The Cathoholic

USCCB on the Job Regarding Obamacare and Abortion

LIFE ISSUES FORUM                                                       July 23, 2010 For Immediate Release   Abortion Returns to the Health Care Reform Debate By Richard M. Doerflinger               Congress passed the Patient Protection and Affordable Care Act (PPACA) in March, amidst an unresolved debate about the legislation’s impact on abortion and conscience protection.  As president of the United States Conference of Catholic Bishops, Cardinal Francis George explained then that the bishops had to oppose the final bill despite their strong support for health care reform, because (among other things) it “appropriates billions of dollars in new funding without explicitly prohibiting the use of these funds for abortion.”  Others dismissed this charge, saying that legislative intent and a last-minute executive order from President Obama prevented abortion funding.             Fast-forward to July, when one of those PPACA provisions appropriating billions of dollars was about to take effect.  Section 1101 of the Act provides $5 billion for “high-risk insurance pools,” providing much-needed health coverage for people with “pre-existing conditions” who cannot otherwise get coverage.  This program ends in January 2014, when these patients can join others in purchasing qualified health plans on the new state insurance exchanges.  State governments can propose the benefits list and other details for covering their residents in these pools, but the federal government makes final decisions and provides all government funds for subsidizing this coverage.             Pro-life groups found that several states – beginning with Pennsylvania, New Mexico and Maryland – had announced on their web sites that their statewide plans would include elective abortions.  (New Mexico used the phrase openly; Pennsylvania said its plan would not cover “elective abortions,” but would cover abortions that are legal under the Supreme Court’s decisions – meaning any abortion an abortionist sees as needed for a woman’s social or emotional “well-being.”)  These plans were described as already approved, and New Mexico had already begun signing up enrollees.               Public criticism of this development prompted immediate denials and evasive responses.  An initial response from the Department of Health and Human Services insisted that “federal funds” would not cover these abortions – leaving open the prospect that everyone who enrolls could be forced to fund other people’s abortions with their premium dollars.  Late on July 14, however, HHS issued a new and more welcome response, saying that abortions simply “will not be covered” in these plans except in cases of rape, incest or danger to the mother’s life, as has long been true in federally subsidized health plans for federal employees.             Now pro-abortion groups are crying foul, with the interesting complaint that this pro-life outcome goes beyond anything in PPACA or the executive order.  In other words, they are saying the bishops’ analysis of loopholes in these documents is right.               The high-risk pool program is just one funding stream left open to abortion by PPACA.  For now it seems pro-life forces have won the first round, through careful research and a prompt public response.  But PPACA needs a legislative fix to close such loopholes once and for all.  That fix is offered by the “Protect Life Act” (H.R. 5111) sponsored by Rep. Joe Pitts (R-PA) and 115 other House members, including 13 Democrats.  Whether these or other billions of dollars in taxpayers’ funds are used to help kill unborn children is not a matter we should leave to shifting politics or to chance.     Mr. Doerflinger is Associate Director of the Secretariat of Pro-Life Activities, U.S. Conference of Catholic Bishops.  To learn more about the bishops’ pro-life activities see www.usccb.org/prolife.

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.

Boston's Caritas Christi Deal--What's for Sale?

This spring, when I reported on the Caritas Christi sale to one of the nation's top private equity firms, my story noted that the new buyer would maintain the Catholic identity of the hospital network. At least, that's what I was told at the time. Now, we learn that the deal includes this option: the buyer could pay an additional $25 million to dismantle all vestiges of the network's Catholic identity, including adherence to Catholic moral teaching.

The recent controversy in Phoenix over the morality of a direct abortion at a Catholic hospital underscores the fact that mainstream health care ethics doesn't necessarily conform to Catholic teaching. Critics of the Caritas deal charge that the $25 million opt out fee suggests that even the church's commitment to the sanctity of life is for sale. An additional concern is how this opt out clause--if executed-- would affect the pro-life physicians and nurses who now serve patients through the network.

The U.S. Bishops and the Health Bill: Competing Rights

Here's the USCCB's Richard Doerflinger on the moral conundrum that emerged in the health care bill battle. While I am a great admirer of Mr.Doerflinger--among the foremost advocates for the right to life of  the unborn on Capital Hill, his statement almost appears to give equal weight to the right to life of the unborn and the right to health care for the uninsured. But from my vantage point, the U.S. hierarchy's painful struggle actually confirmed that the right to life remains the central priority of Catholic public policy. Further, the decision to support this specific health bill remained a prudential judgment on which people of good will are free to disagree.

Critics of the bill--sans language securing federal funding of abortion and withholding  adequate conscience protections--do not oppose it with the intention to block access to health care for the uninsured. They just think it's a bad bill that will make things worse, not better. Further, Congress did not provide adequate funding to pay for one more entitlement at the very time that baby boomers are poised to overwhelm the budgets for our present entitlements -- Social Security and Medicare. We need health care reform, but just because a bill is presented as the solution for that need,  doesn't make it so.

The other thing to remember is that the 1970s "values clarification" exercises he cites in his statement on moral conundrums were designed to undermine moral absolutes, not defend them.

To be completely honest, given the serious problems with the bill, which was brought to a vote, I, for one, was relieved that the USCCB could not support it. The Church's credibility is in tough shape, at present, without being tagged as a key advocate for this deeply flawed bill. That is not to suggest that the Church should only back popular legislation, but only to observe that support for this bill is a prudential judgment and not a moral requirement.

LIFE ISSUES FORUM                                                                   April 30, 2010

 

Refusing to Choose

By Richard M. Doerflinger

 

            Some teachers like to pose riddles to their students on “lifeboat ethics.”  People of various ages and professions – a sea captain, a cabin boy, etc. -- are drifting at sea in a lifeboat, with limited provisions, and we have to decide which passenger to kill so the others can survive.

 

            The final situation with health care reform this spring might have been crafted to stump these students.  The House of Representatives had passed a reform bill that the Catholic bishops commended for ensuring access to health care for the poor and immigrants, and for respecting longstanding current laws on abortion and conscience rights.  But the Senate refused to consider this bill.   Instead it approved its own version that was deficient in all these areas, and said: This is our final answer.  Due to a change of one Senate seat, that chamber said it no longer had 60 votes to pass a bill with further substantive changes (though it could make purely fiscal changes under a “reconciliation” process requiring a simple majority).

 

            So the final “take it or leave it” bill could be improved on affordability for the poor.  But it would perpetuate injustices to both legal and undocumented immigrants.  It excluded a conscience rights provision that keeps government entities in other federal health programs from discriminating against doctors, nurses and hospitals that don’t provide abortions.  It refused accommodations for religious institutions that need to purchase health coverage consistent with their moral values.  And it violated the Hyde amendment, which keeps every other federal program from funding elective abortions and health plans that cover such abortions.  The federal government would now subsidize plans covering abortion, and require those plans to collect a special fee for such abortions from every purchaser whether they object or not. Finally, the bill appropriated its own new funds from the Treasury that were exempt from the Hyde policy, including billions of dollars for community health centers serving the poor.

 

            So who would the Catholic bishops throw off the boat?  Uninsured citizens, or immigrants and the unborn?  The answer was: None of the above.  The bishops refused to choose between one moral wrong and another.  They reaffirmed that all the human lives at stake were of inestimable worth, and that Congress must pursue reform in ways that do not attack innocent human life, forget conscience rights or ignore immigrants.

 

            Congress did not have the political will to do this, so passed a law that does many welcome things but is also, as USCCB president Cardinal Francis George said, “profoundly flawed.”  Repairing those flaws will take enormous effort in months and years to come.

 

            Some expected the bishops to give in, to conclude that expanding health care for the uninsured “outweighed” the legislation’s moral flaws.  But Catholic moral reasoning doesn’t work that way.  As the U.S. bishops explained in their Faithful Citizenship document in 2007, doing good and avoiding evil are equally pressing demands.  There is no “ceiling” to the good we are called to do for the poor and vulnerable, and their needs must never be forgotten – but there is a “floor” to that commitment, beginning with respect for the most fundamental good of the human person, life itself.  In particular, we cannot “do good” by expanding direct attacks on innocent human life.  The rule for passing health care legislation is the same as the rule for medical ethics: First, do no harm.

 

            The bishops surely knew that many would be disappointed, and some would see them as being unrealistic.  But sometimes we get to change the world, and occasionally we can only keep the world from changing us.  After all the “realists” have spoken, somebody still has to speak up for that cabin boy.

 

 

Mr. Doerflinger is Associate Director of the Secretariat of Pro-Life Activities, U.S. Conference of Catholic Bishops.  To learn more about the bishops’ pro-life activities, see www.usccb.org/prolife and www.usccb.org/healthcare. 

Health Reform & Abortion: USCCB Answers

The Spanish version is attached.  Thank you!     LIFE ISSUES FORUM                                                                   April 16, 2010                                                                                                             For Immediate Release   Questions about Abortion in the new Health Care Law?  By Tom Grenchik   Since the recent passage of the “Patient Protection and Affordable Care Act,” scores of people have been contacting the Pro-Life Secretariat of the U.S. Conference of Catholic Bishops with a multitude of questions, such as:   Does the new health care legislation actually provide federal funds for elective abortions? Answer: Yes. Can individuals be forced to pay for other people’s abortions even if they are morally opposed? Answer: Yes. Are there new challenges to the consciences of individuals, employers and health care providers? Answer: Yes. Didn’t President Obama’s Executive Order fix the abortion and conscience problems that the bishops had raised about this legislation? Answer: No.   For those interested in more in-depth answers, we offer callers a couple of helpful new resources developed by the bishops’ conference: a one-page fact sheet called “Abortion Funding in the New Health Care Reform Act”: www.usccb.org/healthcare/Abortion-Funding-in-Health-Care-Law-4-12-10.pdf. a 9-page legal analysis of the abortion and conscience issues in the Act and President Obama’s subsequent Executive Order: www.usccb.org/healthcare/03-25-10Memo-re-Executive-Order-Final.pdf.    Then there are callers with tactical questions, like:   Weren’t the bishops just out to kill health care reform all along? Answer: No. Haven’t the bishops just been over-reacting to abortion-related problems that weren’t really there? Answer: No. Can anything be done to fix these problems? Answer: Yes. For many, many months now the U.S. bishops have made statements and sent numerous letters to Congress with the message that our country needs reform that makes health care available to everybody, while killing nobody (www.usccb.org/healthcare/official_documents.shtml#releases). The bishops have long supported reform, but they made it very clear that no matter how much perceived good might be accomplished, such legislation must not promote a fundamental moral evil or force people to participate in that evil. Health care reform should not have become the vehicle for expanding abortion or challenging conscience protection. It was not the bishops who forced the issue, but congressional leaders themselves. They refused to apply longstanding current policies on abortion funding and conscience rights to this legislation, all the while claiming that abortions were not being funded. When it became clearer that congressional leaders would not back down, the bishops’ message to Congress was unambiguous as well. Just before the final vote, the bishops sent one more appeal to Congress that was introduced with a USCCB press release entitled: “Bishops to House of Representatives: Fix Flaws or Vote No on Health Reform Bill.” It stated: “House leadership … won’t even try to address the serious problems on abortion funding… [and are] ignoring conscience protection and fair treatment of immigrants” (www.usccb.org/comm/archives/2010/10-051.shtml). Ignoring the plea of the bishops and the large majority of Americans who oppose abortion funding in health care reform, Congress has now enacted the largest expansion of abortion funding in our nations’ history, since Roe v. Wade.  Assurances that abortion funding would be removed and consciences would be thoroughly protected have turned out to be empty promises. But our efforts are far from over. Now we must go back to all the legislators who stated that the abortion and conscience problems were either not there, or would be fixed at another time, because that time is now! We must fix this “deeply flawed law”, as Cardinal George called it, and we’ll need a strong bi-partisan effort to do so. It will require the active engagement of Catholics and other constituents demanding this congressional response. Correcting this law, so it will truly uphold everyone’s rights to life and health, will take much prayer and hard work, but the stakes have never been higher.   Tom Grenchik is Executive Director of the Secretariat of Pro-Life Activities, U.S. Conference of Catholic Bishops. Go to www.usccb.org/prolife to learn more about the bishops’ pro-life activities.

Planned Parenhood: On the record

Here's a new pro-life film  produced by Live Action that purports to document a conversation between a Planned Parenthood counselor and a pregnant patient considering an abortion. The counselor provides grossly inaccurate information regarding fetal development. Live Action has produced other short films challenging the accuracy and agenda of Planned Parenthood's staff. In the wake of the passage of the health care bill, pro-life advocates worry that Planned Parenhood will benefit from the community health care clinic component of the health care overhaul.

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?

Catholic and Pro-life Leaders: Health Bill Postmortem

Here's my article on reactions to the bill's passage by Catholic and pro-life leaders.

They give high marks to the USCCB and vent frustration regarding the Catholic Health Association's endorsement.

Kathleen Parker: 'the guy who Stupaked health-care reform"

Parker lays it out in the Washington Post:

"Poor Bart Stupak. The man tried to be a hero for the unborn, and then, when all the power of the moment was in his frail human hands, he dropped the baby. He genuflected when he should have dug in his heels and gave it up for a meaningless executive order.

Now, in the wake of his decision to vote for a health-care bill that expands public funding for abortion, he is vilified and will forever be remembered as the guy who Stupaked health-care reform and the pro-life movement."

Obama's Executive Order on Abortion: No Brainer

Today, Rep. Bart Stupak and other pro-life House Democrats agreed to back the health care bill after President Obama promised to issue an Executive Order banning any federal funding of abortion. As noted in my previous post today, the recent executive order ostensibly was designed to block any funding of abortions for the community health clinics mandated by the bill. The problem, according to host of puzzled and angry commentators, from Slate, to  National Review,  is that this Executive Order will do no more than the Senate Bill to comprehensively prohibit federal funding of abortions. Here's Yuval Levin in National Review's The Corner:

"Upon first hearing there was talk of an executive order yesterday, I wondered how the administration’s lawyers thought such an order could go beyond the letter of the law in restricting abortion funding. This was a question the Bush administration examined quite extensively on several occasions, and the lawyers involved always agreed that the legal precedents from the time between the Roe decision and passage of the Hyde amendment, as well as some after the Hyde amendment, are extremely clear in stating that federal funds cannot be denied to the provision of abortion except by explicit legislative prohibition. That’s why the Hyde amendment was necessary. But the Hyde amendment wouldn’t apply to this bill, since it applies only to the annual HHS appropriations bill. Hence Stupak’s concern. So what could the White House possibly give Stupak that would not be thrown out by any federal judge in a second?

Looking at the executive order (which you can read here), the answer is clearly nothing. The executive order quite literally does nothing that the Senate bill does not already do, and it is careful to say as much."

Andy McCarthy in The Corner adds this:

"The Susan B. Anthony List observation that EOs can be rescinded at the president's whim is of course true. This particular EO is also a nullity — presidents cannot enact laws, the Supreme Court has said they cannot impound funds that Congress allocates, and (as a friend points out) the line-item veto has been held unconstitutional, so they can't use executive orders to strike provisions in a bill. So this anti-abortion EO is blatant chicanery: if the pro-lifers purport to be satisfied by it, they are participating in a transparent fraud and selling out the pro-life cause."

This grim judgment was echoed by pro-life groups that also asserted that ruiings during the Bush administration decided against the standing of executive orders.