By Jason Coon & Mandy Cox
In recent months, the Catholic Benefits Association (CBA) has seen a significant increase in requests from member organizations for guidance on a recurring and complex challenge: how to handle healthcare providers routinely prescribing contraceptives—particularly Intrauterine Devices (IUDs)—for a range of medical conditions.
While most Catholic employer health plans rightly exclude contraceptive coverage in alignment with Church teaching, we are seeing more employees raising questions and concerns when such prescriptions are presented as necessary for medical diagnoses. This growing trend calls for renewed attention, education, and the development of clear processes that address the moral wellbeing of the patient, provider and the employer, while also being compassionate
Understanding the Moral Issue: Why IUDs and Contraceptives Pose a Problem
The Catholic Church teaches that the use of contraception to avoid pregnancy is intrinsically immoral. However, the concern deepens with certain methods—like hormonal contraceptives and IUDs—due to their mechanisms of action. While some physicians prescribe these methods for medical reasons like excessive bleeding or endometriosis, these devices can work in multiple ways, including:
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Preventing ovulation (primary function)
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Hindering fertilization (secondary function)
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Preventing implantation of a fertilized egg (final function)
It is this final action—interfering with the implantation of a newly conceived life—that constitutes an abortifacient effect and makes these forms especially problematic from a moral standpoint. Unfortunately, many patients (and even some healthcare providers) are unaware of these mechanisms. Catholic employers have both a duty and an opportunity to educate their employees about the moral concerns associated with these prescriptions, and to explain why their health plan excludes such coverage. Click HERE for a wonderful educational resource for employees.
Why Catholic Employers Should Think Twice About Exceptions
Even with strong exclusion policies in place, employers may face pressure to make exceptions, particularly when a contraceptive is prescribed for a medical—not contraceptive—reason. While compassion for employees’ health concerns is crucial, inconsistent application of exceptions can quickly become problematic.
Employees talk. If one exception is made, others may question why similar cases were denied. This can erode trust and put the employer in a morally and legally precarious position. To mitigate this, Catholic employers should consider establishing a clear, consistent process for evaluating medical exceptions.
A Smarter Process: Review, Refer, and Educate
Instead of defaulting to denial or approval, employers can implement structured review processes:
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Second Opinion by Catholic Medical Experts: Offer employees the opportunity to consult a Catholic provider or a telehealth service that aligns with Church teaching. A great resource for second opinions on complex issues is through MyCatholicDoctor.com.
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Ethical Review Support: The National Catholic Bioethics Center (NCBC) offers real-time consultation on morally complex medical decisions. Employers can work with NCBC to review cases and determine if prescriptions meet the moral criteria for an exception.
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Employee Education: Equip employees with resources to understand the Church’s teachings, and explain why certain medications or devices may not be covered—even when prescribed for health reasons. Contact CBA on how our Catholic open enrollment materials may support this education effort.
Moral Evaluation Principles to Consider
Using contraceptives with the intention to avoid pregnancy is immoral; however, women often use hormonal contraceptives or devices without directly intended the contraceptive effect. Catholic teaching acknowledges that medications may be morally permissible if used for treating legitimate medical conditions and not intended for contraceptive purposes. Here, two key moral principles apply:
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The Principle of Double Effect: An action with both a good and a bad effect can be morally acceptable if the good is intended, the bad is not, and there’s a proportionate reason.
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Proportionate Reasoning: The benefit must be serious enough to justify the unintended (but foreseen) negative effect.
These concepts require thoughtful, case-by-case evaluation. A helpful approach may be to allow an exception from a plan exclusion of contraceptives to address an urgent medical situation, but with established clear timeframes, during which the employee is offered alternative, morally acceptable treatments.
Forming a Review Committee
To ensure consistency, fairness, and professionalism, Catholic employers may wish to form an internal review committee or task force. This team can:
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Evaluate requests based on clearly defined moral and medical criteria
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Collaborate with third-party administrators to formalize protocols
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Distinguish clearly between always-covered, sometimes-covered, and never-covered scenarios
This structure promotes transparency, avoids ad hoc decision-making, and strengthens moral clarity across the organization.
Promote Alternatives that Reflect Catholic Values
While it’s important to exclude services that conflict with Church teaching, it’s just as important to promote services that support health in morally sound ways. Catholic employers should highlight and invest in alternatives like:
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Natural Family Planning (NFP)
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Restorative Reproductive Medicine (RRM)
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Functional Medicine Approaches
These services aim to diagnose and treat the root causes of medical symptoms rather than masking them with contraceptives. They embody a whole-person approach—mind, body, and soul—and affirm the dignity of both the patient and the unborn.
By offering mission-aligned health care, Catholic employers show employees that their well-being matters, not just in physical terms, but in moral and spiritual terms as well.
Conclusion: Uphold the Faith and Care for the Whole Person
This is not just a health care issue—it’s a matter of mission. As Catholic employers, we are called to witness to the truth of human dignity and the sanctity of life in every aspect of our organizations. With the right tools, processes, and partnerships in place, we can faithfully navigate these complex scenarios—protecting conscience, serving our employees with compassion, and upholding the moral teachings of the Church.
As we continue to support our members in addressing these challenges, we want to hear from you.
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Are you encountering pressure to allow coverage for contraceptives due to medical diagnoses?
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Are physicians prescribing IUDs or similar treatments to your employees for reasons not related to contraception?
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What kinds of questions or concerns are you receiving from your staff?
Your experiences will help us better understand the scope of the issue and shape the resources, tools, and guidance we provide going forward. Please reach out to us with your questions, stories, or specific cases your organization is facing. Together, we can work toward solutions that are both morally sound and pastorally sensitive.
Let us know what you’re encountering—so we can face this challenge as a community, grounded in faith and committed to truth.