On Thursday, Senate Republicans released their version of a bill aimed at repealing the Affordable Care Act, drawing swift condemnation from one prominent Catholic health group, which said it is “strongly opposed” to the measure. Catholic bishops took a more nuanced view, strongly condemning portions of the bill that they say harm the social safety net but praising language that would restrict funding for abortion providers.
The bill would replace President Obama’s signature health care legislation with a law that relies on tax credits for low-income Americans to buy health insurance and would make deep cuts to Medicaid funding for states, which was expanded under the A.C.A.
“Just like the House passed American Health Care Act, the Senate proposal will have a devastating impact on our nation’s most vulnerable populations,” Sister Carol Keehan, head of the Catholic Health Association, said in a statement. “After weeks of working behind closed doors, and despite claims that the Senate would start over and develop its own legislation, there is very little that differs from the House bill.”
Sister Keehan: “The Senate proposal will have a devastating impact on our nation’s most vulnerable populations.”
“We can and must do better on behalf of all those who rely on our nation’s health care programs and providers,” she continued. The C.H.A. represents more than 600 Catholic hospitals in the United States.
On June 26, an analysis from the nonpartisan Congressional Budget Office reported that the Senate health care bill would result in 22 million more uninsured Americans over the next decade compared to current law. The C.B.O. projection may further complicate Senate GOP leaders' plans to pass their bill this week. The projected outcome of the Senate plan is barely an improvement upon the health care bill that passed the House—which would have resulted in 23 million more uninsured.
Several GOP senators have said they want to see their bill cover more people than the House version. And President Donald Trump himself called the House bill "mean" — though he's lent his support to the Senate version and is lobbying for passage.
Catholic bishops released a statement on Thursday evening saying that parts of the Senate proposal would “cause disturbing damage to the human beings served by the social safety net” and that it could “wreak havoc on low-income families and struggling communities, and must not be supported.”
Promising to review the full bill more closely, Bishop Frank J. Dewane, head of the bishops’ domestic justice committee, said, “It must be made clear now, however, that this proposal retains many of the fundamental defects of the House of Representatives-passed health care legislation, and even further compounds them.”
“It is precisely the detrimental impact on the poor and vulnerable that makes the Senate draft unacceptable as written,” he continued.
Bishop Dewane: “It is precisely the detrimental impact on the poor and vulnerable that makes the Senate draft unacceptable as written.”
Bishop Dewane praised portions of the bill, however, which would temporarily freeze funding for Planned Parenthood. He lauded “language in the legislation recognizing that abortion is not health care by attempting to prohibit the use of taxpayer funds to pay for abortion or plans that cover it.”
He also expressed disappointment that the bill does not include provisions to include more coverage for immigrants nor conscience protections for health care workers and called on the Senate to “to make changes to the draft that will protect those persons on the peripheries of our health care system.”
According to an early analysis by The Washington Post, the Senate bill retains many elements of a bill passed last month by the House of Representatives, including the repeal of a government mandate that requires Americans to buy health insurance, the repeal of a rule that requires large companies to offer health insurance and large cuts to Medicaid. Both bills also temporarily freeze funding to Planned Parenthood, let young people stay on their parents’ health plan until age 26 and allow insurance companies to determine essential health benefits. Under the A.C.A., essential health benefits, which are regulated by the government, include hospital visits, maternity care and treatment for mental health.
The Senate version, dubbed the Better Care Reconciliation Act, differs from the House bill in that it does not allow insurance companies to deny coverage based on pre-existing conditions.
“The small tweaks made in the newly released Senate bill do not change the fact that millions will lose their health care.”
“The small tweaks made in the newly released Senate bill do not change the fact that millions will lose their health care especially through a complete restructuring and deep federal funding reduction to the Medicaid program,” Sister Keehan said.
A vote on the bill is expected next week, the Post reports. It would then need to be reconciled with the House version before heading to the White House. President Trump supports repealing Obamacare, though he recently called the House version of the bill “mean.”
President Trump supports repealing Obamacare, though he recently called the House version of the bill “mean.”
The Senate bill, drafted in secret, would use the savings from reduced health insurance subsidizes to offer large tax cuts.
Sister Keehan in her statement urged Congress “to ensure that the funds currently supporting health care programs remain in the system under any legislative proposal, instead of being diverted for tax cuts for the more fortunate.”
“And above all, we urge our elected officials always to keep in mind the unborn and the many millions of poor individuals and vulnerable families who will be affected by any changes to our health care system,” she continued.
The Senate bill, drafted in secret, would use the savings from reduced health insurance subsidizes to offer large tax cuts.
Last week, the U.S. Catholic bishops gathered in Indianapolis for their spring meeting spent close to an hour discussing proposed changes to Obamacare, warning that drastic cuts to federal health insurance subsidies would harm the poor.
The U.S. Conference of Catholic Bishops has for months urged legislators not to replace the Affordable Care Act with a law that would reduce access to health insurance. An analysis of the House version of the bill by the Congressional Budget Office earlier this year estimated that up to 23 million more Americans would be without health insurance by 2026 under that plan. The C.B.O. is expected to report on the Senate version of the bill next week.
Bishop Robert McElroy of San Diego said bishops must do more “to recognize the breathtaking nature of the assault on the core principle of Catholic social teaching” present in the health care bill passed by the House of Representatives, adding that “health care is a fundamental human right and government is its ultimate guarantor.”
“The Affordable Care Act for all of its flaws was a movement in favor of comprehensive health care,” he added. The House bill, he said, “is a movement away.”
This story will be updated.
To be even marginally fair and reasonable Mr OLoughlin should have, but failed to note that Sister Keehan was according to President Obama the pivitol driving force enabling ObamaCare to pass. She not only attended the signing ceremony she was given a signing pen.
Obamacare enabled her Association of hospitals to be guaranteed reimbursement for emergency services through Medicaid which in practice could be signed up for under an ObamaCare exemption during admittance .
Little wonder that being so invested she started critiquing the republican repeal plans before she could even have seen them, nonetheless have read them. I fully appreciate Sister's seeking what is best for her Catholic Hospital Association members, but what is best for that group is hardly the measure of what is best or even fair for the nation as a whole.
I don't ever recollect Sister Keehan critiquing the fundamental ObamaCare premises of:
" if you like your plan , you can keep your plan"
" if you like your doctor, you can keep your doctor"
Very odd , since she was a noted expert in the ObamaCare law and how it would work.
Her opinion is fully grounded in keeping the status quo which is demonstrably unworkable
The Republican proposal ought not come as a surprise to any sentient being inasmuch as that party has attempted to sabotage the ACA since its adoption. One only wishes that the Catholic hierarchy had shown some leadership during the presidential campaign when then candidate Trump repeatedly promised to eliminate the law. In my view, health care policy is bogged down in what is essentially a religious war, pitting Catholic social doctrine against neo-Calvinist attitudes toward the "undeserving poor," a theology that appears to dominate the thinking of the religious right. Does the C.H.A. have a financial interest in the outcome? Of course it does, for the simple reason that it cannot fulfill its mission without money. But that is hardly a self-serving position in this instance. After all, it's not as though Sr. Keehan is worried that her year-end bonus will not be funded.
Big government exists to regulate and moderate big business.
Former President Obama started out making idealist promises about his healthcare plan. He wanted to put on public display how wonderful he was to the poor. One of his promises was that every citizen would have the healthcare program that US Senator's have. He could sell sand to a bedouin. He and his healthcare plan are humongous profit making deals for the big insurance providers. He let them put their hands right into the pockets of the individual middle class citizen, as a taxing entity. And Obamacare used the power of government to force those businesses onto the middle class.
Let's look at the issues: No child hungry. And no child without healthcare, should be a driving goal for every grown up in this country. Big government should be stepping in stripping and simplifying and regulate the monsterous big business that makes huge profits on feeding hungry children or providing them healthcare. The paradigm needs to change at the level of the insurance companies. They do not need a green light from government to tax the common citizen or increase their costs by 100 to 125%, which is what Obamacare did. And then further watch the government tax citizens who do not buy their product. (health insurance).
Insurance companies provide a product and doctors and hospitals provide a service. And that is one of the fundamental disconnects with Obamacare. Insurance companies do not care. They are not supposed to care. They have a corporate veil that protects them. They are in business to make a profit. They must go.
There's your start.
What replaces them? Well, for one far reaching idea==return of earnings to the citizens.
After insurance companies go, Medicare and/or Medicaid for all. Big pharma should also go. Advertising of meds should go with them. Big hospital chains, including Catholic ones, should go. Have nuns again in charge instead of overpaid profit-obsessed hospital administrators. Take as much of the profit motive out of medicine as can be done.
For Katherine Marsh,
Re: "He (President Obama) and his healthcare plan are humongous profit making deals for the big insurance providers."
This is a common theme in the overall health care debate. Unfortunately it is inaccurate. The insurers who are exiting specific states and counties have been, for the most part, not-for-profit entities. That alone defeats the meme. Beyond that, several for-profit insurers have exited specific markets after losing hundreds of millions of dollars on Obamacare policies. These losses are real. Let's recall that under Sarbanes-Oxley a senior corporate executive is subject to criminal (not just civil) penalties for material misstatement of financials, so we may take the reported financial losses at face value. The theme is also illogical, since it equates to "For-profit and non-profit insurance companies are making a lot of money ("humongous profits"), so they decided to close up their business (in some cases, their entire business), let go their customers, and no longer collect premiums. I hope this clarification is helpful to the conversation.
Mr Dunn
It is not accurate to say we can trust the hospital financials because their generally accepted accounting is geared to show losses whenever possible as a basis for negotiation with insurance groups like Blue Cross/Blue Schield .
Assume a hospital regularly charges $50,000 for a procedure. If as an insured I get that procedure, the Blues will have negotiated a rate of $$20,000 for that procedure. The hospital books the expected $20,000 reimbursement as revenue and can't book $50,000 because of its contract with the Blues.
BUT IF I AM UNUNSURED AND GET THE SAME PROCEEDURE THE HOSPITAL, NOT CONSTRAINED BY CONTRACT, BOOKS $50,000 AND WHEN IT IS NOT PAID AND I AM JUDGEMENT PROOF (indigent etc) THEN THE HOSPITAL CAN SHOW A $50,000 LOSS!! Note that even though it would only normally get about a positive $20,000 for an insured , an uninsured non payer generates a $50,000 LOSS. . This let's the hospital show accumulated losses for its uninsured clients which compel the Blues in its next negotiation to pay $21,000 for the insured procedure and let's he Blues in turn raise their insurance rates. This vicious cycle/game of posting average rates for various procedures while charging/realizing far less for its insured clients has gone on for so long that no one knows any longer what the real rate for a given procedure is. But total unreimbursed services grow each year which in turn supports another round of negotiations for higher reimbursement from the insurance companies. As I understand it , this is all perfectly acceptable accounting under Sarbanes Oxley.
Mr. Meisenzahl
Thanks for your note. My Reply comment was primarily about insurance company financials, but the same Sarbanes Oxley applies to (at least) for-profit hospitals' financials. You have correctly described the mess, and the financial reporting of it. Everyone who buys health insurance contributes, thru their premiums to the cost of services to the uninsured, to the extent of the hospitals' inability to collect. I suspect most insurance buyers know that, but worth restating as you have. The Blues have access to the published and filed (Sarbanes-Oxley conforming) financial reports of for-profit hospitals. So, they have the ability to negotiate with full knowledge of the hospital's profit or loss as an entity, for each year or calendar quarter. My main point: The notion of "humongous profits" is a meme, since profits cannot be hidden and if they existed they draw competitors into the market, attracted by their own desire for profit.
If your concern is that the hospital can flamboozle the Blues by showing inflated 'regular charges', the Blues can always point to the overall profitability of the hospital. In the end, it will be a negotiation between well-informed parties. I don't see any other potential source for the hospitals to make up for their unreimbursed costs, except of course taxpayers, which gets us back to the same place--he who has, pays. To let the hospital run a deficit until it goes out of business seems contrary to the community's good. Peace.
Postscript: He could sell sand to a bedouin was not charitable.
Former President Obama's biggest financial supporters were Investment Bankers. And once he became President he bailed them out of the subprime fiasco, they made. Mr. Obama did not however, bail out the little Mom and Pop banks that refused to give subprime loans. That was an incredibly telling use of power by him, in my opinion.
We see this use of power replicated in Mr. Obama's Obamacare. Big Insurance companies were given the power of the purse over healthcare. He gave his executive power over to them.
Mr. Obama delivered the pocket books of every tax payer to the insurance companies In order to deliver healthcare to every person in this country. Essentially Mr Obama's program does not serve a free market economy well, because it contradicts what good free market economy does best and does well. Instead it serves the always possible exponential greed of a market economy.
I'm not an expert on this complex issue but I believe Mr. Meisenzahl and Ms. Marsh are not focused on the issue of the Republican repeal and replace offering.
Mr. Meisenzahl reverts to the old Fox News supposed quote about keeping insurance policies without truthfully looking at the context and complete statement. President Obama was saying you can keep positive policies, not garbage polices.
Everyone agrees that the ACA was not perfect. Is that unusual? The Republicans refused to assist in improving the ACA, and now Trump is intentionally sabotaging it.
President Obama, unlike what we now see, encouraged the Republicans to offer alternatives and had countless public forums for a year! Do you remember Sen. Grassley, after months and months saying there would be 'death panels'? And where is he now, when 43,000 will lose insurance?
Do these Catholics wish to say it is agreeable to have millions lose insurance and Medicaid changed drastically along a Planned Parenthood does not receive funds for non-abortion activities? My daughter, the Georgetown grad and I, a Marquette Grad do not accept that trade.
M. Welch
Respecting President Obama's representations about "Keeping your Doctor" and "Keeping your Plan" I would like to remind you that:
1) Jonathan Gruber, the co architect of ObamaCare, stated baldly that the whole idea was to trick the public about what would really happen.
2)Reliably liberal news outlets have reported that Mr. Obama was told by his advisers that his statements were not supportable but he continued to repeat them some 19 times
3) Politifact gave Mr Obama its "Lie of The Year Award for 2013" for these statements, and it analyzed fully the context in which Mr Obama made these statements and found no excuse. Politifact, December 12, 2013
4) The Washington Post awarded both Obama and Valerie Jarrett 4 Pinnocchios for these statements and their equivalent. (Fox News, the Post is Not)
5) After horrendous outcry and condemnation , Mr Obama finally apologized for these statements on NBC with the mealy mouth excuse that he was misunderstood. A tough position since he made simple declarative statements and repeated them numerous times.
At no point did Mr Obama ever try to excuse his "Lie of the Year", as you suggest, by saying he was referring to "positive policies not garbage policies" . Based on your suggested excuse for "if you like your plan...etc , I suppose you are imputing that of course when he was talking about being able to keep your doctor he meant your "positive doctors"?.......or perhaps even your "good doctors and not bad doctors"?
None of the above are Fox talking points .....a simple google search will demonstrate that.
By the way, you may also recall Mr Obama repeatedly and directly stating to George Stephanopoulis that the individual mandate was not enforced by "a tax"..."it's not a tax". (June 29, 2009) Yet as soon as the issue got to the Supreme Court his lawyers presented the legal argument that it was a tax in fact and that became the pivitol item that saved ObamaCare from being declared unconstitutional.( As I recall Mr. Obama touted himself as a Constitutional Law professor) Mr Obama stated it was not a tax in order to defend ObamaCare when he had already promised " no new taxes on persons earning under $250,000" . Just another example of his telling a lie to cover for another lie!
"Sister Keehan" is this newsworthy? Give us a "man bites dog" story if you want to sell more magazines.
I wish the Bishops were equally empathetic for those who work with me whose premiums increased 5x and deductibles 4x.
Yes indeed. Regarding the ACA, it seems many well intentioned Catholic leaders could only see the trees and missed the forest.
Mr. O'Loughlin seems to think he is serving the Catholic world as a journalist by finding immediate reactions by some Catholic officials who are negative of the Republicans. When it is bishops, they are praised but then just show these same bishops praising something Trump or Republicans do and they are then denigrated.
My guess is that no one here especially Mr. O'Loughlin and the editors or authors and especially most of the commenters have a clue about the long term effects of any healthcare legislation. I struggle to understand it and can point to conservative authors who are negative on what the Senate Republicans propose and some who praise it.
America should take the position of trying to understand the pros and cons of the ACA and its proposed replacements. Until then America is being irresponsible to publish anything.
Google
to see an analysis that came out this morning. It is in the Investors Business Daily.
What a heh-heh-heh grin on McConnell's face.
There seems to be little discussion of a third path. It's not Calvinist ethics versus Catholic, as if the ACA was Catholic while the proposed alternatives are irredeemably not. In fact, the ACA was decidedly not Catholic in its choice of bureaucracies far removed from the people and its aggrandizement of federal power over individual lives, particularly in its lack of respect for personal moral autonomy. The USCCB's support was particular tepid, and based largely on health care's extension to the uninsured, especially the poor.
In any case, the unwillingness of both political parties to work together in the passing of the ACA is being perpetuated today. Perhaps if dialogue, rather than demagoguery, was the predominate political tool in the discussions a truly Catholic bill could be crafted, one which fosters the common good of basic health care for all, without imposing a partisan medical ethics by federal fiat.
If you want to know what is in the proposed new healthcare bill, a good assessment of the Republican senate bill is at Forbes by Avik Roy. Just google
It should lower costs of health insurance while fixing some archaic regulations.
The real lowering of costs will come when tort reform happens. This is the main reason US healthcare is more expensive than most of the world. So if anyone who supposedly cares about the poor such as the bishops and Sr Keehan should be on board with that. Where have they been?
I would like to see the Bishops stop cherry-pick one thing they don't like and ignore the larger problem called ObamaCare. When people and groups solely criticize what they don't like, it is clear they don't have a realistic solution. A good example of an unrealistic solution is universal healthcare at any cost. Such a solution is irresponsible because it hides the real cost problems where solutions require courage, innovation and difficult decisions. Any realistic solutions will disadvantage someone or some groups.
I want to make clear that the Republican plan is no panacea. It has major problems. However, let's get real. They pale in comparison to the problems like insurance companies pulling out of all the exchanges and premiums and deductibles that have skyrocketed. ObamaCare is not affordable and it is in a death spiral. The Democrats want you to believe that this problem rests with the Republicans. This is both absurd and dishonest. The truth is the Republican plan may be less onerous but this does not mean it is a solution.
As for the bishops, they should know that offering general guidelines based on social justice principles is never the answer to such a complex problem as healthcare. Solutions need a specific blueprint that balance access, quality and costs. This means details, accurate cost analysis and realistic trade-offs that minimize the negatives based on good unbiased judgment and reason. Criticizing the fact that a certain group will see their costs increase or lose what they have now is a problem. However, it is only one problem is a maze of important issues that must be resolved. ObamaCare was not the answer and neither is this Republican plan. Unfortunately, Washington politics is a big part of the problem. The bishops could help here with a comprehensive and expert white paper of both the problems and potential solutions.
I am sick of the criticism of The US Bishops against Trump and the Republicans that are attempting to pull the Government out of the Health Care Business. The Press, the US Bishops should be glad that there is an attepmpt to bring the disaster of the ACA into something that Our nation can live with and afford. We can't wright blank checks, If any one wants to complain criticize the Obstructionist members of the Congress and the Senate. Quick to critisie to the Mic, but slow on any useful plans to help fix the problems.
Unfortunately, in USA politics, nuance is not a constructive strategy to support or oppose legislation. Most legislation, after its writing, comes down to either “for or against.” In a diverse nation, with so many different cultures, religions, political philosophies, etc., every piece of legislation becomes a compromise. You are either for or against the compromise.
Which is why, to my mind, the nation’s Bishops are so ineffective politically. Sister Keehan, however, grasps political realities. If healthcare for all USA citizens is the goal, then she understands the political dynamics to getting it done.
re: P Welch and
Focus on the Republican bill.
Okay. I agree with the US Bishops that the Republican Bill is not the answer. I disagree with the US Bishops that Obamacare is the answer.
I agree that it is the job of good government to make sure that the sick have good care. I think that the medical profession evolved by learning about diseases and disabilities and injuries and providing the best care in the world for them. Skill and knowledge furthermore, should be handsomely rewarded. I also believe the individual professional can determine when he/she will dispense their skill and knowledge on a pro bono basis to the needy. And we need a tax break angle that recognizes this on their income. Some people enter the profession to care for the poor. I think that industry and big business should pay a larger portion in the form of tax (yikes) for treating disease and illness. I waffle about binding arbitration.
Educating about wellness, preserving wellness, maintaining health however, would be better served with a different paradigm. This should be separate from delivery of medical care for illness and disease.
Health savings plans ultimately will not work for one thing because it makes the medical profession lose the pro bono angle and it sets collection dollars.
I think that we need to find a new business definition for those in the medical insurance and those in the health wellness business. Currently the administrators of non profits can make a fortune. If you want to be in the business of taking the hard earned dollars of every citizen in this country and then providing those dollars for the care of our sick and diseased and disabled who cannot afford it, then you better not be in the profession to become wealthy. This country has other opportunities where you can find something to do. Any profit should be returned to the tax payers at end of the year. Or invested over in the health wellness business.
Well it's clear. Our bishops are intent on not giving up their economic illiteracy, their indifference to the burdens on the poor caused by the ACA, and their moral indifference to abortion and euthanasia.