Catholic bishops urge Congress not to repeal Obamacare without a replacement

The federal government forms for applying for health coverage are seen at a 2013 rally held by supporters of the Affordable Care Act at a health care center in Jackson, Miss. (CNS photo/Jonathan Bachman, Reuters) The federal government forms for applying for health coverage are seen at a 2013 rally held by supporters of the Affordable Care Act at a health care center in Jackson, Miss. (CNS photo/Jonathan Bachman, Reuters) 

Catholic bishops in the United States urged a pause in efforts to repeal the Affordable Care Act until Congress can ensure that the millions of Americans who rely on the A.C.A. for health insurance can be guaranteed coverage.

In a letter sent to senators and representatives on Jan. 18, Bishop Frank J. DeWane, head of the U.S. Conference of Catholic Bishops’ committee on domestic justice, wrote that while the group originally opposed Obamacare because it “expanded the role of the federal government in funding and facilitating abortion,” it nonetheless recognizes “that the law has brought about important gains in coverage and those gains should be protected.”

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“The Catholic bishops of the United States will examine health care proposals in greater depth and from various perspectives in the days ahead,” he continued.

“But we note for now that a repeal of key provisions of the Affordable Care Act ought not be undertaken without the concurrent passage of a replacement plan that ensures access to adequate health care for the millions of people who now rely upon it for their wellbeing.”

President-elect Donald J. Trump promised during his campaign that he would repeal Obamacare, and the Republican-controlled Congress has taken the first steps in recent days to make that possible.

Bishop DeWane’s letter notes that Catholic bishops have long supported universal access to health care in the United States. The Congressional Budget Office, Congress' nonpartisan budget analyst, estimated on Jan. 17 that a bill passed in 2016 to only repeal—not replace—the law would result in 18 million more uninsured people and a spike in premiums.

RELATED: Readying for Trump, Catholic Leaders Express Worry over Regulatory Rollbacks

But elements of the Affordable Care Act, which has brought the rate of uninsured Americans down to record low levels and coincided with a plummet in the U.S. abortion rate, promote greater access to contraception. The law included limited exemptions from its contraception mandate for some employers who object on religious grounds.

The act’s critics charge that its design has led to federal funding for abortion, as some insurers include the procedure in plans that can receive federal subsidies. These provisions caused a row within the church during the bill’s passage in 2010, with bishops largely opposing the measure while other Catholic leaders supported it.

John Carr, who led the U.S.C.C.B.’s domestic policy shop for many years before his retirement in 2012, told America that the statement was “an important, principled and timely contribution because it lifts up the moral and human imperative to provide health care for all in the middle of a partisan and ideological battle."

Fallout from the bill has led to several lawsuits from Catholic entities in recent years, perhaps most notably from the Little Sisters of the Poor, a group of women religious who run nursing homes for the elderly.

Claiming that their religious liberty was at stake, the sisters successfully sued the Obama administration over its requirement to sign a form stating that their health insurance plans did not cover contraception, which would trigger third-party coverage for contraception through insurers.

But other Catholic leaders have been supportive of the law’s overall goal.

At a conference in Washington earlier this month, Sister Carol Keehan, head of the Catholic Health Association, called health care “a basic human right,” and she urged “a united voice” from Catholic leaders to say it is “intolerable” for the tens of millions of Americans who receive health insurance through Obamacare to risk losing their coverage.

Sister Keehan was a key early supporter of the bill, receiving one of the pens President Obama used to sign the bill into law.

Michael O’Loughlin is the national correspondent for America and author of The Tweetable Pope: A Spiritual Revolution in 140 Characters. Follow him on Twitter at @mikeoloughlin.

Updates to follow

This story was updated at 12:31 p.m. on Jan. 18 with a reaction from John Carr, former head of U.S.C.C.B. Office of Social Development and World Peace.

Comments are automatically closed two weeks after an article's initial publication. See our comments policy for more.
Lisa Weber
10 months 1 week ago
The bishops would be more credible if they had not helped to bring about the repeal of the ACA.
Derrick Weiller
10 months 1 week ago
Yes!
Rudolph Koser
10 months 1 week ago
Double yes. The Trump administration will ignore the Bishops on this, immigration, and a host of other core issues. The Republicans got tacit support from a number of Bishops. They were used and now they will be cast aside till the next election.
J Cosgrove
10 months 1 week ago
From what I understand the Republicans including Trump have said there will be an immediate replacement of health care. So is this a fake news story? Or are the Bishops ill informed? Or are the Republicans being dishonest when they say there will not be a lapse in an opportunity to get insurance? This story would be credible if it went into all the problems of the ACA and why so many want it to be repealed. For example, from Paul Ryan http://cnn.it/2iCjDQU Why don't the bishops know about this? Why doesn't Mr. O'Laughlin? The man who will be in charge of the new health care law is being interviewed today by Congress.
Derrick Weiller
10 months 1 week ago
a) From what I understand the Republicans including Trump have said there will be an immediate replacement of health care. Yet, although the move to repeal is well under way, there is as yet no credible replacement on the table that would cover pre-existings, under-26s, reasonable affordability to all, and so on. It must be concluded, therefore, that the Republicans are being repeal-and-replace deceptive. b) ACA problems have been front and center since first inceptions. They need not be rehearsed here. They can be addressed without a "repeal-first" c) The man who will be in charge of the new health care law [Tom Price] is, indisputably, a corrupt liar. His oh-so-clever "My accountant made me do it" is as laughable as the dog who ate his homework. So what's your point, here?
Kathleen McCaffrey
10 months 1 week ago
The bishops have demonstrated an ignorance of healthcare economics as well as of the medical complexities inherent in such issues as coverage for pre-existing conditions, banning lifetime caps, the meaningless of "access" without affordability, the absence of conventional marketplace markers in the medical sphere, etc. Nor have they shown the slightest grasp of women's health, of which reproductive health is as aspect. And just for fun, here's a trick question: if the embryo is a person, and if a corporation is a person, is a woman also a person? Can this be divined from Catholic social teaching?
Derrick Weiller
10 months 1 week ago
Nicely said, Kathleen. Thank you.
Vincent Gaglione
10 months 1 week ago
The Bishops’ political advisors, besides each other, are likely Republican. Were they to consult anyone linked favorably to the issues against which they have lobbied for the past 30 years, they no doubt believe that they would tarnish their reputations as well as their alleged integrity. Many of the Bishops also do not believe that Catholics can disagree with integrity with their political views. They conflate doctrine with political action. In a multi-cultural, multi-religious and non-religious, and multi-racial society they lack insights into day-to-day living and working in a diverse democratic society. They tend to have a “my way or the highway” vision for Catholics. Politically most of them are neophytes. They don’t teach politics in a seminary. And the echo chamber of their own conference so narrows their perspectives that they become deaf and blind to the real world in which the majority of Catholics live. There is a reason that the pews have emptied during the past 30 years. The Catholic Bishops’ political naïveté and attacks on the Affordable Care Act only bolstered opposition to the legislation without any concern for consequences such as we now see. The talk of replacement legislation now centers on “catastrophic insurance” plans, which cost consumers much “out of pocket” dollars long before any real coverage kicks in. It makes people think twice and three times about seeking medical assistance if it’s going to bite into their weekly budgets. The Bishops’ statement speaks to that concern. However, if politically sophisticated, they would have opposed repeal and they would have been much more effective talking about improvements than giving succor to those who want repeal. Ironically nuns (whom they sought the Vatican to investigate) probably would have been a much better source of political knowledge and expertise to them on the topic. But, alas, nuns are women!
Chuck Kotlarz
10 months 1 week ago
A piece in America Magazine describes Bishop Vera as one of Mexico’s most outspoken and respected promoters of human rights. The Bishop notes, “Society has been abandoned by politics and economics; it cannot be abandoned by the church as well.” US Bishops have eight men in their back yard with as much wealth as the poorest three billion people on the planet. Bishop Vera’s plea perhaps is too late. http://www.americamagazine.org/content/dispatches/another-priest-murder-mexico-raises-security-questions http://www.huffingtonpost.com/entry/income-inequality-oxfam_us_58792e6ee4b0b3c7a7b13616?tmqb3t69iefp3nmi
Tim O'Leary
10 months 1 week ago
This article and some comments below seem oblivious to the hardships brought on by Obamacare for blue-collar and middle-class Americans. While it did reduce the uninsured (was 18%, now 13.4%), it ballooned the cost of insurance for most Americans and reduced choices. It needs to go. Here is Speaker Paul Ryan: “We can and should have a system in this country where everybody can have access to affordable healthcare, including people with pre-existing conditions, no matter how much money they make. That's not what this law is doing. This law is failing on that front and I think there is much, much better system that could be put in its place. “Obamacare came in with all this fanfare and all this promise. Remember, "If you like your plan you can keep it"? That was proven the lie of the year at the time. Remember, it was going to lower premiums $2500? They have skyrocketed since then. Remember, you were going to have all these choices? Five states, you only have one choice. Thirty-one percent of all the counties in America? One choice. That's not a choice, that's a monopoly. And the problem is, the premiums are going so high, the deductibles are getting even higher -- the law is collapsing. And, so, we've got to rescue people from the collapsing of this law and fix this problem. Re premium increases: “Arizona -- this year, 116 percent; Oklahoma, 69 percent; Tennessee, 63 percent; Minnesota, 59 percent. The problem is, these increases were double- digit last year. They are really high this year. This thing is collapsing…There is a better way to fix that problem without giving everybody else all these massive premium increases. Deductibles are so high it doesn't even feel like you've got insurance anymore." Read the rest here http://transcripts.cnn.com/TRANSCRIPTS/1701/12/se.01.html
Derrick Weiller
10 months 1 week ago
Tim: That the ACA is an imperfect solution is clear and cmpelling. The issue, however, is whether fix/improve/replace be concurrent with repeal. To repeal on the mere promise of fix/improve/replace would be a damnable immorality.
Kathleen McCaffrey
10 months 1 week ago
The Affordable Care Act saved lives, mine among them. Yes, deductibles have risen and insurers have opted out of state exchanges, problems not inherent to the Affordable Care Act, which has slowed the growth rate of healthcare through improved delivery systems and has improved the quality and efficiency of care. The issue is healthcare’s cost: the US spends $10,000 per capita, 17.8% of GDP, more than twice the average of other developed countries, with significantly worse health outcomes than theirs. Medical costs are high because prices aren’t regulated (as elsewhere) and vary wildly across states. Costs to insurers are high, and, since our health insurance industry isn’t regulated (as elsewhere) and chases high profits for shareholders, costs are shifted to patients. US prescription drug prices are not negotiated downward. But Pharma CEOs and shareholders are flush. Paul Ryan wants to bring back HIGH RISK POOLS—where patients drown in debt or die. The very idea of an insurance pool is to spread risk; high risk pools do the opposite. Before Obamacare, patients in those death traps faced caps on coverage ($100,000 lifetime) and paid premiums 150 to 200% higher than everyone else. They got away with murder—not hyperbole. As far as buying insurance across state lines: beware. You may pay a low premium in a state with loose regulation; just be sure you never really need coverage. Avoid cancer and chronic diseases. Don’t have a baby with a congenital heart defect requiring surgeries or a child with MS or leukemia or even asthma. Creating health savings accounts or offering tax credits? Sure, you might save, depending upon your income, anywhere between $5,000 to $50,000. No heart surgery for you, unless you’re super rich. Catholic social teaching? Conclusion: We must keep Obamacare and improve upon it.
Tim O'Leary
10 months 1 week ago
We have had 7 years of Obamacare and it has failed in nearly every promise that was made about it, from keeping one's doctor to covering everyone (no way near) to costing less. Almost everyone interacting with it is unsatisfied. The very poor uninsured may like it because it is free for them , but that could have been solved by expanding medicaid and not messing up the system for everyone else. Not only are individuals seeing higher deductibles and less choices and longer waiting lines, but there are other less visible costs: higher taxes, unfunded subsidies (increasing federal debt). Possibly the biggest cost are the lost jobs - so many employers are keeping people part-time (<30 hrs) or not hiring to avoid the prohibitive costs. Probably the scariest number of all, after the national debt, is the labor force participation rate (the percentage of working age population that is part of the labor force). It has been declining right through the Obama 8 years. A record 95,102,000 Americans are not in the labor force - a 38-year record. While Obamacare is only part of the cause for that (EPA regulations also contribute), it hasn't helped. It has thousands of pages no one can read, increasing the cost of lawyers. http://www.cnsnews.com/news/article/susan-jones/record-95102000-americans-not-labor-force-number-grew-18-obama-took-office We would be better off it it was completely eliminated and the government (medicare and medicaid) picked up the bill for any doctor visits until it was replaced.
Douglas Fang
10 months 1 week ago
"the government (medicare and medicaid) picked up the bill for any doctor visits until it was replaced" - How much more deficit this would add to our debt? Trillions? And this does not include the massive tax cuts and infrastructure spending proposed by Trump. After all, you guys all act like Dick VP - "Deficit doesn't matter". Except when it is under a Democratic government. It is so hypocritical and deceitful. There is nothing honest and sincere in this debate.
Douglas Fang
10 months 1 week ago
duplicate
Tim O'Leary
10 months 1 week ago
Wait a minute - Your guy adds $10 trillion to the national debt, including billions from Obamacare, and you are using the words hypocritical and deceitful? What world do you live in?
Chuck Kotlarz
10 months 1 week ago
Life expectancy in eight right-to-work states is at least four years lower than California. A 2014 Gallup survey found that the two states with the most dramatic drop in their respective rates of uninsured are Kentucky and Arkansas, both right-to-work states. The Kentucky rate plummeted from 20 to 10 percent, while the Arkansas rate dropped from 22 to 11 percent. “Probably the scariest number of all, after the national debt, is the labor force participation rate…” An acquaintance notes the labor force participation rate in 1960 was 70% vs 80% today. In 1960, two newly built homes in his neighborhood sold for about $28,000, one to a fireman with four kids and stay at home spouse and the second to a policeman with five kids and stay at home spouse. A few miles away and two years earlier, Warren Buffet paid $35,000 for a house, the one he still lives in.
Tim O'Leary
10 months 1 week ago
California is not a good example for managing its affairs. It has an unsustainable debt ($400B) that even has its dominant Democratic leadership in a tizzy. http://www.sfchronicle.com/politics/article/California-s-400-billion-debt-worries-analysts-6812264.php. This also proves that taxes alone can't solve the issue, since it has one of the highest state taxes in the nation (income tax up to 13.3%, sales tax up to 9.5%). State tax is even 8% for those making under $50k (and they have to pay the full sales taxes).
Chuck Kotlarz
10 months 1 week ago
Good old divide and conquer Paul Ryan. States balance their budget (by law). Anytime tax revenue falls off, legislators can cut either health care or education funding or both. Ask Paul Ryan about Black educational achievement (college degrees). Wisconsin has the worst rate in the country. With Paul in charge of healthcare, what could possibly go wrong? Thanks in advance Paul. The imminent demise of Obamacare starts with cutting the capital gains tax from 23% to 15% for the 400 highest earning Americans. The 400 have a $100 billion combined income, the majority coming from capital gains. Take from the poor, give to the rich starts with a capital gains tax cut on the 400 highest incomes. Look at the top 25 incomes and a capital gains tax cut gets downright disgusting.
Tim O'Leary
10 months 1 week ago
A good part of this letter from the bishops is that they agree it should be replaced. They will be pleased with Trump's desire of "insurance for everybody," which Obamacare has certainly failed to do. I just hope this promise does not end up like Obama's "you can keep your doctor." https://www.washingtonpost.com/politics/trump-vows-insurance-for-everybody-in-obamacare-replacement-plan/2017/01/15/5f2b1e18-db5d-11e6-ad42-f3375f271c9c_story.html?utm_term=.fe1fd88e0e20
Douglas Fang
10 months 1 week ago
Tim, repeating a lie doesn’t make it become true. Trump does NOT have any plan to repeal and replace Obamacare with something better, i.e. coverage for everyone and cheaper, i.e. lower premium and deduction. The only thing that can accomplish this is a single payer health plan like most other advanced countries (actually, someone points it out after Trump’s interview with WaPo) Yuval Levin, a reporter from the conservative magazine, National Review, has something to say about the plan that Trump described to Washington Post: “After Trump’s Washington Post interview this past Sunday, the conservative health-care universe, including some people on Trump’s own team, quickly concluded that the separate administration plan he described was entirely a figment of Trump’s imagination,” Levin writes. http://www.vox.com/2017/1/16/14281206/trump-obamacare-plan http://www.vox.com/policy-and-politics/2017/1/18/14312052/obamacare-repeal-disarray Also, quoting Ryan’s plan as a counter argument here is very strange and meaningless. It is as if someone use Obama’s quote to support the concerns of the Bishops. The kicker here is that “ Obamacare Has Never Been More Popular: NBC News/WSJ poll” – Maybe people now are seeing something valuable that is being taken away from them and they would miss it. http://www.nbcnews.com/politics/first-read/brink-repeal-obamacare-has-never-been-more-popular-n707806 Actually, here is the real reason that Republicans what to repeal Obamacare: http://www.cnbc.com/2017/01/18/obamacare-and-why-republicans-so-eager-to-repeal-it-commentary.html The Republican alternatives vary in many important ways, they all fundamentally offer stingier insurance to a narrower group of people. If this is true, then the Republicans seem to act like the rich man in the parable of the “Rich Man and Lazarus” Luke:19-31. I feel sorry for the reaction of the Bishops now. They should have known better.
Tim O'Leary
10 months 1 week ago
Douglas - I agree about your point re repeating a lie. We heard so many times that you could keep your doctor, etc. Since Trump has lied so much in the past I can't predict what he will do. But, Speaker Paul Ryan is an honest and incredibly smart man and I trust him. We will know very soon.
Michael Barberi
10 months 1 week ago
I have spent 30 years in the healthcare industry both as a senior partner in a worldwide benefits consulting firm and as a senior vice president of a Fortune 100 healthcare services company. Clearly, the Affordable Care Act (ACA) is not working and this is a dramatic understatement. A truly effective replacement plan will not be easy and a real solution to rising healthcare costs and comprehensive affordable access has hampered experts for decades. I will evaluate Trump slowly and incrementally, not giving too much emphasis to his rhetoric and tweets, but to what gets done for the American people. Left without significant changes, the ACA will collapse under its own weight which is what we are witnessing. We have to do something. Unfortunately, universal national healthcare, as a so-called solution, will be worse than the problem.
J Cosgrove
10 months 1 week ago
Michael, I have some questions that you may be able to answer. They are really all related 1. The content of the specific plans of the ACA is arbitrary. By that I mean that what the plan is supposed to cover is at the discretion of those in HHS who designed the regulations relevant to it. In other words there is no necessity in the law to cover contraception or abortion techniques but these were written in by those who wrote the regulations. Obviously under the direction of the Cabinet Secretary based on input from the White House. If so, such elements could be changed as soon as a new HHS person is in place. 2. Related - the plans offered could be wide range of options and not necessarily the same for everyone. If so this would allow lower priced plans to exist. 3. Again related - How much could be changed without new legislation? I understand the requirements to cover pre existing conditions would remain as well as the coverage of children till they are 26.
J Cosgrove
10 months 1 week ago
The accusation that the Republicans do not have a health care plan is disingenuous at best. Of course a specific plan does not exist but there are several well thought out alternatives that do exist and await the confirmation of the new HHS secretary. The Democrats did not have a plan when Obama won the election in 2008 so why the sudden criticism of Republicans now? It took 18 months to finally approve the ACA as it made its way through Congress. And the Speaker of the House made her famous comment
we have to pass the bill so that you can find out what is in it,
So I suggest that those who make the claim there is no Republican plan and who make links to sites that say this are really guilty of promoting "fake news." Of course there is the question of just what is "fake news" these days. Now it may turn out that many of the ideas by the Republican congress legislatures may prove inadequate but to say they don't have a plan is nonsense.
Charles Erlinger
10 months 1 week ago
I'm sure that most commenters already know this, but since it has not been stated explicitly, I would like to state it for the record: The policy objective of universal health care is fundamentally incompatible with the strategy of achieving the objective by means of the commercial insurance business model. The insurance model as we know it is completely dependent on the workable intersection of actuarial risk assessment, underwriting risk evaluation and selectivity, and product pricing to insure the ongoing ability to pay anticipated claims. For some reason that escapes me, we tend to talk as if care insurance is the same as care. How obvious does it have to be that the two terms are not synonymous?

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