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The Affordable Health Care for America Act, passed by the House of Representatives on Nov. 7, is both an achievement and a mere first step. It is an achievement because no other administration has moved this far toward universal health care, although many presidents and candidates aspired to this, beginning with Theodore Roosevelt in 1912. The passage of the House bill by a vote of 220 to 215 could become more than a transitory victory, but its lasting significance depends on what is learned from the 11th-hour effort to win passage of the reform bill. It will also depend on the contents of the Senate bill and the final House-Senate conference bill.

Should it become law, H.R. 3962 would offer the nation benefits historic in scope:

• mandated coverage for 96 percent of American citizens, including 36 million of those currently uninsured;

• federal subsidies to help persons with low-incomes afford the premiums;

• an employer mandate to provide health insurance for workers, with an exemption for small businesses (currently 160 million workers have employer-sponsored plans);

• limitations on insurers, who could sell only policies that meet government standards and could no longer refuse coverage to persons with pre-existing conditions, cap lifetime coverage, drop policyholders who become seriously ill or charge co-pays for preventive care; and parents’ policies could cover children up to age 27.

The bill would also expand Medicaid and streamline Medicare. It would be funded by a “millionaire’s tax,” reducing the deficit by millions over 10 years, according to the Congressional Budget Office. A public option would be one of many choices in a government-sponsored marketplace set up for small businesses and others without insurance. But the public option and government-subsidized plans in the marketplace would not pay for or subsidize elective abortions.

Ironically, it was an amendment to prohibit taxpayer funding for elective abortions, sponsored by Representative Bart Stupak, Democrat of Michigan, and Joseph R. Pitts, Republican of Pennsylvania, that secured the bill’s passage and provided its most bipartisan moment. The amendment passed 240 to 194, with support from 176 Republicans and 64 Democrats. At the last roll call, however, a single Republican voted for the bill: Anh Cao of New Orleans, who said restrictions on abortion were essential to his vote.

One lesson to be learned is that Democrats and Republicans can work together to continue to limit federal financing for elective abortion, though it is not easy.

A second lesson is that the U.S. Conference of Catholic Bishops and the Catholic Health Association can accomplish much by working behind the scenes with legislators. This is a more constructive, successful approach than public attacks questioning the faith of Catholic lawmakers. According to published reports, personal calls by Cardinal Francis George to the Senate minority leader, John Boehner, and by Cardinal Theodore McCarrick to House Speaker Nancy Pelosi appear to have been well timed and effective. The bishops “command respect because they have a good social-justice record,” said Representative Michael F. Doyle, a Pennsylvania Democrat and one of several Catholic leaders behind the amendment. “They actually wanted to pass the bill. That’s why they had status.”

Yet the bishops’ ultimatum to lawmakers—“If the final legislation does not meet our principles, we will have no choice but to oppose the bill”—succeeded only after legislators prepared an amendment that secured votes, and after Speaker Pelosi allowed the amendment on the floor once she saw there were too few votes to pass the bill without it.

Now opponents claim erroneously that the amendment violates “abortion neutrality” by keeping women from buying even a private policy with abortion coverage on the exchange. Not so. H.R. 3962 would allow insurers to offer supplemental abortion coverage, which women could buy without support from taxpayers. Nor is the financing ban unprecedented. It already applies to Medicare, Medicaid, S-chip and health insurance for federal employees, including members of Congress. Still, a group of legislators threatens to oppose the final bill if the amendment is retained. Lesson three: Brinkmanship is a two-edged sword.

For supporters of health care reform, the next step is crucial: passage of a strong Senate bill. Given that 60 votes are needed to prevent a filibuster, it is reasonable to assume the Senate bill too will exclude federal funding for abortion. Building bipartisan support will take at least as much time, energy, money and attention from Catholic leaders as passage of the House bill did. That commitment could finally achieve near-universal health coverage and major improvement in health care for generations of Americans.

Comments

James Lington | 11/24/2009 - 12:05pm
Robert above brings up a very interesting point, one I hadn't thought of until now. Why aren't the bishops letting the Republicans have it for defiantly standing in the way of reform? Republicans have all declared their intent to simply vote no and deny the bishops the reformed health system that they have been advocating for years. So why do they remain silent with them? I wouldn't be surprised if the whole abortion debate is just a Republican tactic for undoing all the work that has gone into health care reform. It would sure be a shame if we find out that the bishops have been tools of the Rep. party. I thought they were above that.
James Lington | 11/24/2009 - 11:47am
While it is great to see our bishops having such an effect in advocating against abortion funding in the Democrats’ reform bills, I wonder why we aren’t hearing anything about their efforts to rally the Republican law makers around the need to pass meaningful health reform. In every statement they issue, the USCCB is always so careful to express ALL their demands for reform: no abortion funding, access for all with special concern for the poor, inclusion of immigrants, protecting conscience rights, and creating a system that restrains costs and applies them equitably across the spectrum of payers.

So while the bishops are enjoying all this success around the abortion issue, having convinced enough House Democrats to side with the Church’s demands, why aren’t they trying equally as hard to convince the Republicans to support universal access, coverage for immigrants, and a cost-effective and fairly financed system? Is abortion really the only issue they care about? Are the other demands for a reformed system merely empty words that they feel compelled to say because of our Catholic moral and social justice tradition, but when it comes right down to it, they don’t really believe that “that stuff” is very important?

Surely they see that the abortion issue alone could, in the end, sink reform, leaving us with the same broken and unjust health system that we’ve suffered with for decades. If strong restrictions around abortion funding are present in the legislation going forward, there could be enough pro-choice Democrats voting against the final bill to stop reform in its tracks. But it could be argued that strong anti-abortion provisions would likely survive if enough Republicans were convinced that voting for meaningful reform is the right thing to do. But we aren’t hearing anything about the bishops working with Republican law makers to shore up votes. So in the absence of their efforts to court Republicans, it makes me wonder if the USCCB’s goal, as sneaky and underhanded as it might be, is ultimately to sink health reform in America.

The bishops have demonstrated tremendous influence with one group of legislators, who aren’t always in sync with Church teaching, in a very difficult and contentious area. Why not use that same power of persuasion to turn a few Republican friends our way to give reform that extra push it needs right now? Makes one question the true intent of their tactics.
C Walter Mattingly | 11/23/2009 - 9:15pm

In Oregon's Public Health plan, a 54-year-old man applied for an important operation  which both he and his physician deemed essential to provide a chance to recover from cancer.  The state refused to approve the operation, but it was kind enough to offer him assisted suicide in its place, with the generous offer that it would be paid for by the state.


It is bad enough when Harry Reid asks whether we agree that no person should go broke to receive health insurance in the US. If he had given the companion piece, no person should be denied life-saving health care and be offered free death instead, I wonder which would have been chosen by most americans.

James Sheehan | 11/23/2009 - 9:36am
When it comes to health care, the solution lies in the old adage "What would Jesus Do"? Did Jesus preach the survival of the fittest in Matthew 25?
Those who are so concerned about their wealth and capitalism should realize that small businesses cannot afford the current health care costs. Something needs to be done. The status quo cannot exist. People who have a sick child end up in bankruptcy. Those of us who have good health insurance (for now)cannot stand and not care about those without. Jesus never told us to to teach one to fish...he said, whatever you do to the least...
GORDON LORD JR MR | 11/23/2009 - 9:12am
what ever happenned to teach a man to fish and he will be able to eat forever .. you seem to like forcing people to do things and give away health care and lots of other things.instead of teaching individual responsibility for their health care and life I do not like people who lobby for their own give aways and hold backs.. you and the bishops havebecome political lobbiests instead of educators of gods way...
Paul Louisell | 11/23/2009 - 12:06am

Are you out of your mind?  Universal health care provided by government taxation is a recipe for disaster.  First of all, it will not decrease the cost of health care.  Because of the government componant, it will necessarily increase the cost. Has there ever been a government program that didn't exceed initial cost projections?   Secondly, it will encourage private employers to pay a penalty rather than insure their workers because the penalty is less than the cost of insurance, forcing workers into the national plan (medicare/medicaid) and driving private insurers out of the market (thus limiting competition and resulting in higher prices).  When the system cannot be afforded, the allowable services will necessarily be limited - Medicare is already on the chopping block to have its benefits greatly curtailed.  Seniors and the seriously ill will not be covered.  Your wonderful encouragement of government run health care will, as with every other government entitlement program, have disasterous unintended consequences for the poor, the elderly and the seriously ill. 


This magazine steadfastly refuses to recognize economic realities - You can't continue stealing from the rich to provide benefits for the poor.  A government that takes that path will destroy the incentive of those who create wealth.  There will be no one left to tax.


Charity is a great and necessary component of a Christian society.  Enforced taxation to accomplish charitable goals destroys the ability and will of the individual to direct his wealth toward charitable causes of his choice.  By placing on the government the responsibility for providing food, clothing, shelter, education and health care to every one, you encourage the recipient of those items to do nothing with his God given gifts.  You also guarantee the destruction of our entrepreneurial class.  When 20% of the population pays 80% of the taxes, the 20% are going to find another place to invest their capital. 


Government health care will continue this trend of increasing taxes on the upper 20% and then blame the rich when the system breaks down.  To call government mandated universal health care an achievement is only a cause for joy if you believe that a society where a government official, as opposed to an individual citizen, can best determine where resources are to be allocated is a good thing.  I don't.  I think government mandated universal health care will place a third of our economy entirely under the control of the federal government.  Nothing good will come of such a blatant attempt at the redistribution of wealth.


 

E.Patrick Mosman | 11/22/2009 - 12:16pm

The following letter was sent to Cardinal George President of the USCCB:


"So We Might See and Government Takeovers: Is Charity Next?
To:president@usccb.org
Date:Tue, Nov 17, 2009 3:10 pm
Cardinal George, President,
I respectfully forward the following letter sent to Archbishop Dolan, unacknowledged and unanswered to date, as you have recently defended the Church's right and duty to oppose the Obamacare bills under consideration. It is increasingly obvious that the Catholic Bishops and the USBBC cannot see the forest of government take over of one-sixth of the US economy because of their sole focus on three trees, abortion, universal care and immigration.This approximately 2000 page bill is full of government mandates, control, rationing administrated by at least 111 new agencies, commissions or boards.
Tax increases and a half billion cuts in care for Medicare users while increasing by millions the number of Medicaid patients  whose cost is a burden to cash strapped states. Many so called Catholic politicians are publicly challenging Catholic beliefs  in supporting OBAMACare while the USCCB dithers on speaking out on the pure socialistic health care program which is not even practiced in socialistic countries.
It is time for the Catholic Cardinals bishops to wake up  and alert their flocks to the immanent dangers to personal freedoms and the right to manage and control their own health care under this administration.
Respectfully
E. Patrick Mosman
Pleasantville NY 10570

Sent: Mon, Nov 2, 2009 7:50 am
Subject: So We Might See and Government Takeovers: Is Charity Next?

Most Reverend Archbishop Dolan,
The following letter was sent to Archbishop Chaput after reading his response to the Catholic Bishop's role in the
George Soros sponsored organization "So We Might See." and its attempts to silence conservative critics.
Archbishop Chaput kindly replied and suggested I bring my concerns to my Bishop which I am doing now.
It is time that the USCCB investigate thoroughly and completely the Obama administration's plan to socialize not only the health care system but the economic power of the USA. The Communist Party USA, CPUSA provides its presidentil platform on its website , find "Election 2008"T and it sounds very familiar to Obama's direction to date.
For the Catholic Bishops to continue to support Obama's social engineering plans in the name of 'Social Justice' is to support the imposition of a pre-1990 Russian and Chinese centralized government directed godless, economic and social system on the USA, 'liberation theology' by law not by the gun.
It is time for the USCCB and the shepherds of the Catholic flock to speak out against this threat against individual rights, liberty and freedom of expression.
Respectfully,
E. Patrick Mosman
Pleasantville NY 10570
 

Sent: Thursday, October 29, 2009 5:58 AM
To: Archbishop Chaput
Subject: So We Might See and Government Takeovers: Is Charity Next?
Most Reverend Chaput,
 
  As an admirer of your positions on 'right to life' and support of the Catholic Church's teachings on other moral and ethical issues, I was not only surprised but shocked to find that the Catholic Bishops, USCCB, of the United States are party to and members of a George Soros sponsored organization "So We Might See." Mr. Soros is openly opposed to the Constitution of the United States as he is a major supporter and financial backer of a One World Government that would destroy the American economic, social system and individual freedom.
 
Catholic Bishops 'Misrepresented' by Fox, Talk Radio Attackers
  http://spectator.org/archives/2009/10/27/catholic-bishops-misrepresente
 
 Somewhere the Catholic Church's leaders have failed to take note that their emphasis on social justice,i.e., government run health care for all, immigration and other government mandated social engineering programs gives the government control of the financial resources to dictate policies inimical to Catholic beliefs.
 
  One example is the various iterations of government health care being  considered and the Catholic Churches seemingly only interest is right to life when these bills are replete with mandates, increased taxes, repeal of 'Conscience opt out provisions for doctors, nurses and hospitals, draconian provisions criminalizing the failure to have health insurance and the list goes on.
 
  The following is an example which will have a serious negative effect on the ability of the Catholic Church and other churches and charities to raise money from big donors and have to go begging to the government for funds that can only be used as per the government's mandates.
Columnist Government Takeovers: Is Charity Next?
  http://townhall.com/columnists/HowardHusock/2009/10/29/government_takeovers_is_charity_next#at  
 The following summarizes my feelings and belief about the role of the Catholic Church vs. government run charity:
 By publicly supporting government mandated universal health care the Catholic Bishops enter into the arena of negotiating with those who support abortion, euthanasia, rationed care for the infirm, disabled, elderly and counseling on end of life care or not.
 
  Jesus Christ rejected negotiations with evil when he rejected the devil's temptations three times. Like the devil, Mr. Obama wraps his views on abortion, euthanasia, rationed care et al, in terms that are intended to lure Catholics into negotiations or acceptance of abortions for some promised good results in other areas. Apparently some 'Catholics' with their subjective conscience have swallowed Mr. Obama's lure and join those who claim that Jesus was a big-government socialist provider with regard to helping those in need and reducing individuals personal responsibility to "Love the Neighbor' and replacing it with government programs is a misreading of His message. Jesus Christ made the point "to render to Caesar the things that are Caesar's and to God the things that are God's" with no guidelines as to how the Romans were to spend the tax monies.
 
  "For you will have the poor always with you" Matthew 26.11 and nowhere in the New
 
  Testament does Jesus Christ lay the responsibility for caring for the poor, the sick the hungry or thirsty, the homeless or any oppressed people on any governmental body. He did not cite King Herod, the priests of the temple, the local mayor or the Roman powers as the source of Charity. He made it an individual responsibility time after time in His sermons, in His parables and in His own acts. The Good Samaritan was not an example of "Love thy neighbor" because he stopped at the nearest inn and asked that a 911 call be made but because he acted, providing aid, comfort and financial assistance to his neighbor.
 
  It is unlikely that Jesus would be available to negotiate or accept Obama's promises for government programs to reduce intrinsic evil acts any more than He negotiated with the devil."
 
Respectfully,
E. Patrick Mosman
Pleasantville NY 10570

J v | 11/22/2009 - 9:13am
The health care reform bill as Stupak and republicans want it will mean proverty and a nation based on ignorace for many women. With not supporting abortion rights you are denying also the need for women's health care and education. The catholic church loses more and more women every year with its shame based and male views on their body. Without abortion rights many women will face proverty if they keep the child. More meth babies and alcohol babies will be born. Since republicans think they love human life too bad they don't want to take care of them once they are born. The catholic church always needs more and more money to take care of the proverty flock. Mean while women and men who believe a women's choice is being shamed by the church. Told they shouldn't receive communion. No wonder people are leaving the church. Funny how even down south in the bible belt and mega churches women in the churches are having the same number of abortions even if they shouldn't. The church should stay out of politics. If you don't want to be taxed don't get involved. Once men believe their sperm is a living being then maybe we can talk.
Brigid Dunn | 11/21/2009 - 7:18pm

As I read recently in another publication, the US Bishops' and other anti-choice groups' opposition to universal healthcare (on the grounds that the abortion language is not strong enough) could, ironically, lead to the death of thousands of under-insured children. Could we please understand that millions of Americans experience severe, even catastrophic economic consequences as a result of illness? I was told from the time I was a small child that I should be grateful to be an American because I have many freedoms that other nations do not enjoy. Can we please put aside the Fox News fear-mongering and start to behave like citizens who care about each other? As a Catholic (Jesuit-educated) I was taught that my faith should be put into action and I should be a person for others. Does this philosophy extend to advocating for those who are sick or now bankrupt due to illness? I believe the pro-life stance extends beyond the abortion question. At least, I hope so.

TM Lutas | 11/21/2009 - 10:36am

It is not just to rob future generations to pay for the present. The actuarial sustainability of any system is a key factor to consider in the justice of promoting any social spending plan. Unsustainable spending in a deficit spending government regime means future generations have heavier payments and less benefits than the present. Doing this is intergenerational robbery. 


The current public health plans we already have are teetering on the brink of insolvency and are not considered actuarially sustainable. Adding new obligations to the public treasury and causing reasonable people to depend on them when we do not have the ability to make good on promises is presently pleasing to our own pride but ultimately an evil we should avoid. 


The history of government social spending is one of underestimating costs and overestimating available funds. Both Medicare and Medicaid have both blown past the long term cost estimates that were given during their legislative debates.


The one exception to the trend seems to be President Bush's Medicare Part D, widely decried as mean-spirited due to the donut hole financial measures that instilled an unusual amount fiscal discipline for a federal social spending program. The same cries do not seem to be accompanying this legislation. This is not encouraging. 

Denis Quinlan | 11/20/2009 - 7:38pm

In the grand tradition of Catholic social teaching access to health care for all citizens is not just a goal, it must be an imperative.  But we are nowhere near consensus on just HOW thst is to be achieved in our current situation.  Developing the enabling legislation that will make access to affordable quality health care a reality in our country is one man's expression of love for one's neighbor; and another man's recipe for rampant socialism and fiscal irresponsibility in the midst of a major recession.  So, what are we to do?  While we are pondering an answer to that question let's not destroy eachother by throwing grenades made up of insults and put downs over the wall of anyone who doesn't see things the way we do.  This situation is very very complicated, and it is truly heavy stuff that we are dealing with here.  Catholic social teaching has never had to look further than the gospels and Christ's message that we love our neighbor as ourselves for its inspiration and its justification.  So let those values also guide our dialogue now because reforming healthcare will not come easily.  The easy decisions, such as they are, have already been made. 

LEONARD VILLA | 11/20/2009 - 6:42pm

The House Health care bill a first step?? First step to what? Insolvency and socialism?  Come on!  It has recently been shown that the government cannot even give away money efficiently putting out phony statistics as to who got money and what jobs were created.  This bill in view violates a cardinal principle of Catholic social teaching the principle of subsidiarity.  Right now no one can be refused emergency room treatment.  With respect to the availability of health care the goal is to make it cheaper and more accessible.  You do this by reducing costs through competition at the state level.  Bureaucrats should not be rationing health care and you can be sure the abortion issue is not over.  Senator Reid wants to tax voters to pay for abortions via health care.You can only tax people so much and you can only punish the producers so much.  Projected costs are always lower than the actual costs when the program starts.  It is also absurd to be raising taxes in a recession when we are at double digit unemployment!  This kind of irresponsibility puts the US at risk vis a vis creditors like Chine who scolded us to get our fiscal house in order. Social justice and statism via centralized government are not necessarily the same.

Christian Rideout | 11/20/2009 - 6:21pm
Once again, we are on a precipice. Once again, great advances in health care hang by a thread. Once again, the Roman Catholic bishops are playing a crucial role in promoting a culture of life. As I said in a comment a few weeks ago, the conscience of American Christianity is best expressed, in this situation, by the USCCB. Other religious groups are playing their roles as well, but let us all pray that the bishops and other leaders maintain the moral position that there should be no tax dollars spent on abortion, and still push for the moral imperative of near-universal health care. Let us all pray for them. The weight of office must bear down heavily on their shoulders.

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