Health Care: Simply Catholicism

The news that Congressman Bart Stupak, the champion of pro-life Democrats, will be out of town for the rest of the week due to a death in his family is the most discouraging news I have heard in a long time. The House appears set to move forward on its health care reform bill, possibly by the end of the week, and Stupak’s absence complicates everything. As the USCCB has instructed, now is the time to be calling your congressional representatives in both the House and Senate and telling them that you are anxious to support health care reform but that government funding for abortion is a deal-breaker. That phrasing is not my own: It is what Cardinal Sean O’Malley said to President Obama before the funeral Mass for Sen. Ted Kennedy.

Cardinal O’Malley’s succinct statement is a perfect example of what Cardinal Francis George calls "simply Catholicism" in his new book The Difference God Makes. This is a time for all Catholics to put their partisan positions in second place and consider the health care debate in terms of simply Catholicism. Yes, some Democrats are so eager to get health care reform, they might be tempted to skirt the abortion issue. They must resist the temptation. Some Republicans may be tempted to hide behind the abortion issue to oppose health care reform on other grounds. They, too, must resist the temptation.

Now, determining what precisely does and does not constitute federal funding is a little bit trickier than anticipated because the health care reform bills so far passed by committees in either house use subsidies for private plans to help reach universal coverage. But, before we get to the key question of where to draw the line, it is important to note the "Pay no attention to that man behind the curtain" quality to the negotiations going on in the House. Yes, the closer the bill is to what we eventually want the more likely the Conference Committee, where the House and Senate bills will be reconciled, will go smoothly. But, the truth is that the most important negotiations are the ones going on over in the Senate. If, the House passes a bill that comes close to Stupak, that strengthens the hand of pro-life Democrats in the Senate assuredly. But, one stubborn Senator may be all it takes to keep federal funding of abortion out of the final bill.

So, where to draw the line? I think there is some disingenuous posturing on both the pro-life and pro-choice sides. Pro-lifers must concede that banning all federal subsidies to plans that include abortion coverage is, in effect, telling insurance companies they cannot provide coverage for a procedure that is legal. On the other hand, pro-choicers have to admit that federal subsidies constitute federal funding and we pro-lifers are not going to sit around and see 20 million Americans suddenly have tax-payer subsidized abortion coverage. The Capps Amendment is insufficient and, as important as health care reform is, unless there are changes to Capps, Congress should vote no. On the other hand, if there is a way to pass a health care bill that neither encourages nor discourages abortion coverage but honors the current status quo, Congress should vote yes.

There are three solutions. First, Congress can create vouchers with which individuals go and buy whatever plans they want. As in the case of private school vouchers, this does not constitute any kind of direct federal funding. Second, and similarly, the subsidies can be in the form of tax credits. This, too, gets around any issue of federal funding of abortion but I worry that tax credits are never the way to go, that some sliver of the population that is due the subsidy will not get it because tax forms are confusing enough. Finally, Congress can mandate a "basic plan" that does not include abortion services and only provide subsidies for that plan, although citizens would be free to buy whichever plan with whatever additional coverage they want.

What can’t get lost in this debate is how important it is to pass universal health insurance. The Republicans announced their counter-proposal but the Congressional Budget Office analysis said it would scarcely make a dent in the number of uninsured. Some reform. As well, GOP protestations about the cost of health care reform are laughable when you realize that the last major health care reform – Medicare Prescription Drug Coverage – was enacted by the GOP with absolutely no funding mechanism, none, zip, zilch. Similarly, those Catholics who invoke the principle of subsidiarity to oppose health care reform misunderstand subsidiarity. It works both ways: Problems that can be dealt with at a lower level of society or government should be dealt with at that level, but when the family, or the community, or the city or the state can’t deal with the problem, the federal government has an obligation to step in.

Yes, abortion is a deal breaker, but it is incumbent upon all Catholics to seriously push for health care reform provided the abortion issue is dealt with satisfactorily. Those who are complaining about other aspects of the bill are free to do so, of course. But, they are standing in the way of the fulfillment of a cardinal principle of Catholic Social Teaching, that health care is a right not a privilege. And, they are failing to be simply Catholic.