The Cost is too High; the Loss is too Great

The Catholic Bishops of the United States have long and consistently advocated for the reform of the American health care system. Their experience in health care and in Catholic parishes has acquainted them with the anguish of mothers who are unable to afford prenatal care, of families unable to ensure quality care for their children, and of those who cannot obtain insurance because of preexisting conditions.

Throughout the discussion on health care over the last year, the bishops have advocated a bipartisan approach to solving our national health care needs. They have urged that all who are sick, injured or in need receive necessary and appropriate medical assistance, and that no one be deliberately killed through an expansion of federal funding of abortion itself or of insurance plans that cover abortion. These are the provisions of the long standing Hyde amendment, passed annually in every federal bill appropriating funds for health care; and surveys show that this legislation reflects the will of the majority of our fellow citizens. The American people and the Catholic bishops have been promised that, in any final bill, no federal funds would be used for abortion and that the legal status quo would be respected.

However, the bishops were left disappointed and puzzled to learn that the basis for any vote on health care will be the Senate bill passed on Christmas Eve. Notwithstanding the denials and explanations of its supporters, and unlike the bill approved by the House of Representatives in November, the Senate bill deliberately excludes the language of the Hyde amendment. It expands federal funding and the role of the federal government in the provision of abortion procedures. In so doing, it forces all of us to become involved in an act that profoundly violates the conscience of many, the deliberate destruction of unwanted members of the human family still waiting to be born.

What do the bishops find so deeply disturbing about the Senate bill? The points at issue can be summarized briefly. The status quo in federal abortion policy, as reflected in the Hyde Amendment, excludes abortion from all health insurance plans receiving federal subsidies. In the Senate bill, there is the provision that only one of the proposed multi-state plans will not cover elective abortions – all other plans (including other multi-state plans) can do so, and receive federal tax credits. This means that individuals or families in complex medical circumstances will likely be forced to choose and contribute to an insurance plan that funds abortions in order to meet their particular health needs.

Further, the Senate bill authorizes and appropriates billions of dollars in new funding outside the scope of the appropriations bills covered by the Hyde amendment and similar provisions. As the bill is written, the new funds it appropriates over the next five years, for Community Health Centers for example (Sec. 10503), will be available by statute for elective abortions, even though the present regulations do conform to the Hyde amendment. Regulations, however, can be changed at will, unless they are governed by statute.

Additionally, no provision in the Senate bill incorporates the longstanding and widely supported protection for conscience regarding abortion as found in the Hyde/Weldon amendment. Moreover, neither the House nor Senate bill contains meaningful conscience protection outside the abortion context. Any final bill, to be fair to all, must retain the accommodation of the full range of religious and moral objections in the provision of health insurance and services that are contained in current law, for both individuals and institutions.

This analysis of the flaws in the legislation is not completely shared by the leaders of the Catholic Health Association. They believe, moreover, that the defects that they do recognize can be corrected after the passage of the final bill. The bishops, however, judge that the flaws are so fundamental that they vitiate the good that the bill intends to promote. Assurances that the moral objections to the legislation can be met only after the bill is passed seem a little like asking us, in Midwestern parlance, to buy a pig in a poke.

What is tragic about this turn of events is that it needn’t have happened. The status quo that has served our national consensus and respected the consciences of all with regard to abortion is the Hyde amendment. The House courageously included an amendment applying the Hyde policy to its Health Care bill passed in November. Its absence in the Senate bill and the resulting impasse are not an accident. Those in the Senate who wanted to purge the Hyde amendment from this national legislation are obstructing the reform of health care.

This is not quibbling over technicalities. The deliberate omission in the Senate Bill of the necessary language that could have taken this moral question off the table and out of play leaves us still looking for a way to meet the President’s and our concern to provide health care for those millions whose primary care physician is now an emergency room doctor. As Pope Benedict told Ambassador to the Holy See Miguel H. Diaz when he presented his credentials as the United States government’s representative to the Holy See, there is “an indissoluble bond between an ethic of life and every other aspect of social ethics.”

Two basic principles, therefore, continue to shape the concerns of the Catholic bishops: health care means taking care of the health needs of all, across the human life span; and the expansion of health care should not involve the expansion of abortion funding and of polices forcing everyone to pay for abortions. Because these principles have not been respected, despite the good that the bill under consideration intends or might achieve, the Catholic bishops regretfully hold that it must be opposed unless and until these serious moral problems are addressed.