As the Chairmen of the three committees most directly involved in the efforts of the U.S. Conference of Catholic Bishops on health care reform, we are writing to set the record straight on some important issues raised during and after final consideration of the “Patient Protection and Affordable Care Act” this spring.
From our first statement to Congress a year ago (http://usccb.org/sdwp/national/2009-05-usccb-health-care-statement.pdf) to Cardinal George’s March 23rd, 2010 statement about the enactment of a “profoundly flawed” final bill, the position of our Conference has been unified and consistent. Reflecting decades of advocacy on behalf of universal access to health care, the bishops were clear in calling for health care reform as a moral imperative and urgent national priority. We called for reform that would make health coverage affordable for the poor and needy, moving our society substantially toward the goal of universal coverage. We were equally clear in stating that this must be done in accord with the dignity of each and every human person, showing full respect for the life, health and conscience of all.
Specifically we insisted that the provisions of the Hyde amendment and other longstanding current laws, which forbid federal funding of abortion and of health plans that cover abortion, must be preserved in this or any new legislation. Likewise, we sought to have longstanding policies of respect for rights of conscience applied to this legislation. Americans must retain in new legislation the rights they had before its enactment. These include the full range of protections regarding the right to provide and purchase health care in accord with their religious beliefs and moral convictions. In addition, since access to basic health care is a right inherent in each human person, as acknowledged both in Catholic social teaching and the Universal Declaration on Human Rights, legislation must not unfairly exclude immigrants from health coverage (January 26, 2010 Letter to the House).
Apparently, because we always presented these criteria together and insisted that each had profound moral implications, some thought the bishops might ultimately be persuaded to abandon one or the other in response to political pressures from left or right. Some hoped or feared that we would join with those who reject the need for vigorous government action to reform our ailing health care system. Others hoped or feared that, for the “greater good” of making progress on health care, we would neglect or deny the rights of the most vulnerable members of our society, including unborn children who have no voice and of immigrants.
There was never any chance that the bishops would do any of these things. We will never cease to advocate for everyone, beginning with the most needy, to have access to health care. We will never conclude that we must accept what is intrinsically evil so that some good may be achieved. Specifically we reject the argument made to us by some Catholics that expanding health care coverage justified setting aside our longstanding opposition to government participation in elective abortions or weakening rights to life and freedom of conscience. Catholic teaching rejects any idea that the weakest or “disposable” members of society must be forgotten to serve alleged “greater goods.” Arguments of this sort undermine the common good. Our vision of the common good embraces the good for each and every member without exception, beginning with those who are weakest and most vulnerable.
Ultimately the House of Representatives approved a health care reform bill that the bishops welcomed for substantially meeting most of the principles and goods we were espousing. We hoped to address final concerns as the legislation moved forward. However, the Senate rejected the House legislation, including the key elements that we supported, and produced a bill that abandoned the very principles that we espoused: no expansion of abortion, protections for freedom of conscience and the rights of immigrants. With these foundational principles rejected, it was then announced that no further substantive changes were possible. From that moment on, the bishops were clear and consistent in saying that this “take it or leave it” offer was morally unacceptable and politically divisive. Whatever might be the positive aspects of the Senate bill, we had no choice but to oppose the Senate version as a matter of principle. As bishops we must faithfully proclaim the truth. We must defend the rights of the unborn and the weakest and most vulnerable among us. We must oppose the advance of elective abortion in our society, especially the use of government authority and funding to advance it, and we must speak out in favor of the rights of freedom of conscience for persons and institutions. We urged Congress to vote against this version of the bill, with the hope that together we could find a way to address our legitimate concerns in a bill which would thus have broader appeal and greater support. Unfortunately, the political will to do so did not emerge.
The final result is legislation that expands health care coverage, implements many needed reforms, and provides welcome support for pregnant and parenting women and adoptive families. Unfortunately it also perpetuates grave injustices toward immigrant families and makes new and disturbing changes in federal policy on abortion and conscience rights. We have documented the legislation’s serious flaws in several analyses available on the bishops’ web site, www.usccb.org/healthcare.
Since final passage of the legislation, we have been disturbed and disappointed by reactions inside and outside the Church that have sought to marginalize or dismiss legitimate concerns that were presented in a serious manner by us. Our clear and consistent position has been misrepresented, misunderstood and misused for political and other purposes. Our right to speak in the public forum has been questioned. Our teaching role within the Catholic Church and even our responsibility to lead the Church have come under criticism. All of us must be open to different points of view and recognize the legitimacy of serious criticism. However, whether from within or without the Catholic community, very often these critics lacked an understanding of these particular issues or of the moral framework that motivated our positions. Others did grasp the seriousness of the issues we were attempting to address. Yet other priorities, in our judgment, led them to accept an inaccurate reading of the proposed legislation. They gave credence to analyses by those who were likewise dedicated to minimizing important concerns so as to pass the legislation. In the end, they made a judgment that the moral problems in the new law – for example, the fact that the federal government, for the first time in decades, will now force Americans to pay for other people’s elective abortions – simply are not serious enough to oppose a particular health care reform bill.
We regret that this approach carried the day, as some overlooked the clear evidence or dismissed careful analysis and teaching on the morality of these matters. But making such moral judgments, and providing guidance to Catholics on whether an action by government is moral or immoral, is first of all the task of the bishops, not of any other group or individual. As Bishops, we disagree that the divergence between the Catholic Conference and Catholic organizations, including the Catholic Health Association, represents merely a difference of analysis or strategy (Catholic Health World, April 15, 2010, “Now That Reform Has Passed”). Rather, for whatever good will was intended, it represented a fundamental disagreement, not just with our staff as some maintain, but with the Bishops themselves. As such it has resulted in confusion and a wound to Catholic unity.
Following enactment of the health care reform legislation, our challenge remains formidable but in some ways is simpler. Since the battle over the bill is over, the defects can be judged soberly in their own right, and solutions can be advanced in Congress while retaining what is good in the new law. Indeed, any failure to do so would only leave these genuine problems as ammunition for those who prefer total repeal of the law. In this context we do not need agreement among lawmakers that the problems are serious enough to oppose the legislation – we only need agreement that the problems are real and deserve to be addressed. This provides a new opportunity for the Catholic community to come together in defense of human life, rights of conscience and fairness to immigrants so we will have a health care system that truly respects the life, dignity, health and consciences of all. We urge Catholics, members of Congress of all parties and others of good will to join us in advancing this worthy goal.
Cardinal Daniel DiNardo of Galveston-Houston
Chairman, Committee on Pro-Life Activities
Bishop William Murphy of Rockville Centre
Chairman, Committee on Domestic Justice, Peace and Human Development
Bishop John Wester of Salt Lake City
Committee on Migration