Bishops on health care: Abortion out, immigrants in

Nancy Frazier O'Brien

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WASHINGTON -- As a Senate committee considered a range of amendments on many of the same issues, bishops representing three committees of the U.S. Conference of Catholic Bishops called on senators to insist that any final health reform bill exclude mandated coverage of abortion, protect conscience rights, safeguard the health of immigrants and protect "the life, dignity and health of all."

In a Sept. 30 letter to members of the Senate, the three bishops also said affordability should be a major consideration, so that health reform would be "truly universal and genuinely affordable."

The letter was signed by Bishop William F. Murphy of Rockville Centre, N.Y., chairman of the Committee on Domestic Justice and Human Development; Cardinal Justin Rigali of Philadelphia, chairman of the Committee on Pro-Life Activities; and Bishop John C. Wester of Salt Lake City, chairman of the Committee on Migration.

The bishops made their comments as the Senate Finance Committee continued its markup of the health reform plan proposed by Sen. Max Baucus, D-Mont., the committee chairman. By a 13-10 vote Sept. 30, the committee rejected an amendment proposed by Sen. Orrin G. Hatch, R-Utah, that would have required women who wanted coverage for abortions to purchase it and pay for it separately.

The committee also turned down a proposal by Sen. Charles E. Grassley, R-Iowa, that would have required those applying for Medicaid or a children's health insurance program to present a photo ID. Sen. Jon Kyl, R-Ariz., offered a similar amendment that would have required a photo ID with applications for tax-credit subsidies for health insurance.

In their letter, the bishops said none of the health reform proposals considered in committee, including the Baucus bill, has "met President (Barack) Obama's challenge of barring use of federal dollars for abortion and maintaining current conscience laws."

"These deficiencies must be corrected," they added.

In his Sept. 9 address to a joint session of Congress on health care reform, Obama said, "Under our plan, no federal dollars will be used to fund abortions, and federal conscience laws will remain in place."

On immigrants, the bishops' letter suggested several "effective ways to safeguard the health of immigrants, their children and all of society," including:

-- "An adequate safety net for those who remain uncovered."

-- Elimination of the five-year waiting period before legal immigrants can enroll in Medicaid.

-- An end to barriers, such as waiting periods to obtain subsidies, when immigrants seek to obtain private health insurance.

-- Health coverage of pregnant women giving birth to U.S. citizen children, no matter what the women's legal status.

"Immigrants pay the same taxes as citizens, and their health needs cannot be ignored," the bishops said. "Leaving them outside a reformed system is both unfair and unwise."

On the issue of affordability, the USCCB letter said the debate over health care reforms "must begin with the principle that decent health care is not a privilege, but a right and a requirement to protect the life and dignity of every person."

Health coverage should not be dependent on an individual's "stage of life, where or whether they or their parents work, how much they earn, where they live or where they were born," the bishops said.

But for lower-income families, "significant premiums and cost-sharing charges can serve as barriers to obtaining coverage or seeing a doctor," they added.

The Baucus bill received specific criticism on affordability from the bishops, who said it could require families living just above the federal poverty line to pay up to 25 percent of their income on out-of-pocket health care costs.

"We urge Congress to limit premiums or to exempt families earning less than 200 percent of the federal poverty level from monthly premiums," the bishops said. "We also recommend limiting co-payments and other costs which could discourage needed care. ... We support the increase in eligibility levels in Medicaid to no less than 135 percent of the federal poverty level for all citizens and immigrants residing lawfully in the United States."

In 2009, the federal poverty level for a family of four in the continental United States was $22,050.

In their letter, the bishops reminded senators that "health care choices are not just political, technical or economic, but also moral."

"This legislation is about life and death, who can take their children to the doctor and who cannot, who can afford decent health care coverage and who are left to fend for themselves," they added. "Health care reform especially needs to protect those at the beginning of life and at its end, the most vulnerable and the voiceless."

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