The Cathoholic

Obamacare and Abortion Funding, Part II

This was a busy week for the pro-life movement and the USCCB. On Tuesday, the National Right to Life Committee released a report charging that the high-risk insurance pools in Pennsylvania that would receive $160 million in federal funds--courtesy of the new health bill--would include abortion services. The Department of Health and Human Services and Rep.Bart Stupak denied the charge, and insisted that the Executive Order already prohibited federal funding for abortion. The next day, without precisely saying so, the HHS spokeswoman said that the new state high-risk insurance pools "will not" fund abortion services. By Thursday, the USCCB was able to release a statement that confirmed an HHS policy shift had occurred. Here's the story. I've Googled this issue, and most major media organizations don't appear to be interested in the matter.  ABC and Fox pulled together stories.

UPDATE: NPR covered this issue yesterday, mostly from the perspective of abortion-rights groups who contend that preventing coverage of abortion services in the state high-risk insurance pools is going beyond the boundaries of the Executive Order.

Here's some of the documentation organized by the National Right to Life Committee:

Following NRLC's release on the Pennsylvania plan on July 13, the initial statement from DHHS, issued late July 13, was as follows:

 

< STATEMENT FROM JENNY BACKUS - HHS SPOKESWOMAN

Under the Affordable Care Act and the President’s related Executive Order, federal funds made available to states for the Pre-Existing Condition Insurance Plan may not be used to fund abortion.  We will reiterate this policy in guidance to those running the Pre-existing Condition Insurance Plan at both the state and federal levels. >

 

In a second statement, issued late July 14:

FOR IMMEDIATE RELEASE                                            Contact:   HHS Press Office

Wednesday, July 14, 2010                                                                         (202) 690-6343      

STATEMENT OF HHS SPOKESWOMAN JENNY BACKUS ON THE PRE-EXISTING CONDITION INSURANCE PLAN POLICY

 

As is the case with FEHB plans currently, and with the Affordable Care Act and the President's related Executive Order more generally, in Pennsylvania and in all other states abortions will not be covered in the Pre-existing Condition Insurance Plan (PCIP) except in the cases of rape or incest, or where the life of the woman would be endangered.

 

Our policy is the same for both state and federally-run PCIP programs. We will reiterate this policy in guidance to those running the Pre-existing Condition Insurance Plan at both the state and federal levels. The contracts to operate the Pre-existing Condition Insurance Plan include a requirement to follow all federal laws and guidance.

 

****

http://www.whitehouse.gov/the-press-office/executive-order-patient-protection-and-affordable-care-acts-consistency-with-longst

 

The White House

Office of the Press Secretary

For Immediate Release

March 24, 2010

Executive Order -- Patient Protection and Affordable Care Act's Consistency with Longstanding Restrictions on the Use of Federal Funds for Abortion

EXECUTIVE ORDER

ENSURING ENFORCEMENT AND IMPLEMENTATION OF ABORTION RESTRICTIONS IN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT

By the authority vested in me as President by the Constitution and the laws of the United States of America, including the "Patient Protection and Affordable Care Act" (Public Law 111-148), I hereby order as follows:

Section. 1. Policy. Following the recent enactment of the Patient Protection and Affordable Care Act (the "Act"), it is necessary to establish an adequate enforcement mechanism to ensure that Federal funds are not used for abortion services (except in cases of rape or incest, or when the life of the woman would be endangered), consistent with a longstanding Federal statutory restriction that is commonly known as the Hyde Amendment. The purpose of this order is to establish a comprehensive, Government-wide set of policies and procedures to achieve this goal and to make certain that all relevant actors -- Federal officials, State officials (including insurance regulators) and health care providers -- are aware of their responsibilities, new and old.

The Act maintains current Hyde Amendment restrictions governing abortion policy and extends those restrictions to the newly created health insurance exchanges. Under the Act, longstanding Federal laws to protect conscience (such as the Church Amendment, 42 U.S.C. 300a-7, and the Weldon Amendment, section 508(d)(1) of Public Law 111-8) remain intact and new protections prohibit discrimination against health care facilities and health care providers because of an unwillingness to provide, pay for, provide coverage of, or refer for abortions.

Numerous executive agencies have a role in ensuring that these restrictions are enforced, including the Department of Health and Human Services (HHS), the Office of Management and Budget (OMB), and the Office of Personnel Management.

Sec. 2. Strict Compliance with Prohibitions on Abortion Funding in Health Insurance Exchanges. The Act specifically prohibits the use of tax credits and cost-sharing reduction payments to pay for abortion services (except in cases of rape or incest, or when the life of the woman would be endangered) in the health insurance exchanges that will be operational in 2014. The Act also imposes strict payment and accounting requirements to ensure that Federal funds are not used for abortion services in exchange plans (except in cases of rape or incest, or when the life of the woman would be endangered) and requires State health insurance commissioners to ensure that exchange plan funds are segregated by insurance companies in accordance with generally accepted accounting principles, OMB funds management circulars, and accounting guidance provided by the Government Accountability Office.

I hereby direct the Director of the OMB and the Secretary of HHS to develop, within 180 days of the date of this order, a model set of segregation guidelines for State health insurance commissioners to use when determining whether exchange plans are complying with the Act's segregation requirements, established in section 1303 of the Act, for enrollees receiving Federal financial assistance. The guidelines shall also offer technical information that States should follow to conduct independent regular audits of insurance companies that participate in the health insurance exchanges. In developing these model guidelines, the Director of the OMB and the Secretary of HHS shall consult with executive agencies and offices that have relevant expertise in accounting principles, including, but not limited to, the Department of the Treasury, and with the Government Accountability Office. Upon completion of those model guidelines, the Secretary of HHS should promptly initiate a rulemaking to issue regulations, which will have the force of law, to interpret the Act's segregation requirements, and shall provide guidance to State health insurance commissioners on how to comply with the model guidelines.

Sec. 3. Community Health Center Program. The Act establishes a new Community Health Center (CHC) Fund within HHS, which provides additional Federal funds for the community health center program. Existing law prohibits these centers from using Federal funds to provide abortion services (except in cases of rape or incest, or when the life of the woman would be endangered), as a result of both the Hyde Amendment and longstanding regulations containing the Hyde language. Under the Act, the Hyde language shall apply to the authorization and appropriations of funds for Community Health Centers under section 10503 and all other relevant provisions. I hereby direct the Secretary of HHS to ensure that program administrators and recipients of Federal funds are aware of and comply with the limitations on abortion services imposed on CHCs by existing law. Such actions should include, but are not limited to, updating Grant Policy Statements that accompany CHC grants and issuing new interpretive rules.

Sec. 4. General Provisions. (a) Nothing in this order shall be construed to impair or otherwise affect: (i) authority granted by law or Presidential directive to an agency, or the head thereof; or (ii) functions of the Director of the OMB relating to budgetary, administrative, or legislative proposals.

(b) This order shall be implemented consistent with applicable law and subject to the availability of appropriations.

(c) This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees or agents, or any other person.

BARACK OBAMA

THE WHITE HOUSE,
March 24, 2010.

Health Care Reform & Catholic Hospitals

Here's my story for the National Catholic Register that addresses the new health care bill's impact on Catholic hospitals. The story was published following  news that Caritas Christi--the hospital network affiliated with the Archdiocese of Boston--would be sold to one of the nation's largest private equity firms. 

Despite the Catholic Health Association's endorsement of the bill, it's difficult to predict whether this legislation is likely to help or harm the bottom line of most Catholic hospitals. And that's putting aside any consideration of the critical issues of conscience protections and federal funding of abortion.

When the Catholic Health Association ultimately endorsed the bill, the CHA applauded the expected expansion of health insurance coverage for an additional  30 million Americans. But, weeks after the vote, when I contacted the CHA for this story--and asked whether their members expected the legislation to stem the rising tide of red ink that has forced the closure of stand-alone charity hospitals like St.Vincents in New York--the CHA refused to comment.

The fact is: some hospitals are likely to grow stronger under the new regime and others may lose ground.  Big networks like Ascension Health,  flush with cash, may do better than ever, or they could get hit with the expected decline in reimbursements.

Despite headlines marking public concern regarding the Caritas sale and the St. Vincents closure, Fred Caesar, a CHA spokesman, argued in an email message that a story about the health bill's impact on Catholic hospitals “would not be of interest to the general reader. People want to know more about the benefits from the health insurance legislation in regards to new access, elimination of pre-existing conditions, etc.”

Why the effort to deflect public attention regarding this issue? Despite mainstream media stories that frequently depicted the CHA endorsement as a  prophetic, religiously inspired position,  some politicians and commentators have suggested that the CHA members will directly benefit from a bill that expands the number of patients able to pay their bills. If so, the CHA's uneasiness is more understandable. At the same time, strengthening Catholic hospitals seems like a good thing, so why not just acknowledge the hope that hospitals will  benefit?