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.

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."

Catholic Church's Healthcare Debate/War

Capital Hill has endured months of wrangling over health care reform. Now the debate has moved to the Catholic Church, as we face the cathartic moment of an extended, deeply frustrating political drama. As this battle within the Church plays out in real time, a friend of mine who works at the highest levels of "Catholic health care" wrote this message:

"The Church and shadow-Church and the Magisterium and parallel-magisterium are finally, after 45 years, on public display with a clarity that no Catholic can ignore.  If the health bill passes, with "Catholic health care" support, we will have moral crisis the likes of which we have not seen since slavery since every Catholic will be paying to provide abortion."

From the beginning, the U.S. bishops wanted to make universal health insurance a reality. That was clear. They offered just a handful of preconditions: no federal funding of abortion and robust conscience protections. President Obama said he would honor those concerns. The hierarchy was heartened by the Stupak amendment, which imposed an outright ban on federal funding of abortions. The Senate chose a different path. More wrangling, more closed door meetings. By last Friday, the Democratic party leadership walked away from negotiations with Stupak, and the USCCB had to walk away from a tempting, if flawed solution to the mounting red ink that has forced the closing of many Catholic hospitals throughout the country.

Then Sister Carol Keehan, the president and CEO of the Catholic Health Association backed the Senate bill, a move that prompted Archbishop Charles Chaput, O.F.M.Cap. of Denver, the USCCB President, Cardinal Francis George of Chicago, and Archbishop Dolan of New York to reaffirm the USCCB position--and Cardinal George explicitly  took  aim at Sister Keehan's stance. A few days pass, and two House Democrat holdouts signal their willingness to climb on board the Obamacare train.

Yesterday, the Leadership Conference of Women Religious, already smarting from Rome's decision to launch an apostolic visitation that will review the practices of progressive-minded U.S.women's congregations, issued a statement of support for the Senate bill. Will the statement provide cover for a few more Democrats to back the Senate bill? We'll know the answer to that question very shortly.

Today, the orthodox Council of Major Superiors of Women Religious  jumped into the fray with a statement backing the U.S. bishops as the authoritative voice for the Catholic Church.  Meanwhile,  the USCCB has issued yet another statement that provides further ammunition for pro-life opponents of Obamacare.

I've posted the USCCB response in full below:

U.S. BISHOPS PROVIDE RESOURCES EXPLAINING FLAWS IN SENATE HEALTH CARE BILL  WASHINGTON—The United States Conference of Catholic Bishops (USCCB) has made available several new resources explaining its calls for essential changes to the Senate health care reform bill. In a March 15 statement, Cardinal Francis George of Chicago, President of the USCCB, said that the U.S. bishops would, regretfully, have to oppose the final bill if these changes were not made.             The resources are available at: www.usccb.org/healthcare             Among them is an analysis of the abortion funding provisions of the Senate health care bill that highlights the bishops’ objections (www.usccb.org/healthcare/030410facts.pdf). Two pieces respond to recent criticisms of the bishops’ position on the health care bill, namely criticisms from Timothy Stoltzfus Jost of Washington and Lee University Law School (www.usccb.org/healthcare/jost-response.pdf) and the other regarding the funding of abortion at community health centers (www.usccb.org/healthcare/communityhealthcenters.pdf).             With so much of the health care debate focusing on the nature of the legal “status quo” of federal abortion funding, the page also features a backgrounder on current federal policy on abortion funding (www.usccb.org/prolife/issues/healthcare/abortion_funding_102309.pdf) and an analysis of the House health care bill’s Stupak Amendment (www.usccb.org/healthcare/StupakAmendmentFactsheet.pdf). Update: The USCCB just issued a sharply worded  "clarification," responding to a statement issued by the religious lobbing group, NETWORK, which sent a letter to every member of the U.S. Congress endorsing the Senate bill and purported to represent  tens of thousands of women religious. The USCCB clarification is offered in full here: "Washington—A recent letter from Network, a social justice lobby of sisters, grossly overstated whom they represent in a letter to Congress that was also released to media.  Network’s letter, about health care reform, was signed by a few dozen people, and despite what Network said, they do not come anywhere near representing 59,000 American sisters. The letter had 55 signatories, some individuals, some groups of three to five persons.  One endorser signed twice.  There are 793 religious communities in the United States.  The math is clear. Network is far off the mark." Most unusual! Hard to know where this debate/war is headed. Will it be papered over, once the dust settles? Or will the fissures revealed in these statements erupt into something more definitive--that much discussed, long anticipated schism?     Sister Mary Ann Walsh Director of Media Relations United States Conference of Catholic Bishops

Archbishop Chaput Takes on Senate Healthcare Bill

As Capital Hill enters the final stretch of the Obamacare legislative marathon, Archbishop Charles Chaput of Denver has targeted the Senate bill, which has yet to gain the requisite House votes, according to the House Majority Whip who made the rounds on media news shows last weekend. I've included the entire text of Chaput's statement, and the National Catholic Register will soon post my story on the subject. But it's worth noting here that if the Senate bill fails to get sufficient votes from House members, it will be due, in part, to the amazing perseverance of political and Catholic leaders like Rep Bart Stupak, the USCCB's Richard Doerflinger, and pro-life bishops like Archbishop Chaput.  As Chaput notes in his statement below, the U.S. bishops have pressed for health care reform for decades, and do not view it as a partisan issue. But the USCCB will not support any legislation that violates the right to life of the unborn. Full Stop.Below are statements addressing the remaining health care reform issues from Archbishop Chaput, followed by a statement from Cardinal George:

CATHOLICS, HEALTH CARE AND THE SENATE’S BAD BILL

By Charles J. Chaput, O.F.M. Cap.

Archbishop of Denver

 

Denver Catholic Register, 3.17.10

Web release, 3.15.10

 The Senate version of health-care reform currently being forced ahead by congressional leaders and the White House is a bad bill that will result in bad law.  It does not deserve, nor does it have, the support of the Catholic bishops of our country.  Nor does the American public want it.  As I write this column on March 14, the Senate bill remains gravely flawed.  It does not meet minimum moral standards in at least three important areas: the exclusion of abortion funding and services; adequate conscience protections for health-care professionals and institutions; and the inclusion of immigrants.  

Groups, trade associations and publications describing themselves as “Catholic” or “prolife” that endorse the Senate version – whatever their intentions – are doing a serious disservice to the nation and to the Church, undermining the witness of the Catholic community; and ensuring the failure of genuine, ethical health-care reform.  By their public actions, they create confusion at exactly the moment Catholics need to think clearly about the remaining issues in the health-care debate.  They also provide the illusion of moral cover for an unethical piece of legislation.

 As we enter a critical week in the national health-care debate, Catholics across northern Colorado need to remember a few simple facts.

First, the Catholic bishops of the United States have pressed for real national health-care reform in this country for more than half a century.  They began long before either political party or the public media found it convenient.  That commitment hasn’t changed.  Nor will it.

Second, the bishops have tried earnestly for more than seven months to work with elected officials to craft reform that would serve all Americans in a manner respecting minimum moral standards.  The failure of their effort has one source.  It comes entirely from the stubbornness and evasions of certain key congressional leaders, and the unwillingness of the White House to honor promises made by the president last September.

Third, the health-care reform debate has never been merely a matter of party politics.  Nor is it now.  Democratic Congressman Bart Stupak and a number of his Democratic colleagues have shown extraordinary character in pushing for good health-care reform while resisting attempts to poison it with abortion-related entitlements and other bad ideas that have nothing to do with real “health care.”  Many Republicans share the goal of decent health-care reform, even if their solutions would differ dramatically.  To put it another way, few persons seriously oppose making adequate health services available for all Americans.  But God, or the devil, is in the details -- and by that measure, the current Senate version of health-care reform is not merely defective, but also a dangerous mistake.

The long, unpleasant and too often dishonest national health-care debate is now in its last days.  Its most painful feature has been those “Catholic” groups that by their eagerness for some kind of deal undercut the witness of the Catholic community and help advance a bad bill into a bad law. Their flawed judgment could now have damaging consequences for all of us.

Do not be misled.  The Senate version of health-care reform currently being pushed ahead by congressional leaders and the White House -- despite public resistance and numerous moral concerns -- is bad law; and not simply bad, but dangerous.  It does not deserve, nor does it have, the support of the Catholic bishops in our country, who speak for the believing Catholic community.  In its current content, the Senate version of health-care legislation is not “reform.”  Catholics and other persons of good will concerned about the foundations of human dignity should oppose it. 

Update: Since my article about the final phase of health care reform negotiaions appeared online, Cardinal Francis George, the USCCB president, has issued his own statement that expresses great regret for the Democrats' path on health care reform and concludes that the bishops have given up any hope that it can still be salvaged in any form they can support. Cardinal George notes that the Catholic Health Association does not share the USCCB's stance.

 

Healthcare Reform: Rep. Stupak & Abortion Funding

Yesterday I listened to an NPR interview with Rep Bart Stupak, the leader of House Democrats opposing abortion funding for health care reform. The NPR interviewer reminded Stupak that both the White House and the Secretary of Health and Human Services insisted that the Senate bill maintained the status quo (ie. no federal funding of abortions). Stupak begged to differ. Then the NPR interviewer asked him if he was prepared to deny health benefits to 30 million uninsured people, just to prevent the funding of abortion. He replied that that some principles were worth fighting for.

It was frustrating to listen to the Stupak interview, as the questions repeated  the Democratic Party leadership's claim that the Senate's health care reform bill doesn't really depart from the Hyde amendment. However, today, perhaps in reaction to Stupak's principled stance, both the New York Times and the Washington Post  published an AP wire service  article on the abortion impasse that actually explained the source of the confusion--or whatever you want to call it.  

For anyone still puzzled by the "he said, she said" back and forth between pro-lifers and Democratic party leaders, here are the relevant passages from the AP article:

"Government policy on taxpayer funding for abortion has been settled for years, following the Hyde amendment.

But the Democratic health care bills altered the balance by creating a new stream of federal money to help working households afford health insurance premiums. Those funds were not subject to the Hyde restrictions.

The House responded by adopting Stupak's amendment, although it was opposed by most Democrats. It says no health insurance plan receiving federal subsidies can pay for abortion, except under the three exceptions already allowed by federal law. Women who want insurance coverage for abortion would have to buy a separate policy.

The Senate bill took a different approach. It says health insurance plans operating in a new consumer marketplace can cover abortion, but it may only be paid for with private premiums. Money from federal subsidies would have to be strictly segregated from any funds used to pay for abortion. Consumers would have to write two checks to their insurance plan, one for the regular premium, the other for abortion coverage.

Leading abortion opponents - including the nation's Catholic bishops - say the Senate language is a fig leaf, opening the way for government subsidies for abortion. They're urging defeat of the health care bill unless it takes Stupak's approach."

For the final word, here's Charmaine Yoest of Americans United for Life in today's online  Wall Street Journal:

"In November, presidential adviser David Axelrod, on CNN's "State of the Union," also talked around the Hyde Amendment, saying that the president "doesn't believe this bill should change the status quo as it relates to the issue of abortion." But then Mr. Axelrod claimed that "this shouldn't be a debate about abortion" before concluding that there were discussions in Congress about "how to adjust [the abortion language bill] accordingly."

Apparently, his definition of "adjust" means opening up the spigot for the abortion lobby. The president's latest proposal mirrors legislation that has passed the Senate, which doesn't include a Hyde Amendment, and would inevitably establish abortion as a fundamental health-care service for the following reasons:

• It would change existing law by allowing federally subsidized health-care plans to pay for abortions and could require private health-insurance plans to cover abortion.

• It would impose a first-ever abortion tax—a separate premium payment that will be used to pay for elective abortions—on enrollees in insurance plans that covers abortions through newly created government health-care exchanges.

• And it would fail to protect the rights of health-care providers to refuse to participate in abortions.

The president's plan goes further than the Senate bill on abortion by calling for spending $11 billion over five years on "community health centers," which include Planned Parenthood clinics that provide abortions.

The bottom line is that the president wants to deploy words that sound soothing like "balance" and "adjust." Meanwhile, the courts are rendering precedent with stark words like "mandatory." "

Abortion and African-Americans

Pro-lifers, especially those who routinely join prayer vigils at abortion clinics, have long observed the over-representation of African-American women seeking abortions. Yesterday, The New York Times gave the issue page-one attention.  As the fight over health care reform continues on Capital Hill this week, it's worth noting that a limited, but critical number of pro-life Democrats may stop the reform juggernaut in its tracks if the Democratic leadership doesn't reinstate the Stupak Amendment. The Times story underscores the truth that opposition to abortion remains the social justice issue of our era.

Healthcare Reform and Abortion: Risks Remain

President Obama gave his State of the Union address today, and told Capital Hill, "Do not walk away from [healthcare] reform." Today, the National Catholic Register posted my story about the future of health care reform and the possibility that the Democratic leadership will still try to include a mandate for federal funding of abortion in any final bill. Doug Johnson of the National Right to Life Committee believes that pro-lifers must stay vigilant, as Democrats look at a variety of legislative options, from reconciliation to a series of small bills that might include abortion provisions.

Brown Victory Cheers Catholic Pro-lifers

Last night's  Republican victory in Massachusetts' special election has thrilled pro-lifers worried about the effort to mandate federal funding of abortion through the passage of Obamacare. Here's my exclusive for the National Catholic Register that offers the Catholic, pro-life angle on Brown's sudden surge of support.

Update: Here's Phil Lawler's excellent analysis of the Scott Brown victory and what it means for the future of Democratic politics in the Bay State.d

Obama at Notre Dame: Deconstructions

Just read a very  interesting deconstruction of President Jenkins of Notre Dame and President Obama's comments at Notre Dame's commencement posted on the National Catholic Register. 

In the Wall Street Journal, Bill McGurn provides context for Jenkins' ambiguous stance and Obama's powerful impact at the commencement: Unlike Jenkins, Obama clearly articulated his position. The imbalance is created by Notre Dame's weak institutional support for Catholic moral teaching. The  university puts its considerable resources towards the work of social justice, argues McGurn; there is little standing for pro-life leaders and initiatives. Writes McGurn:

"With its billions in endowment and its prestigious name, Notre Dame ought to be in the lead here. But when asked for examples illuminating the university's unambiguous support for unborn life, Mr. Brown could provide only four: help for pregnant students who want to carry their babies to term, student volunteer work for pregnant women at local shelters, prayer mentions at campus Masses, and lectures such as a seminar on life issues.

"These are all well and good, but they also highlight the poverty of Notre Dame's institutional witness. At Notre Dame today, there is no pro-life organization -- in size, in funding, in prestige -- that compares with the many centers, institutes and so forth dedicated to other important issues ranging from peace and justice to protecting the environment. Perhaps this explains why a number of pro-life professors tell me they must not be quoted by name, lest they face career retaliation.

"The one institute that does put the culture of life at the heart of its work, moreover -- the Center for Ethics and Culture -- doesn't even merit a link under the "Faith and Service" section on the university's Web site. The point is this: When Notre Dame doesn't dress for the game, the field is left to those like Randall Terry who create a spectacle and declare their contempt for civil and respectful witness.

"In the National Portrait Gallery of the Smithsonian, there is a wonderful photograph of Father Ted Hesburgh -- then Notre Dame president -- linking hands with Martin Luther King Jr. at a 1964 civil-rights rally at Chicago's Soldier Field. Today, nearly four decades and 50 million abortions after Roe v. Wade, there is no photograph of similar prominence of any Notre Dame president taking a lead at any of the annual marches for life."

Meanwhile, Archbishop Chaput of Denver offers an incisive statement on the issues that remain on the table at Notre Dame as Obama returns to Washington, D.C.: "The most vital thing faithful Catholics can do now is to insist – by their words, actions and financial support – that institutions claiming to be “Catholic” actually live the faith with courage and consistency.  If that happens, Notre Dame’s failure may yet do some unintended good."

Postscript: Just read Ralph McInerny's superb reflection on the two parallel events that occurred over the weekend. The news media and the majority of seniors stuck with one half of the story, but McInerny's heart remained with the other-- the beloved Notre Dame where he has taught philosophy to generations of students, 'in season and out.' This divided world is rooted, he observes, in the larger profound divisions that fragment the Body of Christ in the decades following the Second Vatican Council.  

And another excellent statement from Bishop Finn of Kansas. It appears that the Notre Dame commencement has provided an opportunity for great moral clarity in the Church.