does not seem right to us to stop providing health insurance to our employees.”
“If we chose to offer insurance without the objectionable services,” she continued, “we would honor our consciences, but we’d have to pay $100 per day per employee. … [F]or an organization with 50 employees, that would mean almost $2 million per year.”
Constance added that Medicaid reimbursements from the government cover only half the cost of caring for elderly sick people “in the way they deserve.”
She also explained to the National Catholic Reporter that although the Catholic Church’s primary objection to Obamacare involves reproductive health care — a subject seldom associated with nuns or their elderly patients — “we are concerned about what could happen later.”
“What we fear is that, if the federal government succeeds in this case, there are other areas where they could exert pressure or enact measures that could endanger our apostolate — particularly in end-of-life care and in the possible rationing of care to the elderly as a cost-saving measure.”
For the moment, however, the Little Sisters are focused more on providing health care than on fighting health-care battles. A contentious and public battle with Washington, D.C. has made some residents of their nursing homes and assisted-living facilities all over the country anxious about whether the organization will be there in years to come.
“We wish to avoid causing them any further anxiety,” Constance said.
“They are always our first concern, our employees as well.”
This story was updated after publication to include an estimate of the number of lay employees who work in Little Sisters of hte Poor homes throughout the United States.