A plea to grant health care reform a papal dispensation.

A plea to grant health care reform a papal dispensation.

A plea to grant health care reform a papal dispensation.

How to fix health policy.
Feb. 5 2010 7:09 PM

Dear Pope Benedict

A plea to grant health care reform a papal dispensation.

Click here for a guide to following the health care reform story online.

Pope Benedict XVI blesses faithful at the end of the Vesper ceremony in the St. Peter's basilica at Vatican.
Pope Benedict XVI

Dear Pope Benedict XVI,

I am writing to request a papal dispensation. Not for myself—I'm not even Catholic. My plea is for the Patient Protection and Affordable Care Act, more commonly known as the health care reform bill.

I'm not sure you even know this, but (apart from the Republican Party) no institution poses a greater obstacle to the passage of health care reform than the Catholic Church. The U.S. Conference of Catholic Bishops refuses to support a compromise the Senate reached on the question of whether private health insurers operating within the new insurance exchanges established under the bill could provide unsubsidized coverage for abortions. This issue gave both the House and Senate considerable heartburn when they debated health reform (click here for a helpful analysis of their respective approaches), but they pushed through it. Now, however, some parliamentary peculiarities affecting the U.S. Congress make abortion the single biggest roadblock to final passage.

Ordinarily, I wouldn't waste my breath trying to change the Catholic Church's views on anything having to do with abortion. But I'm emboldened by a letter the U.S. Bishops sent on Jan. 26 to members of the House and Senate urging passage of health reform. "Now is not the time to abandon this task," wrote Bishops William F. Murphy (Rockville Center) and John Wester (Salt Lake City) and Cardinal Daniel DiNardo (Galveston-Houston),

but rather to set aside partisan divisions and special interest pressures to find ways to enact genuine reform. Although political contexts have changed, the moral and policy failure that leaves tens of millions of our sisters and brothers without access to health care remains. We encourage Congress to begin working in a bipartisan manner providing political courage, vision, and leadership.


These words gave me momentary hope that the U.S. Bishops, whose role in health reform previously had been confined largely to promoting the House-passed abortion amendment sponsored by Rep. Bart Stupak and opposing the Senate-passed compromise, had decided to set aside their concerns about precisely how the health insurance bill would restrict abortions (as both versions do) to serve the larger goal of extending health insurance to somewhere between 31 million and 36 million of the 45 million Americans who currently lack it. Healing the sick has always been among the Catholic Church's highest priorities. In his 1981 encyclical "On Human Work," your predecessor, John Paul II, wrote, "The expenses involved in health care, especially in the case of accidents at work, demand that medical assistance should be easily available for workers and that as far as possible it should be cheap or even free of charge." The U.S. Bishops put this quotation on their Web site. Health care, they wrote in the Jan. 26 letters, "is a basic human right." Surely the U.S Conference of Bishops has no greater desire than the U.S. Congress to contribute to a "moral and policy failure." Surely it, too, can work in a cooperative manner and demonstrate "courage, vision, and leadership."

Unfortunately, the Jan. 26 letters went on to reassert the bishops' unyielding opposition to the Senate abortion language. "Disappointingly," they wrote, "the Senate-passed bill … does not meet our moral criteria on life and conscience."

Specifically, it violates the long-standing federal policy against the use of federal funds for elective abortions and health plans that include such abortions—a policy upheld in all health programs covered by the Hyde Amendment as well as in the Children's Health Insurance Program, the Federal Employees Health Benefits Program, and now in the House-passed "Affordable Health Care for America Act." We believe legislation that fails to comply with this policy and precedent is not true health care reform and should be opposed until this fundamental problem is remedied.

The bishops giveth, and the bishops taketh away.

It isn't even true that the Senate bill allows federal funds to be used for abortions. I won't go into the details here (if you're curious, see my Nov. 4 column "Don't Be Stupak"), but when Senate Majority Leader Harry Reid inserted the final abortion compromise language into his manager's amendment, he was assured by the Congressional Budget Office (whose authority in Washington approaches that of the Holy See in Rome) that the abortion provision had no budgetary effect. How could it have no budgetary effect if it allowed federal funds to be used for abortions?

Ironically, the very fact that the Senate bill's abortion provision has no budgetary effect is precisely what is keeping the entire health reform bill bottled up.