SIOUX FALLS, S.D. (CNS) — Bishop Paul J. Swain of Sioux Falls criticized a South Dakota Catholic health care plan’s decision to comply with the federal contraceptive mandate for some of its clients, saying the situation “creates public scandal.”

Bishop Swain instructed two diocesan employees who had served on the advisory board of Avera Health Plans to resign, “to ensure that their continued presence could not be interpreted as diocesan acquiescence and therefore cause an intensification of the scandal.”

Avera Health Plans offers health insurance to individuals and groups and is a separate civil corporation from the Avera Catholic health care system.

Daryl Thuringer, an Avera spokesman, confirmed the resignations in a March 27 telephone interview with Catholic News Service.

Thuringer told CNS “less than 10 percent” of Avera’s 60,000 customers are covered by health plans that comply with the Department of Health and Human Services mandate that all employers, including most religious employers, provide employees with free coverage contraception, sterilization and abortion-inducing drugs.

Bishop Swain, in a March 1 letter to priests and deacons of the diocese, told them that their own health insurance was not affected and neither was that of diocesan employees and Avera health care facilities. He explained that those insurance plans currently are not subject to the HHS mandate because they qualified for the temporary “safe harbor period” that protects employers from immediate government action against them if they fail to comply with the mandate.

In his letter, Bishop Swain said he was not consulted on Avera Health Plans’ decision and was notified after the fact in January by CEO John Porter.

“This development is troubling in a number of ways. Most importantly, as an organization, Avera will now be materially cooperative in the termination of life,” Bishop Swain said. “Avera’s decision, as I explained to Mr. Porter in a subsequent meeting, creates public scandal; as a Catholic institution, its practice is of course inconsistent with church teaching.”

“While health care today is complex and highly regulated, compliance with government requirements must not be viewed as licit reasoning for compromising moral teachings. I have invited, therefore, members of the Avera administration to remain in dialogue with my office so that consultation can be offered as regulatory requirements continue to threaten religious liberty and freedom of conscience,” Bishop Swain said in the letter.

The HHS mandate has been subject to several lawsuits on the grounds the exemption for those who object to it on moral or religious grounds should be expanded. A bill has been introduced in the U.S. House of Representatives — the Health Care Conscience Rights Act — that is designed to protect conscience rights of employers and workers.

New proposed rules issued Feb. 1 by HHS would widen the exemption for religious organizations, but will not be finalized until August. The proposed rules remove three conditions that defined religious employers — as groups whose purpose is the inculcation of religious values, who primarily employ persons of the same faith and who serve those of the same faith. The fourth criterion remains: what is a nonprofit organization under specific sections of the Internal Revenue Code.

No exemption will be given to “for-profit, secular employers” whose owners have moral objections to providing the coverage.

Those affected by Avera Health Plans decision to comply with the mandate “do not carry out religious works,” according to a fact sheet accompanying Bishop Swain’s letter.

A number of religious entities, including the U.S. Conference of Catholic Bishops, say the new proposed rules do not go far enough to exempt all those who object on moral and religious grounds to such coverage, such as individual employees and for-profit employers.

Bishop Swain praised the Avera health care system, saying that through his encounters with its staff and supporters, he has “developed personal affection for this ministry of hope while experiencing firsthand the dignity it has shown to others.” The comprehensive system is “truly a great gift of loving service to those in need who are served without discrimination,” he said, which is why he was “deeply saddened” to learn of the Avera Health Plans decision.

“Sadly, we must consider whether a Catholic health care delivery system in our day will be able to balance the regulatory and financial obligations it faces in order to remain a viable business while maintaining its unique and important mission of the healing ministry of Jesus,” he said.

He noted that he often hears from Catholics who choose their health plan or medical providers based on the Catholic mission of Avera.

Avera’s Thuringer said the company, one of South Dakota’s two largest health care providers, is “working in conjunction with other Catholic health-affiliated systems, the Catholic Health Association and universities in trying to get this mandate reversed, trying to seek sponsored support for legislation recently introduced to see if we can get relief from these mandates from HHS.”

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Contributing to this story was Mark Pattison in Washington.