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House’s health care bill has both laudable and troubling aspects, bishop says

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WASHINGTON — The inclusion of “critical life protections” in the House health care bill is laudable, but other provisions, including those related to Medicaid and tax credits, are “troubling” and “must be addressed” before the measure is passed, said the chairman of the U.S. bishops’ domestic policy committee.

Bishop Frank J. Dewane of Venice, Florida, who is chairman of the bishops’ Committee on Domestic Justice and Human Development, sent a letter March 17 to House members. It was released March 20 by the U.S. Conference of Catholic Bishops.

Congressman Jim Renacci, R-Ohio, takes notes as he listens to House Budget Committee lawmakers deliver statements on the American Health Care Act during a March 16 hearing on Capitol Hill in Washington. (CNS photo/Shawn Thew, EPA)

Congressman Jim Renacci, R-Ohio, takes notes as he listens to House Budget Committee lawmakers deliver statements on the American Health Care Act during a March 16 hearing on Capitol Hill in Washington. (CNS photo/Shawn Thew, EPA)

Regarding life protections in the bill, Bishop Dewane said: “By restricting funding which flows to providers that promote abortion and prohibiting federal funding for abortion or the purchase of plans that provide abortion, including with current and future tax credits, the legislation honors a key moral requirement for our nation’s health care policy.”

Among the “very troubling features” of the bill are the Medicaid-related provisions, he said. Other aspects that must be addressed before the bill is passed include the absence of “any changes” from the current law regarding conscience protections against mandates to provide certain coverage or services, Bishop Dewane said.

His letter follows one sent March 8 to House members by him and three other bishops’ committee chairmen stating they would be reviewing closely the American Health Care Act, introduced in the House March 6 to repeal and replace the Affordable Care Act.

The other signers of the earlier letter were: Cardinal Timothy M. Dolan of New York, chairman, Committee on Pro-Life Activities, Archbishop William E. Lori of Baltimore, chairman, Ad Hoc Committee for Religious Liberty; and Bishop Joe S. Vasquez of Austin, Texas, chairman, Committee on Migration.

In his March 17 letter, Bishop Dewane said one area in the new bill that could be helpful, with “appropriate safeguards,” is an effort to increase flexibility for states and provide more options for health care savings and different kinds of coverage based on economic levels. But still, Bishop Dewane said, “efforts to increase flexibility must be carefully undertaken so as not to undermine” a given program’s “effectiveness or reach.”

In the House bill, Medicaid expansion would be repealed and replaced with a “per capita allotment.” Under the current law, more Americans became eligible for Medicaid, so long as their states opted into the entitlement program’s expansion.

The House bill’s “proposed modifications to the Medicaid program, a vital component of the social safety net, will have sweeping impacts, increasing economic and community costs while moving away from affordable access for all,” Bishop Dewane said.

He also cited the nonpartisan Congressional Budget Office’s assessment of the bill that said “as many as 24 million additional people could be uninsured in the next 10 years for a variety of reasons.”

The U.S. bishops, he said, have stressed that “all people and every family must be able to see clearly how they will fit within and access the health care system in a way that truly meets their needs.”

The CBO estimates millions of people currently eligible for Medicaid under the law “will be negatively impacted due to reduced funding from the per capita cap” proposal, Bishop Dewane said.

“State and local resources are unlikely to be sufficient to cover the gaps,” he continued.

Congress needs “to rework the Medicaid-related provisions of the AHCA to fix these problems and ensure access for all, and especially for those most in need,” said Bishop Dewane.

He also pointed out that the House measure does not provide “conscience protection against mandates to provide coverage or services, such as the regulatory interpretation of ‘preventive services’ requiring contraception and sterilization coverage in almost all private health plans nationwide.”

The mandate requiring most employers to provide such coverage even if they are morally opposed to it, he reminded House members, “has been the subject of large-scale litigation especially involving religious entities like the Little Sisters of the Poor.”

Bishop Dewane outlined other provisions he said need to be addressed before the legislation is passed, including:

  • The new tax credit system, which “appears to create increased barriers to affordability, particularly for older and lower-income people when compared with the cost assistance” allowed under the current health care law.
  • The cap on the cost of plans for older Americans relative to plans for younger people would increase to a 5-to-1 ratio over the current 3-to-1 ratio. Studies show, Bishop Dewane said, that “premiums for older people on fixed incomes would rise, at times dramatically” under the House proposal.
  • A 30 percent surcharge for a 12-month period for those who do not maintain continuous coverage “presents a serious challenge.”
  • No longer any requirement for states to allow individuals seeking Medicaid benefits a reasonable opportunity to verify that they are either U.S. citizens or have a qualified immigration status. “This change would undoubtedly threaten eligible individuals’ access to essential and early medical care,” the bishop said.

The current federal health care law “is, by no means, a perfect law,” Bishop Dewane said, noting the U.S. bishops “registered serious objections at the time of its passage” in 2010.

“However, in attempting to improve the deficiencies of the ACA, health care policy ought not create other unacceptable problems, particularly for those who struggle on the margins of our society,” he said.

The U.S. bishops “look forward to working with Congress to address the problems found in the AHCA, to ensure that all people can benefit from comprehensive, quality health care that they can truly afford.”

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Bishops seek revised health care law that’s ‘affordable and comprehensive’ — updated

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WASHINGTON — Calling health care “a vital concern for nearly every person in the country,” the U.S. Catholic bishops said March 8 they will be reviewing closely a measure introduced in the House March 6 to repeal and replace the Affordable Care Act.

U.S. Health and Human Services Secretary Tom Price gestures at a stack of papers that he said was the Affordable Care Act during a March 7 press briefing as White House Press Secretary Sean Spicer looks on at the White House in Washington. The law, as passed in 2010, was 906 pages long. Republicans in the U.S. House have introduced a measure to repeal and replace the federal health care law. (CNS photo/Carlos Barria, Reuters)

U.S. Health and Human Services Secretary Tom Price gestures at a stack of papers that he said was the Affordable Care Act during a March 7 press briefing as White House Press Secretary Sean Spicer looks on at the White House in Washington. The law, as passed in 2010, was 906 pages long. Republicans in the U.S. House have introduced a measure to repeal and replace the federal health care law. (CNS photo/Carlos Barria, Reuters)

“Discussions on health care reform have reached a level of intensity which is making open and fruitful dialogue difficult, even while most people recognize that improvements to the health care system are needed to ensure a life-giving and sustainable model for both the present and future,” said a letter to House members signed by the chairmen of four U.S. bishops’ committees.

“Given the magnitude and importance of the task before us, we call for a new spirit of cooperation for the sake of the common good,” they wrote.

The letter was signed by Cardinal Timothy M. Dolan of New York, chairman of the U.S. Conference of Catholic Bishops’ Committee on Pro-Life Activities, Archbishop William E. Lori of Baltimore, chairman, Hoc Committee for Religious Liberty; Bishop Frank J. Dewane of Venice, Florida, chairman, Committee on Domestic Justice and Human Development, and Bishop Joe S. Vasquez of Austin, Texas, chairman, Committee on Migration.

Main provisions of the new House bill include: eliminating the mandate that most individuals have health insurance and putting in its place a new system of tax credits; expanding Health Savings Accounts; repealing Medicaid expansion and transitioning to a “per capita allotment”; prohibiting health insurers from denying coverage or charging more money to patients based on pre-existing conditions; and cutting off funds to Planned Parenthood clinics.

The Catholic Health Association in a March 7 statement said it “strongly opposed” the House repeal and replace measure, saying it “asks the low-income and most vulnerable in our country to bear the brunt of the cuts to our health system.” It pointed to the proposal to cap federal financing of Medicaid, which is a state-federal program; to eliminate cost-sharing subsidies for low-income people and create “barriers to initial and continuing Medicaid enrollment.”

CHA said the provision on pre-existing conditions would come with a 30 percent monthly premium surcharge for a year “should they have a lapse in coverage.” Its vision for health care in the U.S. “calls for health care to be available and accessible to everyone, paying special attention to poor and vulnerable individuals,” the CHA statement said.

In their letter, the Catholic bishops called on lawmakers to consider moral criteria as they debate the measure, including: respect for life and dignity; honoring conscience rights; access for all; a plan that is “truly affordable … comprehensive and high quality.”

“Any modification of the Medicaid system as part of health care reform should prioritize improvement and access to quality care over cost savings,” they said.

The U.S. Catholic Church, the bishops said, “remains committed to the ideals of universal and affordable health care, and to the pursuit of those ideals in a manner that honors” the moral criteria they outlined.

Health care is not just another issue, but a “fundamental issue of human life and dignity” and “a critical component of the Catholic Church’s ministry,” they added.

The U.S. bishops have advocated for universal and affordable health care for decades and they supported the general goal of the Affordable Care Act, which was passed in 2010, but the bishops ultimately opposed the law because it expanded the federal role in abortion and failed to expand health care protections to immigrants.

Sister Simone Campbell, a Sister of Social Service, who is executive director of the Catholic social lobby Network, said the new health care bill “must be rejected.”

“Our test for any ACA replacement bill is simple,” she said in a March 8 statement. “Does the bill protect access to quality, affordable, equitable health care for vulnerable communities? After reviewing the House GOP replacement bill, the answer is a resounding no.

“Instead of providing greater health security, the bill increases costs for older and sicker patients and drastically cuts the Medicaid program, all while providing huge tax cuts to wealthy corporations and individuals,” she continued. “This is not the faithful way forward and must be rejected.”

Catholic Charities USA sent a letter March 8 to Congress voicing its opposition to the new health care measure, signed by Dominican Sister Donna Markham, president and CEO of the organization. She noted “commendable efforts” in the bill including protection for the unborn and greater flexibility for the states.

But Sister Markham said the measure makes major reductions in health care for more than 70 million poor and vulnerable on Medicaid and said it “undermines access to life-saving health care coverage.”

Tom McClusky, vice president of government affairs for March for Life Action, praised lawmakers for the bill’s pro-life provisions.

“House leadership and those who drafted the American Health Care Act deserve high accolades for their efforts to make certain that any changes to the health care system do not encourage, subsidize or directly pay for abortions,” he said. “They also deserve praise for sticking to their commitment to eliminate Planned Parenthood, America’s largest abortion provider, from Medicaid reimbursements for one year.”

“This will redirect women to federally qualified health centers, which provide all of the health services American women need and outnumber Planned Parenthood clinics by a ratio of 20:1,” McClusky added.

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