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New U.S. health care bill withdrawn after if falls short of votes in the House of Representatives

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Catholic News Service

WASHINGTON — Sister Carol Keehan, a Daughter of Charity, who is president and CEO of the Catholic Health Association, doesn’t mince words when it comes to the American Health Care Act, which was short of votes and withdrawn by House Republicans late March 24.

U.S. House Speaker Paul Ryan recommended March 24 that President Trump withdraw the American Health Care Act when it didn't have enough votes in the House. (CNS/Joshua Roberts, Reuters)

U.S. House Speaker Paul Ryan recommended March 24 that President Trump withdraw the American Health Care Act when it didn’t have enough votes in the House. (CNS/Joshua Roberts, Reuters)

Two days before the GOP legislation was set for an initial vote in Congress and then delayed due to last-minute wrangling and efforts to gain support, she described the bill as a disgrace, a pro-life disaster, a huge step back, catastrophic for Catholic social teaching and something that would do incredible damage.

The woman religious, who heads an organization of more than 600 hospitals and 1,400 long-term care and other health facilities in the United States, has a vested interest in the nation’s health care and she also knows the ins and outs of health care legislation from working behind the scenes “forever,” as she describes it, on the Affordable Care Act.

At the time that the ACA was being drafted, some Catholic organizations opposed key elements of the measure. Once it became law, more than 40 lawsuits were filed to challenge the subsequent Department of Health and Human Service’s mandate requiring that insurance plans include coverage for artificial birth control, sterilization and drugs that lead to abortions.

Sister Keehan is quick to point out that the health care legislation signed into law seven years ago is far from perfect, but she says it was an “incredible step forward.”

“I do recognize the political conflict and the imperfections in the bill, but when you can make insurance that much better for people who have it and give 20 million Americans insurance, that is a huge step forward,” she said March 21 in her Washington office.

At a 2015 Catholic Health Association gathering in Washington, President Barack Obama thanked Sister Keehan for her steadiness, strength and “steadfast voice.”

“We would not have gotten the Affordable Care Act done had it not been for her,” he said.

The immediate repeal and replacement of the ACA was a key promise of President Donald Trump’s campaign, but the GOP health care measure has faced opposition from both conservative and moderate Republicans. Trump told House Republicans that he will leave ACA in place and move on to tax reform if they do not support the new health care legislation.

Watching the GOP efforts to repeal and replace the ACA has been hard for Sister Keehan mainly because she and other health care leaders were not consulted in the process.

“We should never, ever throw together a bill that’s going to be such a profound impact on the people of this country in this short of time and without any input from those who care for them,” she said.

The work on these two health care bills couldn’t have been more different, she pointed out, noting that prior to the ACA launch she felt like she “lived in committee rooms” because she was constantly meeting with committees, groups and subgroups at the White House and Congress.

With the GOP health care plan, she said there wasn’t any opportunity for hospital groups or the American Medical Association to give any advice.

“We’ve just been dismissed,” she said, noting that she attended a few small group meetings on Capitol Hill but “they were not meetings to get our input on what ought to be done with the bill but meetings to tell us what was going to be done.”

“This has just been railroaded through Congress,” she added.

While the U.S. bishops have applauded pro-life elements of the American Health Care Act, they also have criticized other elements and expressed concern for its impact on the disadvantaged.

In a March 17 letter to House members about the GOP measure, Bishop Frank J. Dewane of Venice, Florida, chairman of the bishops’ Committee on Domestic Justice and Human Development, said 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.”

He said the bill’s restriction of funds to providers that promote abortion and prohibiting federal funding for abortion or the purchase of plans that provide abortion “honors a key moral requirement for our nation’s health care policy.” But he also criticized the absence of “any changes” from the current law regarding conscience protections against mandates to provide certain coverage or services considered morally objectionable by employers and health care providers.

“The ACA is, by no means, a perfect law,” Bishop Dewane said. “The Catholic bishops of the United States registered serious objections at the time of its passage. 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.”

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”; and prohibiting health insurers from denying coverage or charging more money to patients based on pre-existing conditions.

Sister Keehan said she thanked Bishop Dewane for his letter to Congress and said the bishops had carefully gone through the legislation measure by measure on a number of issues. She also noted that she knows people in the pro-life community either think the new bill is strong enough or not doing enough.

As she sees it, the bill is “a pro-life disaster in the fact that when you take health care away from people, you take life.”

“If you want to really, really strengthen the pro-life culture in this country, you make sure people know that their lives and the lives of their children are so valued by our country,” she said, which means providing quality maternity and pediatric care and offering programs like Head Start and food stamps.

Although she said under the ACA no federal funds could be spent on abortion, a nonpartisan government agency in an assessment of the law in 2014 said abortion coverage was available in some plans. Sister Keehan also said the law included help for pregnant mothers to get drug rehabilitation, housing and maternity care, which are not included in the new bill.

“I don’t find this a pro-life bill at all from every perspective,” she added about the new measure.

When asked if there was a silver lining with people at least talking about the need to provide insurance for all Americans, Sister Keehan said the health care crisis for so many people doesn’t give “the luxury of time.”

“To be the only industrialized nation in the world that does not guarantee all its citizens health care is a disgrace,” she said, adding: “We are at a real crossroads in our country’s sense of its responsibility to its people.”

 

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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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Obama thanks Catholic Health Association for support of Affordable Care Act

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Catholic News Service

WASHINGTON — Telling the Catholic Health Association that he was there to say thank you, President Barack Obama June 9 recalled the struggles of passing the Affordable Care Act and ticked off the successes since it became law five years ago.

“Every one of these stories touched me,” Obama said of those without affordable health care before the ACA took effect, referencing an emergency room visit when his daughter Sasha had meningitis. He said he had good insurance at the time but wondered about the families in the ER who did not.

Sister Carol Keehan, a Daughter of Charity who is president and CEO of the Catholic Health Association, greets U.S. President Barack Obama June 9 in Washington during CHA's annual assembly. (CNS photo/Bob Roller

Sister Carol Keehan, a Daughter of Charity who is president and CEO of the Catholic Health Association, greets U.S. President Barack Obama June 9 in Washington during CHA’s 100th anniversary assembly. (CNS photo/Bob Roller

“There is something deeply cynical” about attempts to roll back health care that works, Obama said of ongoing Republican-led efforts to kill the program.

Obama acknowledged that without the support of CHA president and CEO Sister Carol Keehan and its members, the legislation would not have passed. He said he told Sister Carol, a Daughter of Charity, backstage, “I love you” and meant it.

“Her dedication to doing God’s work here on earth, her commitment to serving ‘the least of these,’ her steadiness, her strength, her steadfast voice have been an inspiration to me,” Obama said. “We would not have gotten the Affordable Care Act done had it not been for her. I want to thank the entire Catholic Health Association for the incredible work you do.”

The speech at the Marriott Wardman Park Hotel in Washington was part of the 100th anniversary observances for the CHA, the leadership organization representing more than 600 Catholic hospitals and 1,400 long-term care and other health facilities in all 50 states.

Sister Carol told Catholic News Service after the event that getting the president to address the Catholic Health Assembly, as the CHA conference is known, was “the icing on the cake” of special events planned for the 100th anniversary year. The assembly attended by more than 1,000 people opened with a Mass at the Basilica of the Shrine of the Immaculate Conception across town, with Cardinal Donald W. Wuerl and Cardinal Theodore E. McCarrick, the current and retired archbishops of Washington, respectively, and other bishops. “The shrine was packed,” she said. “It was as beautiful a Mass as I’ve seen.”

She said she personally handed off the invitation to Obama during a meeting with White House Chief of Staff Denis McDonough several months ago. Sister Carol has worked closely with the White House staff over the years on a variety of issues.

Sister Carol told CNS that the current system of health care “is not everything we need by a long shot, but it is an incredible step forward.”

In addition to a majority of Republicans in Congress, some Catholic organizations also opposed key elements of the ACA. The U.S. Conference of Catholic Bishops has challenged in court the law’s provisions for requiring that insurance plans include coverage for artificial birth control, sterilization and drugs that lead to abortions.

In his remarks, Obama referenced his first job after college, working as a community organizer in a program funded by the Catholic Campaign for Human Development, operating out of Holy Rosary Church on Chicago’s South Side.

“The work was hard, and there were times where it was dispiriting,” he said. “We had plenty of setbacks. There were times where I felt like quitting, where I wondered if the path I’d chosen was too hard.”

“But despite these challenges, I saw how kindness and compassion and faith can change the arc of people’s lives,” he continued. “And I saw the power of faith, a shared belief that every human being, made in the image of God, deserves to live in dignity; that all children, no matter who they are or where they come from or how much money they were born into, ought to have the opportunity to achieve their God-given potential; that we are all called, in the words of His Holiness Pope Francis, ‘to satisfy the demands of justice, fairness and respect for every human being.’”

At the time, Cardinal Joseph Bernardin headed the Archdiocese of Chicago and Obama was struck by his example, he said. “He understood that part of that commitment, part of that commitment to the dignity of every human being also meant that we had to care about the health of every human being. And he articulated that, and the church articulated that, as we moved at the state level in the Illinois legislature, once I was elected there later on in life, to advance the proposition that health care is not a privilege, it is a right.”

That is the core of the CHA mission, Obama said, going on to thank the members for their role in helping reform the nation’s health care system.

He and Sister Carol both acknowledged that the ACA is far from perfect.

“Like any serious attempt at change, there were disruptions in the rollout, there are policies we can put in place to make health care work even better,” he said. He said the system needs reforms to how health care is delivered, it needs protection for the coverage of the 16 million people who signed up under the ACA; more states must expand Medicaid for the working poor and improvements are needed in quality of care while bringing down costs.

 

 

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Catholic health group calls N.Y. Times editorial wrong and ‘irresponsible’

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WASHINGTON— The Catholic Health Association said a Dec. 8 New York Times editorial “was misleading and in error” when it claimed that mergers between secular hospitals and Catholic hospitals and the U.S. bishops’ ethical and religious directives that guide Catholic health care restrict quality medical care for women and children.

“It is especially regrettable that such a respected publication would rush to judgment without validating the facts,” the Catholic Health Association said in a Dec. 9 statement issued by the St. Louis-based organization’s Washington office.

“Catholic hospitals in the United States have a stellar history of caring for mothers and infants,” it said. “Hundreds of thousands of patients have received extraordinary care, both in the joy of welcoming an infant or in the pain of losing one. In many communities in our country, the Catholic hospital’s maternity service is the designated center for high-risk pregnancies.”

The New York Times editorial was prompted by a lawsuit filed Nov. 29 in U.S. District Court for the Eastern District of Michigan/Southern Division by the American Civil Liberties Union and its Michigan affiliate claiming that because of the directives, Tamesha Means of Muskegon, Mich., received negligent care at a Michigan Catholic hospital when her pregnancy was in crisis at 18 weeks, leading to the loss of her baby.

The suit claims the directives kept the doctors from giving Means complete information about her condition, treatment options and adequate care, a situation that led her, it says, to suffer emotional and painful trauma that resulted in a premature birth, and the death of the baby shortly thereafter.

“Beyond new state efforts to restrict women’s access to proper reproductive health care, another, if quieter, threat is posed by mergers between secular hospitals and Catholic hospitals operating under religious directives from the nation’s Roman Catholic bishops,” the editorial said. “These directives, which oppose abortions, inevitably collide with a hospital’s duty to provide care to pregnant women in medical distress.”

The suit names as defendants the U.S. Conference of Catholic Bishops; Mercy Health Muskegon, as it is now called, which is the hospital where Means sought care; and three former or current chairs of the board of the health care network that includes the hospital.

The CHA statement said the editorial was “inaccurate and irresponsible to assert that these wonderful community services are unsafe for mothers in an obstetrical emergency, simply because a Catholic hospital adheres to the ethical and religious directives.”

“There is nothing in the ethical and religious directives that prevents the provision of quality clinical care for mothers and infants in obstetrical emergencies,” it said.

The “Ethical and Religious Directives for Catholic Health Care” guide Catholic health care facilities in addressing a wide range of ethical questions, such as abortion, euthanasia, care for the poor, medical research, treatment of rape victims and other issues. They are now in their fifth edition, approved by the U.S. bishops in 2009. The 43-page document includes 72 directives.

The ACLU lawsuit cites only one directive, No. 45, which says in part: “Abortion (that is, the directly intended termination of pregnancy before viability or the directly intended destruction of a viable fetus) is never permitted.”

Directive No. 27 requires informed consent. Directive No. 47 states: “Operations, treatments, and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman are permitted when they cannot be safely postponed until the unborn child is viable, even if they will result in the death of the unborn child.”

Beyond the directives, several independent organizations have oversight responsibility for all hospitals, including Catholic hospitals, the CHA said.

“Nationally, for most hospitals it is the Joint Commission (JCAHO) and, in each state, there is a licensing agency. Both organizations have robust standards and inspections,” it said. “They would not accredit or license a hospital that is unsafe for mothers or infants under any circumstance. Add to that the commitment of health professionals caring for these mothers.”

In a Dec. 6 statement, Archbishop Joseph E. Kurtz of Louisville, Ky., USCCB president, said that “the death of any unborn child is tragic, and we feel deeply for any mother who suffers such pain and loss,” but he called the ACLU lawsuit “misguided.”

He said it was “baseless” for the ACLU to claim the directives encourage or require “substandard treatment of pregnant women” because they do “not approve the direct killing of their unborn children.”

The archbishop added that the USCCB will continue to defend the principles of Catholic teaching, including as outlined in the ethical directives, “in season and out, and we will defend ourselves against this misguided lawsuit.”

 

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