The pope's personal representative to the United States said Wednesday that the Catholic Church in the U.S. is living in a "particularly challenging period of its history."
His words underscored the issues being tackled by the U.S. Conference of Catholic Bishops, which is holding its spring General Assembly in Atlanta.
The gathering of the nation's top Catholic leaders included discussions of threats to religious liberties and sexual abuse by clergy.
"Of course, I am thinking of the whole question of freedom of religion and of conscience - issues close to the heart of the American people - and of the indispensable role of the bishop as chief shepherd in his diocese and all of this in the context of an election year, making interventions even more delicate," said Archbishop Carlo Vigano.
High on the agenda was the Obama administration's controversial mandate that would require insurers to provide a wide range of contraceptive coverage, the church claiming that it violates religious liberty and moral conscience.
Although the administration says religious-affiliated institutions such as schools and hospitals do not have to pay for or refer employees for any coverage, the church argues that since most dioceses are self-insured, they would still bear that responsibility. Their affiliates would also be part of that self-insured plan.
It's a question "of change in the longstanding respect that the government has for religious freedom," said Atlanta Archbishop Wilton D. Gregory. Churches, synagogues, mosques and religious organizations have not previously "been forced by government edict to violate their conscience vis-a-vis ethic or moral issues."
It should be of "serious interest" to non-Catholics too, he said.
"If the government can force Catholics to do something on Tuesday, then the Methodists better be worried about what's going to be coming down the line on Thursday that would be in violation of their religious freedom," Gregory said.
The bishops received an update on how the church is addressing the priest sexual abuse scandal. Al Notzon III, chairman of the USCCB national review board, said while there are have major strides and transparency, it's still "an evolving process."
Notzon said the problem has moved beyond being a legal issue and become more of a pastoral issue that involves training, constant monitoring of effectiveness of programs, clergy evaluations, help for victims and the restoration of trust among parishioners.
While thousands of victims have come forward to tell their secrets, he conceded it was "impossible to know the number of victims."
Meanwhile, more than a dozen people gathered outside the hotel to protest the meeting.
The group spoke out against the Vatican's recent criticism of members of the Leadership Conference of Women Religious, which represents many of the nation's nuns, for being "incompatible with the Catholic faith." The group said it had a petition containing more than 57,000 signatures.
"I think the nuns do an incredible job of reflective discernment about what is God's call for them," said Natallie Keiser, who wore a button reading "I Stand with the Sisters."
"The bishops need to respect them trying to help the poor and the marginalized and not control it."
There were other issues as well. Barbara Blaine, president of the Survivors Network of those Abused by Priests, criticized an update on the child safety policy.
"Where do they get the audacity to claim everything is fine?" she said. "There are so many breeches of their policy. Notice how all their discussions are about dealing with the priests. What about the children?"