Starting today, a number of provisions in the Affordable Care Act (ACA) that affect primarily women’s health begin taking effect. One of them is a mandate that most employers contract with an insurance firm that provides no-cost birth control.

Americans United works to defend church-state separation and took no stand on the ACA. But when the controversy erupted over access to birth control, we made a couple of points that are worth reiterating as these new provisions take effect.

To begin with, it’s important to remember that houses of worship are exempt from this mandate. No Catholic or conservative Christian church that opposes birth control has to make it available to its employees.

The types of entities that will be affected by this new provision in the law are not churches; they are religiously affiliated. That’s a big difference. Church-affiliated bodies (colleges, hospitals, social-service agencies, etc.) are almost always subsidized with taxpayer dollars. They hire people outside the faith and serve the public without regard to the individual’s religious belief.

Because church-related institutions receive so much tax money and act in a quasi-official capacity, they cannot expect to operate without some accountability. Why should they be able to impose religious views on their employees, many of whom don’t even share the faith?

When these new rules were announced last year, the Catholic bishops immediately went ballistic. In response to their concerns, President Barack Obama announced a compromise: Religiously affiliated entities wouldn’t be required to provide free contraceptives directly; rather, they could contract with an insurance provider that made birth control available at no cost as part of a baseline package of care. In another nod at compromise, the administration gave religiously affiliated groups an additional year to implement the plan, meaning they are not under the new rules until this time next year.

In addition, the rule-making that will actually implement the policy for religiously affiliated groups is still under way, so it’s possible that even more compromises will be made. (Americans United hopes not. We weighed in on the matter in June.)

And of course there are a number of lawsuits under way – backed by the bishops – that could affect the issue.

All of this still wasn’t good enough for the bishops. In fact, they began insisting that even private employers should have the right to deny birth control coverage to employees.

When observers pointed out that the church’s stand is wholly unrealistic given that even the vast majority of Catholics ignore church teachings and use birth control, some commentators said this was irrelevant. But it’s not irrelevant. Church leaders tried to persuade their own members to follow church teachings. They failed – and they’re now seeking to twist government policy to achieve something their own teachings could not do. That sure sounds like a church-state issue to me.

One more thought on this: The government has the right to ignore religious demands that are completely out of touch with reality and the way we live today. It is time to stand up and say that the efforts to deny Americans access to essential medication on the basis of rigid theological rules that virtually no one follows any more are misguided and even dangerous.

Just because a large and powerful religious group holds an idea does not mean it is automatically worthy of deference. It may simply be a bad idea that’s not in the best interests of society.

The ability to control your family size by accessing safe, reliable and effective birth control is a fundamental human right. Our government is required to allow those who believe differently to opt themselves out. But those latter-day theocrats have no right to make that decision for other people – nor is the government required to treat their yearning to live in the Middle Ages as a serious basis for public policy.