The National Catholic Review
Nicholas P. Cafardi
Why did the bishops fight health care reform until the end?
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In the second temptation of Jesus in the desert, the devil offered Jesus political power. Jesus turned him down. The American bishops—or rather their leadership and staff—succumbed. How heady it must have felt for those staffers from the U.S. Conference of Catholic Bishops who were present in the room with Rep. Bart Stupak when he was negotiating with Speaker Nancy Pelosi over the anti-abortion language in the House health care reform bill.

But what the lords of this world give, they can take away. How bitter it must have been for these same staffers when Congressman Stupak worked out a reasonable compromise with the administration—an executive order clarifying the anti-abortion language of the Senate bill—so that the Congressman, acting as a pro-life Catholic layman, with a fully-informed conscience, could vote for the Senate version of the health care reform bill.

The Catholic Church has always been a strong supporter of universal health care, ever since Pope John XXIII included it in his list of basic human rights in his encyclical, Pacem in Terris. Yet when the United States finally adopted near (not complete) universal coverage, the bishops of the United States found themselves opposed to it for reasons that were, at best, hard to decipher.

The bishops’ arguments against the Senate bill seemed to come down to suspicions that:

1. The Senate bill did not incorporate the exact language of the Hyde amendment as the House bill did, but it did make Hyde’s restrictions applicable by reference to Hyde. Therefore reject the Senate bill, the bishops said, because if the Hyde amendment is ever not renewed by Congress, then the Senate bill lacks specific protections against federal health care dollars being used to fund abortions. In this doomsday scenario, the bishops ignored the obvious: A congress with enough votes to reject the Hyde amendment would also have enough votes to put abortion coverage into any existing federal health care legislation.

2. The bill funds Community Health Centers that receive federal dollars, and these centers could start doing abortions. Therefore reject the Senate bill, the bishops said. But CHCs have never done abortions. Their sole role is to see that poor people have access to basic primary health care, not specialized operations. And they are prohibited from performing abortions by federal regulation, and the Hyde Amendment, which does not allow any federal dollars, including those provided to Community Health Centers, to be used for abortions. When President George W. Bush doubled federal support for Community Health Centers during his Administration, by opening 1200 new or expanded service sites between 2002 and 2006, the bishops raised no concerns about abortion funding.

3. The Senate bill requires that one insurance plan per state include abortion coverage, and if this should happen to be the best plan, Catholics who want optimal coverage will have to join and subsidize abortions with their premiums. Therefore reject the Senate bill, the bishops said. But under the terms of the bill abortion coverage in any plan is to be paid for with separate premium dollars, not general premium dollars. And these dollars have to be segregated, just as federal grants to Catholic social service agencies have to be segregated so that the government is paying only for neutral charitable services and not for religious activities. If segregation of funds works there, why not here? And the idea that the “best” plan, the one that all the Catholics will want to buy, will be the one plan that includes abortion coverage is hardly a given.

Political Distortions

The bishops were not fighting the real Senate bill. They were fighting a distortion of the bill. Where did these distortions come from? Not from the bishops or their staff—although they were complicit in repeating them. Rather, they came from the far-right groups with whom the bishops in their pursuit of political power found themselves aligned. But unlike the bishops, who truly wished to get the best health care bill possible, their allies wanted no health care bill at all. They wanted, as they have often repeated, to see President Obama fail.

Proof of this alliance? One telling example: a week before the final debate in the House the bishops’ staff wrote a press release disputing a pro-life analysis by Professor of Law Timothy Jost that supported the Senate bill. This release was posted on the Web site of the National Right to Life Committee a full-day before it showed up on the bishops’ own Web site and even before it was given to the press. So who wrote it? Was it the NRLC, which is funded, in part, by the Republican National Committee? The NRLC is one of Obama’s most vehement critics. Why are our bishops cooperating with these political operatives? 

Neither political party is perfect. They each have their own agendas and each will always act in their own, not the church’s, best interests, and each will seek to use the church if they can. That is what partisanship is all about. But our bishops cannot afford to seem partisan. The perception of political partisanship on the part of the bishops is destructive of their credibility.

On complex political issues like the dense language of the Senate health care reform bill, our bishops are not experts, nor, truth to tell, are their staffs—at least not in comparison to the wizards on Capitol Hill. Instead of getting involved in the technicalities of the legislative language, which is not a matter of dogma or theology, the bishops would have been better served to state what they authoritatively could: No Catholic could support a legislative extension of abortion in the guise of health care. Then let the lay people do what they do best: work out the details.

The bishops must leave the political answers, the how of solving political problems, even when those problems have a moral component, to the informed consciences of the laity. Political strategy is not a question of faith. How odd that in the final analysis, the bishops found themselves on the opposite side of their own standard-bearer, Congressman Stupak, when he voted for the Senate version, backed up by a clarifying executive order. There could hardly be a more pro-life member of Congress. But the bishops, again going where they have no expertise, attacked President Obama’s executive order as ineffective.

But executive orders are law, and in the history of our country they have had breath-taking effects. Harry Truman desegregated the armed forces with an executive order. Dwight Eisenhower, John Kennedy and Lyndon Johnson used executive orders to end segregation in the schools and discrimination in federal programs. George W. Bush used an executive order to limit the lines of embryonic stem cells available for federally-funded research. No bishop ever said any of these were ineffective. Congressman Stupak himself, in response to the bishops’ criticism of his compromise, pointedly said he had heard no Catholic bishop argue that Bush’s executive resolution to prohibit federal funding for some embryonic stem cell research was not enough. Rather, all he heard from the bishops on that issue, he said, was praise for President Bush.

There was no praise for President Obama and his executive resolution stating that no federal funds allocated under the health care reform bill could be used for abortions. Could that be the real problem? Have our bishops become so partisan that they cannot accept anything that President Obama does because he is unrelentingly accused of being “the most pro-abortion president” America has ever elected? Are they unwilling to cooperate with the Democratic Party does because it is constantly caricatured as the “party of death”? How much longer can they cling to these illusions when the health care reform law includes provisions such as life affirming “Support for Pregnant Women’s Act/“Pregnant Women’s Support Act,” which funds $250 million of support for vulnerable pregnant women and alternatives to abortion?

So the bishops found themselves opposed to a law that would provide health care insurance to 30 million uninsured Americans, vastly improve health care insurance coverage for the rest of us, and prevent annually an estimated 45,000 deaths from a lack of adequate health care. And why? For the amorphous anxiety that the health care reform bill might perhaps somewhere, somehow, someday underwrite someone’s abortion? How, in any rational sense of justice, does that uncertainty outweigh the pro-life certainties of this law?

I am saddened that our sacred pastors, men whom I truly admire, allowed themselves to be led into a partisan cul-de-sac that they found impossible to exit. I know that they are wise enough to work their way out of this dead-end eventually, but meanwhile the damage to their credibility in being truly pro-life, and not merely pro-life for partisan purposes, is immense.

Members of the U.S. bishops' conference respond to Nicholas P. Cafardi.

Nicholas P. Cafardi is dean emeritus and professor of law at Duquesne University School of Law.

Comments

Rachel Ottenbreit | 7/12/2010 - 7:49pm
The Church is anything but politically popular. When a view of the Church happens to align with the view of a politician, Church officials do not have an evil tendency to jump on the opportunity and use it to gain more political power. In fact, they are speaking out against some of the views of the party in power - not a recipe for quick political success.
As the Church laity, we should certainly not be criticizing our bishops for standing firmly behind Catholicism.
Grace Yawson | 4/20/2010 - 3:26pm
Dean Carfardi, thank you for this detailed article that has revived my faith in the church. A million thanks to the "brave Nuns and Priests" who prayed and made this bill a reality. My family and I joined others in praying to the Blessed Mother to help the situation. I was beginning to think that I am a Catholic who did not understand abortion and why it superseded the lives of 30 million people who did not have healthcare.

The difference between the bishops and the nuns is that "most nuns live in austerity and take care of the poor" sending us back to the real nativity scene". The bishops on the other hand, wear scarlet robes and gold chains and rings. I have been under the impression that they have their own party - that is why they ingratiate themselves with the Republican Party.

There is nothing wrong in belonging to a party of choice. What is misleading is for the bishops to thrust their views on church-goers without considering how the uninsured and some middle class families with young children are faring. There was no attempt in “peace talks” to bring bipartisanship.

I hope that as we share this article with others, the public and the church will understand the danger we are in if we do not pray in situations like this and allow God to guide us in our decision making.

May God bless President Obama and the senators, congressmen and women who put the people first before their own political gains.
Douglas Corkhill | 4/20/2010 - 1:55pm

Thanks to the U.S. Conference of Catholic Bishops we have lost an important ally. Congressman Stupak did the right thing, talking the talk and walking the walk. It woud behoove and it is imperative the Bishops do the same. Don't throw the baby out with the bath water.


Again, though born and raised, another reason I am no longer a Catholic. Kudos to Nicholas Cafardi on his article.

BERNARDO SURVIL | 4/20/2010 - 10:00am
At the annual mini-retreat of the Association of Pittsburgh Priests held at Providence Villa, North Hills, Pittsburgh, PA on April 19th, I was charged to thank Professor Cafardi for his article, “Cul-de-Sac Catholicism,” published in the America magazine on-line edition of April 12, 2010.

Even before I attended the meeting, others had forwarded to me the link to Professor Cafardi’s essay, remarking on its profound, if disturbing analysis of the US bishops fighting health care reform to the end.

Perhaps recognizing the persuasiveness of Cafardi’s insight, the editors of America lost no time by following up with their own editorial: “The Sister’s Witness” in the hard copy of the April 26, 2010 edition in which they say : “…toward the end of the [health care reform legislative process, [U.S. women religious] found themselves holding a different view from that of the U.S. Catholic bishops on a matter of prudential judgment concerning possible loopholes for federal funding of abortion resulting from the bill.”

It’s for that reason that the Association of Pittsburgh Priests also resolved to send a thank you to Network and to the two congregations of women religious with motherhouses in SW Pennsylvania and who signed Network’s statement endorsing the legislation which is now the law of the land. Those would be the Sisters of St Joseph of Baden and the Seton Hill Sisters of Charity.

We agree with Prof. Cafardi when he concludes: “I know that [our sacred pastors] are wise enough to work their way out of this dead-end eventually…” and we say because women’s wisdom has been brought to bare.

Fr. Bernard Survil
Paul Kelley | 4/17/2010 - 7:06pm

I have just become a web subscriber and have been quite pleased with this and other articles. Mr. Cafardi's analysis was excellent. I believe the bishop's behavior in this entire issue has been terrible and it was good to read some criticism of it,  It reminds me a little of the column atthe time by E.J. Dionne inthe Washington Post with the title "Listen to the Nuns" who had come out in support of the bill.

David Smith | 4/16/2010 - 1:50am

This whole issue was extremely partisan in the making and clearly it continues to be extremely partisan.  Ad hominem attacks are in line with that.  Bad bishops.


 


 


 


 


 


 


 


 


 

Michael Bindner | 4/15/2010 - 3:36pm
Thank you Mr. Cafardi for your excellent analysis of these events. I suspect that the only way for the Bishops to get out of the embrace of the Republican Party is to cease contact with the National Right to Life Committee, which is, as you say, a Republican organ. Staff changes, both in terms of committee membership by the bishops, the eventual retirement of the Archbishop of Philadelphia, Cardinal Rigali, and a much needed staff purge at the USCCB, will be necessary for this to occur. The issue of immigration reform, which the bishops have a much better position on, may lead to the marginalization of the Republican Party such that its siren song is no longer attractive to the more authoritarian bishops who embrace it so readily.
John Hayes | 4/15/2010 - 3:19pm

I agree very much with the thrust of Nicholas Cafardi's article and I thank him for writing it. 


 


I haven't looked back at the txt of the law as enacted, but I wonder if numbered paragraph (3) is factually correct. My recollection is that the law requires at least one plan to *not* include abortion services, while all the others can unless a state decides differently. A person who choses a plan which does include abortion services would have to make a separate payment to fund the cost of the abortion services - even though that person intends never to use the abortion services.  


 


At some point, theologians will have to determine if that is sufficiently remote cooperation so that a person can choose a plan because it provides coverage that best meets ther person's needs - even though it also includes abortion services, or whether the person must choose only from plans that don't include abortion services.


 


Since the law does require that there always be at least one plan available that doesn't include abortion services, I agree with Nicholas Cafardi that there was no proportional reason to oppose the passage of a law which will provide health care to millions of previously uninsured people   

George Purnell | 4/15/2010 - 1:33pm
Whom God would destroy he first makes mad. The hierarchy,as it has existed, is self destructing.
ed gleason | 4/15/2010 - 1:10pm

I see no easy way out of the Cul de sac for them  Bishops are being wedged back into the back of the Cul-de-sac  by the pushing crowds/mob of what I call Tea Party Catholics that have picked up the cry 'stop Obama'..It takes a couragous bishop to push his way out of that crowd and I see none up to the task. The bishops denigrate Obamas' Executive Order as 'a wothless piece of paper' but their minions are scururring around the Vatican looking for some paper that would save the reputation of PiusXII and BXVI. Wouldn't they like to find some 'worthless piece of paper' there.????

Gerelyn Hollingsworth | 4/15/2010 - 12:52pm
Are they "Jeopardizing Tax-Exempt Status" by their activities against Obama and health care legislation in particular and Democrats in general?

http://www.irs.ustreas.gov/pub/irs-pdf/p1828.pdf

(See p. 5.)
Tom Maher | 4/14/2010 - 11:23pm
Thank God for the Bishops' firm stand against facilitating the expansion of abortions in America. How could the Bishops have done otherwise? For four decades the church has preached most compellingly and effectively that society should protect the unborn, that abortion is wrong and that the number of abortions in America must be limited as far as possible. How could the Bishops now back away from one of the the church's most inspired moral teachings of this age? What could the Bishops now say to uncommit themselves from their own moral teachings? "We were only kidding." or " We really did not mean all that stuff about life being sacred"? What an absurd propostion that the Bishops are somehow to blame for acting on their own deeply held moral principles.

Thank God that the Bishops of the church in this anything-goes world are able to say yes life does matter and we uphold the importance of life and its defense. Life principles can not be abandoned for the political expediency of enacting a health care law. The ends do not justify the means.

Congress sent an opposit message. When put to a vote the Senate repeatedly rejected definative language to not fund or facilitate the expansion of abortions. Lacking definative language in the law is unacceptable to everyone concerned about the defense of the unborn. Both Senator Ben Nelson of Nebraska and Representative Bart Stupak of Michigan last minute switch in support of the health care law are no heros. They are both vilified by their constituances for caving in under political pressure.

The Bishops have no problems from the Catholic laity over their stand on the health care law. The Bishops remained faithful. They can recieving nothing but praise and admiration from the people of faith. The Bishop's credibility has never been stronger than when they took their firm stand on principle.
Dan Hannula | 4/14/2010 - 3:40pm

So often do we discovery that Ideology is unencumbered by the facts.

Lori Amann-Chetcuti | 4/14/2010 - 2:37pm

Thanks for this very clear explanation of a complicated issue.  Clearly, our bishops trust Republicans much more than they trust Democrats.