WASHINGTON – In the thousands of pages that make up the Affordable Health Care for America Act and the Patient Protection and Affordable Care Act, the House- and Senate-passed versions, respectively, of health reform legislation, the word “abortion” only comes up a few dozen times.
But as congressional leaders work to hammer out an agreement on health care reform, a key player in the U.S. bishops’ lobbying efforts thinks an insistence on expanding abortion funding in this country could sink the reform movement that the bishops have encouraged for decades.
“It’s a high-risk strategy” for Democratic leaders in Congress to work behind closed doors to reconcile the House and Senate health reform bills, Richard Doerflinger, associate director of the bishops’ Secretariat for Pro-Life Activities, told Catholic News Service Jan. 11.
If House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid present a bill that has not been debated openly and say, “Take it or leave it,” Doerflinger added, “Congress may leave it.”
Throughout the process, Catholic leaders have been clear that they want to see the U.S. health system reformed but not in a way that expands abortion funding or leaves too many people behind.
“It’s very difficult to figure out even what’s going on” in the reconciliation process, Doerflinger said. “We hear very little about what’s getting worked out.”
In January, through a series of bulletin inserts and pulpit announcements, the bishops were mobilizing Catholics nationwide to tell their senators and representatives that the final health reform bill must not “advance a pro-abortion agenda” and must be “accessible and affordable for all,” including immigrants.
The bill that comes closest to meeting those criteria is the House’s Affordable Health Care for America Act. It specifically states, “No funds authorized or appropriated by this act (or an amendment made by this act) may be used to pay for any abortion or to cover any part of the costs of any health plan that includes coverage of abortion,” except in cases of rape, incest or danger to the mother’s life.
The House bill also gives purchasers in the “health insurance exchanges” full choice of health plans without any requirement that they pay for elective abortions, but the Senate bill does not, according to an analysis of the two bills prepared by Doerflinger for the bishops.
“The Senate bill allows all but one plan in each state exchange to cover abortions, and forces each purchaser of these plans to write a separate check each month to pay for other enrollees’ abortions,” the analysis says.
Doerflinger said the Senate bill also is flawed because its language restricting abortion funding through health plans is not permanent and could change from year to year and because the limitation “doesn’t cover the entire bill.” For example, the section of the bill on a new $7 billion program expanding community health centers around the country has no restrictions on abortion funding, he said.
Another failure in both bills is a lack of full conscience protection for health care providers, plans, institutions and employers, Doerflinger said.
Another USCCB official is working to improve the final bill’s treatment of immigrants.
Kevin Appleby, director of migration and policy services in the bishops’ Migration and Refugee Services, said in a Jan. 13 telephone briefing with media that “Congress would be wise” to lift the current five-year ban on legal immigrants participating in federal health programs like Medicaid.
“Many of them will soon be Americans,” he said. “Why wait to give them good health?”
He and others participating in the briefing also advocated for allowing undocumented immigrants to buy health insurance through the state exchanges with their own money.
“Access to health care should not be governed by where someone was born but by their God-given dignity,” Appleby said.
The bulletin insert that the bishops have asked parishes nationwide to put out as soon as possible offers separate but similar messages for Catholics to send to their senators and representatives.
The House message says in part: “I urge you to work to uphold essential provisions against abortion funding, to include full conscience protection and to assure that health care is accessible and affordable for all. Unless and until these criteria are met, I urge you to oppose the final bill.”
The proposed message to senators expresses disappointment that their bill “fails to maintain the long-standing policy against federal funding of abortion and does not include adequate protection for conscience” and urges opposition to any final bill that does not meet the bishops’ criteria.
On the USCCB Web site at www.usccb.org/action, people can send a prewritten e-mail to members of Congress expressing those points.
“Our message agrees with the public sentiment in the country,” Doerflinger said, noting that a recent poll showed 68 percent of Americans – and 69 percent of women – did not want abortion to be covered by their health insurance plan.
“Most people don’t see abortion as health care,” he said. But the ultimate fate of health reform legislation “might depend on how Congress decides this divisive issue.”