Cul-de-Sac Catholicism: Why did the bishops fight health care reform until the end?

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.