The Affordable Healthcare Act, the Supreme Court and the U.S. Bishops

Chief Justice John Roberts’ decision to join the progressive wing of the U.S. Supreme Court to uphold the individual mandate in the Affordable Care Act is earning him the expected vilification in the Tea and Republican Parties, both of them now controlled by wealthy extremists who disdain the political center and the responsible moderation and compromise that might achieve meaningful political progress in this country. God bless our Chief Justice and give him strength. He will need it to deal with the onslaught to come from the right wing crazies. One conservative commentator even blamed the “cognitive dissociation” of the Chief Justice’s opinion on his epilepsy medication. When the Chief Justice said, at a judicial conference after the ACA decision was issued, that he would have to take refuge in an “impregnable fortress” he was only half-joking.

But think about what upholding the ACA achieved:

- Young people can remain on their parents’ health insurance until age 26. At a time when many folks just out of college are having trouble finding employment due to the stagnant economy, which in turn is caused by that same right wing refusal to compromise on issues of stimulus and tax reform, this is quite a benefit. Without it, these young people would be at great risk, unable to afford their own health care coverage.

- Lifetime limits placed by insurance companies on healthcare coverage, the kind that often leave seniors without adequate health insurance when they need it most, in their final years, are gone.

- The elderly can also keep the ACA generated discounts on their prescription drugs.

- Insurance companies can no longer refuse coverage to children (and this will soon expand to include us all) for a pre-existing condition.

- Insurance companies can no longer refuse renewals to their customers who get sick.

- Healthcare premiums can now only go up when the companies can justify the increase; gouging is gone.

- Preventive care is now covered to prevent the onslaught of illness or to catch it and treat it at its earliest stages.

The Chief Justice’s vote rejected the clear political partisanship of the dissenting opinion in the ACA case. Four Justices, all Republican appointees, and, sad to say, all Catholics, would have declared the entire act unconstitutional. The harm that such a blatantly political act would have done to the credibility of the Court (already at a low point because of these Justices’ prior political shenanigans) apparently did not matter to them. Nor did it trouble them that their decision would have wreaked phenomenal cruelty by the denial of necessary healthcare to the young, the poor and the elderly. If ever a group needed to be catechized by our bishops, it is these four, not on what the Constitution means, but on what the 25th chapter of Matthew means.

And speaking of our bishops, one would think that, once all the very good things that the ACA does were upheld, religious leaders with a concern for social justice would be happy with the Court’s decision. Until the ACA, the United States was the only major western democracy without universal healthcare coverage (and truth to tell, because of the need to compromise, which the President to his credit did, the ACA provides almost, but not complete, universal coverage). So it is troubling to see our bishops, who are true moral leaders, sitting sadly on the sidelines again. The bishops’ statement in response to the U.S. Supreme Court’s decision is anything but joyful.

Their statement offers no congratulations on the tremendous achievement that the ACA is. Rather, it complains about three things: (1) That the ACA funds abortions. It does not. (2) That the HHS regs on mandated coverage for the ACA do not have appropriate conscience protections. In fact, the regs are still being worked out, and in the meantime, the church itself and church-affiliated agencies are covered by exemptions, although perhaps not phrased as the bishops would want these exemptions to be phrased. But the bishops are partially correct here. The regs need work. And (3) That the ACA fails to treat immigrant workers and their families fairly.

This last is a just criticism of the ACA by the bishops. The ACA does not adequately provide for immigrant workers and their families because they are excluded from participating in the new health care exchanges that the ACA creates to lower insurance costs. But if the bishops want this part of the ACA changed, they need to talk to the anti-immigrant Republican politicians. You know, the ones but for whom the Dream Act and meaningful immigration reform would be law by now.

I would not count on any help from that quarter, though. Despite the partisan boost, whether intended or not, that our bishops’ religious freedom campaign has provided those right wingers and their presidential candidate, our bishops are still standing up for the poor. They have harshly criticized the Romney-endorsed Ryan budget that cuts $5.3 trillion from anti-poverty programs in order to fund additional tax cuts for the wealthiest Americans. That criticism will make the bishops no friends and get them no help from these extremists, who luxuriating in their wealth and the sense of power that it gives them, brook no dissent. If these extremists can throw Chief Justice Roberts under the bus for not siding with them 100 percent of the time, they can do it to anybody.

Nicholas P. Cafardi