The U.S. Supreme Court’s decision to uphold health care reform, the Patient Protection and Affordable Care Act, makes it even more urgent for Congress to act to fix the law’s “fundamental flaws” on abortion funding, conscience protection and immigrants’ access to health care, the U.S. bishops said. The court ruled on June 28 that the commerce clause of the Constitution did not offer cover for the extension of federal authority required to enforce the individual mandate included in the Affordable Care Act. But in a decision that overturned the expectations of many court watchers, Chief Justice John Roberts argued that the law still passed Constitutional muster as an exercise of Congress’ powers to tax.
“The Affordable Care Act’s requirement that certain individuals pay a financial penalty for not obtaining health insurance may reasonably be characterized as a tax,” Chief Justice Roberts wrote in the majority opinion. “Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness.” In a 65-page opinion announced by Chief Justice Roberts, five members of the court essentially let the Affordable Care Act stand in full, rejecting only the act’s threat to punish states that resist its expansion of Medicaid by withholding all federal Medicaid funding.
Commenting on the decision shortly after it was announced, the U.S. Conference of Catholic Bishops said it “neither diminishes the moral imperative to ensure decent health care for all, nor eliminates the need to correct fundamental flaws” in the law
The Pro-Life Office statement added that the conference “has not joined in efforts to repeal the law in its entirety, and we do not do so today” before arguing that the A.C.A. is in need of repair. The bishops argue that the law “allows federal funds to pay for elective abortions,” and they charge it “fails to include necessary language to provide essential conscience protection...illustrated in dramatic fashion by [the Department of Health and Human Services’] ‘preventive services’ mandate, which forces religious and other employers to cover sterilization and contraception.” The bishops also argue that health care reform leaves immigrant workers and their families “worse off by not allowing them to purchase health coverage in the new exchanges created under the law, even if they use their own money.”
Other Catholic voices were more enthusiastic about the decision. “We are elated,” said Simone Campbell, of the Sisters of Social Service, the executive director of Network, a social justice lobby based in Washington, D.C. “We know that this pro-life decision will save many, many lives,” she said. “Knowing that people with pre-existing conditions cannot be denied coverage and that young people can continue to stay on their family healthcare policies is wonderful news for every family and individual.”
Carol Keehan, a member of the Daughters of Charity who is president and chief executive officer of the Catholic Health Association, was pleased that the health care law “has been found constitutional and will remain in effect.” The association had played a pivotal role in the A.C.A.’s passage in March 2010. “In the coming weeks and months, we will continue working closely with our members, Congress and the administration to implement the A.C.A. as fairly and effectively as possible,” Sister Keehan added.
Court cases and conflict around A.C.A.’s new requirements for contraception services in health care packages were unaffected by the decision. The C.H.A. has joined U.S. bishops in urging the government to expand its definition of religious employers who are exempt from the new requirement.