In a move that has stirred the Catholic rank and file, Barack Obama is holding fast to the demands that his health care package will place on Catholic hospitals, universities, and service centers.

The Obama administration's regulations under the health-care law requir[e] religiously affiliated entities to provide free sterilization and contraception, including some drugs that cause abortions, to their employees and, in the case of Catholic universities, their students. It's a decision that's politically baffling as the president heads into a tough election in which the Catholic vote could be critical.

One in six patients in the United States receive their care in a Catholic-run hospital.  As the ruling stands now, they may have to find other means of obtaining medical treatment in the future.

Churches themselves would be exempt from the rule, but Catholic schools, hospitals and social service organizations that serve and employ many non-Catholics would not. Reportedly the decision came after heavy lobbying by abortion rights advocates. Now many faith-based institutions are left with three options, says Washington's Cardinal Donald Wuerl: to violate their beliefs; to stop providing insurance and face fines under the health-care law; or to stop serving non-Catholics.

As bold as Obama's move may seem, it's even bolder when you consider that Catholics represent a quarter of the voting public;  With a sour economy and plunging approval ratings, Obama is facing a rough campaign cycle as it is and this move appears to alienate a large voting bloc along the way.

Four years ago, Barack Obama won the Catholic vote which is about a quarter of the electorate and swings back and forth in presidential elections, usually going with the winner. But he won it only because he had such overwhelming support from Hispanics; he lost non-Hispanic Catholics. The way things are going this year, Obama could be endangering himself even with Hispanics by courting such full-throated opposition from the hierarchy.