For the regulators at HHS are not simply dedicated to the nationalisation of healthcare in the United States; they are committed to the use of federal regulatory power to promote and enforce their understanding of "preventive healthcare", a euphemism that masks their commitment to the sexual revolution in its most extreme forms and their devotion to a virtually unrestricted abortion licence (which is itself, of course, a key factor in making the sexual revolution "work"). Thus it seemed self-evidently clear to those drawing up plans for the implementation of Obamacare that all employers providing health insurance to their employees should be required to buy insurance plans that covered, not only contraceptives, but sterilisations and abortifacient drugs — all of which, to the permanent bureaucracy at HHS, are components of "preventive healthcare".  

That contraceptives are more readily available in the US than cigarettes or beer is a fact of 21st-century American life that has become completely lost in the media fog. Moreover, the government already has ample means at its disposal to provide cost-free contraceptives, which it does through voluntary organisations like Planned Parenthood (a recipient of vast amounts of governmental money) and an extensive network of community health clinics in poor areas; there, contraceptives are provided by Medicaid, the government's healthcare programme for the poor. But this was not sufficient for the HHS regulators and their allies in the White House — which brings us to the second circle in this debate.

Under the HHS mandate, one of the largest employers that would be required to provide preventive health services is the Catholic Church, which, through various institutions and agencies, serves one in six hospital patients in America (often the poorest of the poor), runs thousands of educational institutions (which frequently serve more non-Catholics than Catholics), and conducts an extensive programme of social services in impoverished rural areas,  among immigrants, and in America's inner cities. And the Catholic Church, as a matter of settled moral conviction, objects to what the administration demanded that the church provide to the employees of these Catholic institutions and agencies. From the church's point of view, which coincides with the constitutional and legal reality of the matter, this has not been a debate about birth control; the church was not imposing its moral doctrine on anyone. Rather, this was about the US government, through coercive state power, compelling Catholic institutions to provide what the Catholic Church teaches is wrong. This was about religious freedom, which includes a broad freedom for the church to conduct its educational, medical, and charitable ministries according to its own moral standards. 

The Catholic reaction to the administration's January 2012 "contraceptive mandate" was fiercely negative across the spectrum of Catholic opinion (and irrespective of the critics' views on the morality of various methods of family planning). Progressive Catholics who had been stalwart proponents of the Obama administration suddenly found themselves criticising HHS and the White House for unnecessarily coercing the church, and for doing so in a politically inept way in an election year. The administration, taken aback by this criticism, proposed an accommodation of religious concerns on February 10, which many of the pro-Obama Catholics quickly embraced. But the Catholic bishops of the United States were unimpressed, rightly regarding the "accommodation" as an accounting shell game that left the church's religious freedom concerns unaddressed.