House bill's 'life protections' said laudable, other aspects 'troubling'


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

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.

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expansion would be repealed and replaced with a “per capita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

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

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

— 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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