During the past three decades, the tide in religious affiliation has rapidly shifted in Latin America. The predominance of Catholicism in the region has been challenged by the expansion of Evangelicalism and the number of individuals with no religious affiliation. Changes in Brazil’s religious landscape are explained in part by the opportunities and restrictions that government regulations place on religious organizations. Regulation shapes religious competition by changing the incentives and opportunities for religious producers (churches, preachers, revivalists, etc.) and the viable options available to religious consumers (church members). Importantly, as our description of Brazilian regulations shows, the incentives defined by regulation affect religious denominations differently, creating winners and losers. Moreover, established religious groups are often able to reshape religious regulation, reinforcing the degree to which it favors them.
Claudia Cerqueira and Guadalupe Tuñón
The American Catholic Church has a long history in health care. At the turn of 19th century, Catholic nuns began developing the United States’ first hospital and health care systems, amassing a high level of professionalization and expertise in the field. The bishops also have a well-established record advocating for healthcare, stemming back to 1919 with the Bishops’ Program for Social Reconstruction, which called for affordable and comprehensive care, particularly for the poor and vulnerable. Moving into the latter part of the 20th century, the bishops continued to push for health care reform. However, in the aftermath of Roe v. Wade (1973), the American bishops insisted that any reform or form of universal health care be consistent with the Church’s teaching against abortion, contraception, and euthanasia. The bishops were also adamant that health care policy respect religious liberty and freedom of conscience. In 1993, these concerns caused the bishops to pull their support for the Clinton Administration’s Health Security Act, since the bill covered abortion as a medical and pregnancy-related service. The debate over health care in the 1990s served as a precursor for the United States Conference of Catholic Bishops’ (USCCB) opposition to the Obama Administration’s Affordable Care Act (ACA) and the Department of Health and Human Services’ (HHS) contraception mandate. The ACA also highlighted a divide within the Church on health care among religious leaders. For example, progressive female religious leadership organizations, such as the Leadership Conference of Women Religious (LCWR) and their affiliate NETWORK (a Catholic social justice lobby), took a different position than the bishops and supported the ACA, believing it had enough protections against federally funded abortion. Though some argue this divide lead to institutional scrutiny of the sisters affiliated with the LCWR and NETWORK, both the bishops and the nuns have held common ground on lobbying the government for affordable, comprehensive, and universal health care.