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Michael Sean WintersMarch 15, 2010

As the Congress gets ready for final votes on the health care reform bills, the USCCB maintains that they cannot support the final bill because it permits federal funding of abortion. But, a series of analyses have raised questions about the factual accuracy of the assertions made by the USCCB.

The most frightening claim is that the bill would directly fund community health clinics that perform abortions. This would indeed be troubling, but it is apparently not true. The USCCB objection focuses on whether the funds for the clinics would be covered by the Hyde Amendment, but that is not the real issue. In his article at PoliticsDaily, David Gibson demolishes the objection by pointing out that the community health clinics in question do not, never have, and have no intention of performing abortions.

The claim that the health care bill will permit federal funding of abortion is also troubling. Originally, pro-choice groups favored the Capps Amendment which really was an accounting trick. A federally subsidized plan could cover abortion, but the insurance company would have to pull the money from the premium payment, not the subsidy. How this would be done it did not explain. But, the Senate-approved measure never permits the funds to be combined and insists instead that every person who purchases a plan that covers abortion in the exchanges must write a separate check for their abortion coverage. This is functionally and morally indistinguishable from the "riders" covering abortion that the Stupak Amendment specifically contemplated. For details about this point of controversy, you can consult a document put out by the group Faith in Public Life.

Faith in Public Life also has an analysis of the different bills from Professor Timothy Jost of Washington and Lee University, which you can read here. The USCCB has issued a point by point rebuttal of Jost’s commentary, which you can read here.

The separate check for abortion coverage has itself become a source of controversy, and again all sides seem to be talking past each other. The USCCB argues that people will be forced to pay for other people’s abortion. But, that is only the case if someone chooses a plan that covers abortion. Now, it is anybody’s guess how the market forces will play out. Abortions are cheaper than pregnancies, so the insurance companies have an interest in offering coverage for the procedure, but in fact most women who procure abortions pay out of pocket in order to maintain their privacy. On the other hand, because the insurance company will have to collect separate checks for the abortion coverage, keep that money in a separate account, and pay for any abortions only out of this separate fund, they will have to maintain a staff to oversee all this, and as any businessman can tell you, this kind of oversight can get pretty expensive. It is also impossible to predict how long it will take for people to get fed up with having to write a separate check for abortion coverage and ask their insurers if they can get the same insurance without the abortion coverage. As I say, it is unclear how this will all work out, but I do not believe anyone’s guess about the future performance of market forces is the kind of ground upon which successors of the apostles should base their stance.

The latest statements from the USCCB also fail to note the specific pro-life provisions of the current bill. In the Senate negotiations, Sen. Bob Casey succeeded in having provisions from the Pregnant Women Support Act inserted into the bill. The current health care legislation includes $250 million dollars to support pregnant women and both increases the adoption tax credit and makes it refundable so poorer families can participate. A group of pro-life leaders have called specific attention to these provisions in a letter to Congress that was drawn up by Catholic in Alliance for the Common Good. If the USCCB at least acknowledged these parts of the current bill that are pro-life, but still concluded it was insufficient, their stance would have more credibility. Their failure to acknowledge these provisions is difficult to explain.

It is troubling that the USCCB seems to be working hand-in-glove with the National Right to Life Committee, which has become, for all intents and purposes, an adjunct to the Republican Party. These talking points against the health care bill are being repeated by groups like the American Life League. It should be remembered that the judgment of such groups has been more than questionable in the past: Judie Brown, the head of the American Life League, condemned Cardinal Sean O’Malley for presiding at the funeral of Senator Ted Kennedy, saying the funeral constituted "spitting on Christ." I am not sure I would trust her judgment on the content of the current legislation. And, as I have pointed out before, Professor Robert George’s political organization, the American Principles Project, made its intentions clear when they ran an item under the headline: "Abortion funding still last best hope for halting health care legislation passage." These groups all want to defeat health care reform no matter what.

The USCCB point man on the pro-life issues is Mr. Richard Doerflinger. Mr. Doerflinger is undoubtedly sincere and undoubtedly smart. But, he tends to view all policy issues through a single lens, the lens of abortion policy and a certain way of approaching that policy. It is like going to a 3-D movie and only wearing the red lens over your right eye: The picture gets distorted. Of course, his job is to monitor pro-life issues, not health care issues, but the bishops have an entirely different mandate and that is to articulate a moral vision for the Church and the nation. They must wear the full 3-D glasses, not half. 

Mr. Doerflinger has trouble acknowledging in the current case that there is more than one way to skin the cat, that the Senate bill is not ‘pro-abortion’ in any real sense but is, in fact, a different approach to the issue. He may prefer one approach over another, but he has an obligation to acknowledge that the differences between the Senate and House bills are pretty thin. He has a further obligation to explain why these small differences warrant the risk that is now obvious, the risk that the U.S. bishops will be tagged for causing the failure of universal health insurance. Instead, he continues to grant interviews in which he repeats the mantra that his way is the only way. 

The bishops should be wary of following his way. Many commentators think he is mistaken in many of his assessments and prognostications, but even if he is not, the bishops should only risk defeating health care over a genuine moral principle, not because of anyone's guess about how market forces will react, or what insurance companies will do. Neither the House/Stupak bill nor the Senate bill provides government funding of abortion. That is a statement of fact, not a statement of opinion and Mr. Doerflinger is entitled to his own opinions but not to his own facts.

I am not persuaded by the argument one hears frequently on the left, that health care is simply too important to let it be side tracked because of abortion. If the current bill actually was pro-abortion I would oppose it. I find the idea of being pro-abortion and pro-health care oxymoronic. But, it seems to me that the language in the final bill does clear the necessary hurdle of not providing federal funds for abortion. Then, and only then, do I feel comfortable moving on to the other merits of the bill. I certainly would have drafted a different bill, but on the merits, I would vote in favor of its passage. I hope the bishops will recognize that pro-life Catholics can, in good conscience, disagree about the different aspects of the bill. Even if they feel compelled to oppose it, there are sufficient reasons on all sides to not draw any lines in the sand or to turn this vote into a litmus test of Catholic orthodoxy. Indeed, the differences of opinion about the facts themselves indicates the wisdom of a point the bishops made in their two landmark teaching documents on nuclear weapons and the economy: At the level of principle, the bishops can assert their position with great certainty and authority, but as the focus moves to the practical, legislative level, that certainty becomes less and their authority must be used more lightly.

The USCCB has made its decision and there is no going back. But, individual bishops will be called upon in the coming week to lobby their members of Congress. They should make clear, as the USCCB statements have not done, that they recognize that people of good will, with equal commitment to the pro-life cause, can differ about specific legislative proposals. There are plenty of conservative Catholics who are ever chomping at the bit for a culture war, and whose venom toward the President has colored their views of the health care debate. They see everything in black and white when, as shown above, there is a fair amount of contention about the facts themselves. The bishops should resist the counsel of those who want them to draw lines in the sand over health care. We don't need a culture war but we do need health care reform. Only the gravest deficiencies in the current legislation warrant stiff opposition and it is far from clear such deficiencies exist. Moral certainty is one thing; political certainty another. And, if anything is clear in the current debate, it is that there is precious little political certainty. Why should the bishops risk their moral authority on such uncertain terrain?

Michael Sean Winters

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David Nickol
13 years 11 months ago
Although the last I heard, Stupak was optimistic about negotiating acceptable language on abortion for the health care reform package, he is on record in a Wall Street Journal interview from a couple of weeks ago saying even if the abortion language were fixed, he would vote against the bill. I don't know what to make of this. If he really doesn't support the bill, surely that fact would influence his judgment regarding what was acceptable language on abortion.
As I have been saying, it seems to me that the only way to measure the House and Senate with any degree of confidence is to divide the country into equal thirds and implement the House version in one third of the country, the Senate version in another third, and just stick with the status quo in the remaining third. Then in about ten years there may be data that makes sufficiently clear who was right and who was wrong. 
Peter Lakeonovich
13 years 11 months ago
Michael, thanks for the impassioned plea, but you are no good tempter. I'm with the USCCB on this one (see Archbishop Chaput's piece on First Things posted today). "We don't need a culture war but we do need health care reform." You use the line of reasoning offered to our Lord by the devil in his first temptation: "just turn these stones into bread; that's what you need; that's what the hungry need." The USCCB must draw a line in the sand because we will not "live on health care alone." And what good does it do us if we receive health care "reform" in exchange for our souls? Oh, and Michael, risk as they may, the bishops (i.e., the appointees of Jesus and the successors of the Apostles) can never lose their moral authority, which comes not from men or public opinion but by the grace of God, who alone gives and can revoke their authority. How about this website try for once to lead the faithful, rather than confuse and scandalize.
Gabriel Marcella
13 years 11 months ago
If the differences between the House and Senate versions are "pretty thin" why not adopt the House version and get on with passing the legislation? This Catholic feels more comfortable with the judgment of the USCCB than that of David Gibson, Professor Jost, or Jonathan Karl.
James Lindsay
13 years 11 months ago
Excellent analysis. I hope the USCCB and their staffs read it. If Stupak is so superior, then the USCCB should insist that the Senate Bill, with Stupak added, be a must pass bill for the National Right to Life Committee to support. No one should have a perfect pro-life score if they don't vote yes. If they are unwilling to take this step, then they need to back down (and so does Stupak).
David Nickol
13 years 11 months ago
Pete Lake,
Whether or not the bishops can lose their moral authority, this is not a matter of morals but of politics. The bishops are not really making a moral argument. They are arguing that the Hyde Amendment must be the guide for federal spending in health care reform. The Hyde Amendment permits federal funds to be used for abortion in the case of rape, incest, and threat to the life of the mother. The Catholic Church does not. They have (and I do not fault them on this) already settled for less than strict adherence to Catholic morality. If the bishops were truly arguing the Catholic stand on abortion, then no health care reform bill could allow abortion under any circumstances.
While Catholics of course must pay careful attention to what the bishops say, the bishops have no special competence to determine whether it is the House or the Senate language that more clearly reflects the principles of the Hyde Amendment. Nor do the bishops have a crystal ball to predict whether the House language will be, in actual practice, more effective in limiting the number of abortions should health care reform pass with one or the other. 
I personally think the bishops should have articulated the moral principles involved and let the American people and the pro-life politicians decide how the legislation itself could best be written. I don't believe it is the job of bishops to say, "We approve that provision in the bill, but we want this other provision to be rewritten." They are bishops, not legislators.
Charles Ferry
13 years 11 months ago
The result of the 'no less than a $1' language in the Senate bill would be greatly expanded abortion coverage in the private market by making it a profitable enterprise by setting its coverage price at that arbitrary price floor. (See http://www.slate.com/id/2246905/pagenum/all/ for the estimated cost of covering abortion)
Knowing what we know about health insurers, why wouldn't they direct, promote and encourage customers to enroll in the one they can charge a profitable surcharge from? These plans won't be basic and basic + abortion. There's no regulation to say the non-abortion plan can't be on a plan that covers a larger set of procedures at a significant premium cost. If they can manipulate the market towards the products with higher yields, they'll certainly do it with the provisions the Senate bill allows.
Many would like to hide behind a strict reading of the bills. You think politicians say one thing and mean the same thing and that third parties will react the same way?
Designing legislation and loosening regulation to make it profitable for insurers isn't a matter of Hyde (no one ever claimed it was), but it's a matter that a pro-life person can not endorse as a proper action of the government to perform.
Marc Monmouth
13 years 11 months ago
Alan Legett (#5), the double standards at America Magazine never cease to amaze us!  I have in the past suggested that the editors of America have their primary loyalty to the Democratic Party and my remarks have never been published. You write that the bishops have their primary loyalty to the Republican Party and your remarks are published!  This is further proof, as if any further proof were necessary, that the editors of America find anything said about Republicans and conservatives acceptable, but any criticism of Democrats and liberals a sin that must be expunged!
John Hayes
13 years 11 months ago
I was discouraged to see this post on Bishop O'Malley's blog tonight. It states as facts, interpretations on which there is substantial disagreement.
"The bishops’ position on health care reform has favored a new system that will provide universal coverage, but the current process may end up creating a bill that will provide federal funding for abortion. As much as we agree on the need to provide universal coverage, we cannot support a health care bill at the expense of life.
The Senate Bill that passed before Christmas and which is now expected to be “reconciled” is unacceptable in terms of funding for abortion and conscience protection. It even includes funding for Planned Parenthood abortion centers among other anti-life related issues."
Fortunately, the post doesn't recommend any action other than watching a video by Kathy Saile of the USCCB.

Tom Maher
13 years 11 months ago
Wow. What a incredibly biased analysis. Catholics are not baptized into the Democrat party anymore. This is the analysis of a 1920's Democrat city ward boss - Democrats good, Republicans bad. The political labels just do not reveal the essential merits or demerits of the Senate healthcare reform bill. Long ago the Democrat party changed where now concerns of Catholics are often vigorously opposed by the Democrat party. Who can forget the 1992 Democratic Convention where Governor Casey was not even allowed to address the convention with a pro-live message?

The question is: can the Democratic leadership be trusted to not fund ,finance or facilitate abortions? The Healthcare legislative history of the last year especailly the Capps amemndment in the House shows the Democrat leadership can not be trusted. The Nelson Amendment was defeated and is not part of the Senate bill. Fool me once shame on you; fool me twice shame on me. The USCCB needs to not be fooled by insisting that any legislation must definitely prohibit abortion funding. The Stupak Amendment must be demanded by the USCCB.
Helena Loflin
13 years 11 months ago
The Republican bishops are against healthcare reform.  Period.  Doesn't matter if abortion coverage is in (which it is not) or out (which it is).  Party first.  The American people are somewhere down the list of concerns after the usual Republican agenda items. 
Pearce Shea
13 years 11 months ago
David Nickol
I think the impetus, in part, for the Bishops to speak up has to do with the fact that a number of prominent, self-proclaimed Catholic institutions are actively lobbying in support of health care reform lock-step with the liberal wing of the Democratic party. In this sense alone, a very clear statement ought to help alleviate confusion for the faithful.
And frankly, the USCCB was created, in part for the very purpose of giving the Bishops a unified voice on public matters, so the USCCB is just doing what it was meant to...
And last but not least, I think the "not paying for the abortions of others" canard MSW makes simply because of how the bill now works is pretty slithery and he flat out seemed to be in opposition to this very thing back when the reform talks just got under way. Why are Caesareans so frequently preformed? Because they are cheaper for the doctor and the more doctors preform them, the lower their premiums go. If abortion really does start becoming the cheaper option, and I realize this isn't a 1:1 analogy, I wonder if it starts becoming something pushed by doctors.
john Carr
13 years 11 months ago
I admire much of the work of Michael Sean Winters, but I do not share his view that the explanation for the USCCB’ s positions on abortion funding and health care reform is that Richard Doerflinger has too much influence. First, that underestimates the Bishops’ involvement and decision-making and second, it over-emphasizes Richard Doerflinger’s role. I am a USCCB staff member and have worked side by side with Richard on this and other issues. While the bishops are deeply involved in setting all USCCB positions and priorities, I have never seen key Bishops more involved than on this issue. If people have a problem with the bishops’ judgments on how best to keep abortion funding out of health care, they have a dispute with the President of the USCCB and the three bishops who chair the USCCB Committees on Domestic Justice, Pro-life and Migration. These leaders of the Bishops’ Conference have been personally involved at every step in this long process and have made all the key decisions on the USCCB positions and priorities.

The Conference’s stance has been clear and consistent. For decades, the USCCB has supported health care that protects the life, dignity, conscience and health of all. The USCCB seeks to ensure that much needed health care reform does not violate or undermine the current restrictions on federal funding for elective abortion and plans which include elective abortion. The bishops want to fully apply the Hyde amendment, no more, no less. This is the law of the land and the will of a majority of Americans. In the House, this position was adopted by an overwhelming bi-partisan vote and it paved the way for passage of health care reform by a narrow margin. The Senate bill fails that test because it funds plans that include elective abortions and requires people who select a plan, other than the one plan required to not include abortion, to pay directly and regularly into a fund exclusively for other people’s abortions. All the USCCB seeks is the same provisions that cover Medicaid, S-Chip, and the Federal Employee Health Benefits Plan.

Richard Doerflinger is a smart, committed and determined defender of human life and dignity wherever it is threatened. He is a skilled and determined advocate for the unborn and the vulnerable. The Bishops rely on him and the rest of us to offer analysis and assistance. However, the policies and priorities the USCCB advocates are the decisions of the bishops, not the staff.
13 years 11 months ago
It's time to pass HC reform so we can move on to immigration and prison reform and all the other reforms that Catholics & the USCCB so strongly believe in. One-note anti-abortionists should take a deep breath and back off. I heard President Obama at Notre Dame last February and believe he is sincere about reducing abortions. BTW, he's not a Catholic. He doesn't have to do it our way. But he does have to govern a diverse nation. And he's our only hope for immigration reform, prison reform, abolishing the death penalty, a just end to the wars in Iraq & Afghanistan - all the things that authentically pro-life Catholics support & one-note anti-abortionists refuse to acknowledge as important.
Marc Monmouth
13 years 11 months ago
Steve Harper writes: "he's [Obama] our only hope for immigration reform, prison reform, abolishing the death penalty, a just end to the wars in Iraq & Afghanistan - all the things that authentically pro-life Catholics support & one-note anti-abortionists refuse to acknowledge as important."  Steve, put your faith in higher things!  You're only going to be disappointed with your faith now

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