Two years ago when the Patient Protection and Affordable Care Act became law, NCR editorialized that the largest expansion of the nation's social safety net in 45 years, extending health coverage to more than 30 million uninsured Americans "is a monumental achievement worthy of praise."
Now the U.S. Supreme Court has upheld this most important piece of legislation, resisting pressure from conservative ideologues to overturn the law that was passed by a majority of the U.S. House of Representatives, a supermajority in the U.S. Senate, and signed by a duly elected president.
The grounds for the decision are less important than the fact that the court understood that it had to take seriously its frequently cited, but often ignored, commitment to judicial restraint.
Standing behind any particular constitutional provision was the recognition that Congress and the president have the obligation to "promote the general welfare" and that such general welfare is not promoted by a system that left almost 50 million Americans without affordable access to health care.
Most Americans do not share the tea party's hostility to federal government programs that bind us together. Americans love Medicare.
We all appreciate the free market, but we also think some things, like health decisions, should not be tied to anyone's ability to pay for them. It is, after all, against the law for an emergency room to decline treatment to a person who cannot pay.
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In reaching its decision, the high court did nothing more than recognize what we all know: Of course, the government is involved in health care, Congress has the right to regulate it, and of course the broken system needs to be fixed.
In our April 2, 2010, editorial, we noted that "several distinctive Catholic groups" deserve thanks for the law's passage. Now that the law has moved definitively into the implementation phase, these distinctive Catholic groups must work even more diligently to ensure the widest enactment of this legislation.
The Nuns on the Bus tour (See Story) shows that NETWORK and other Catholic social justice lobbies are up to this task, as is the leadership of the Catholic Health Association.
Now we need the bishops on board.
A poll taken days before the high court's ruling found that 43 percent of Americans said the court should not overturn the law, and 35 percent hoped it would. Among Catholics, 46 percent hoped the law would be left in place and 36 percent wanted the Supreme Court to reject it, according to the Public Religion Research Institute poll. The poll also found that one in five Americans (21 percent) didn't know what the court should do.
There is no doubt how the U.S. Catholic bishops should respond. They have in fact called a lack of health care a serious moral issue that "challenge[s] our consciences and require[s] us to act."
The bishops need to ensure that those one-in-five Americans hear this message. But that is not the message they have been delivering. Since the ruling, the message from the bishops' conference has been dour at best and sometimes downright negative. It is time to move beyond pointing out what is wrong with the law and work to make it better.
One of their objections is a canard. ("Brazenly dishonest," some have called it.) The law does contain sufficient protection against federal funding of abortion. In our 2010 editorial we praised the persistence of the U.S. bishops and their staff to assure that prohibitions against federal abortion funding extended to the new law. Court rulings since the Affordable Care Act was passed have said the law, on its face, does not provide for taxpayer-funded abortions.
Yes, the U.S. bishops' conference can and should continue to press for a resolution of the provision in the law that too narrowly defines a religious employer, but that issue cannot blind the bishops, or any Catholics, to the blessings the act will bring.
The bishops are correct that the law unjustly excludes undocumented immigrants from the new health care exchanges, and Catholics must work to correct this. But if the new exchanges aren't rolled out on time and efficiently, there will be nothing to fix.
Statements from the bishops' conference inevitably include the line: "Health care for all has been a goal for the U.S. bishops for almost a century." For those committed to social justice, universal and affordable health care has been a most frustratingly elusive policy for decades, but we are closer to that goal than ever before; let's not stumble on the way or abdicate through silence or half-hearted engagement.
However complicated the intricate policy aspects of the Affordable Care Act, however confusing the actuarial tables, however conflicting the legal principles at stake, the moral issue is as clear as day: Every industrialized country in the world has found a better fix to the issue of health care than has the U.S.
Only the U.S. is so beholden to powerful, entrenched corporate and partisan interests that we have failed to achieve universal access to health care. It is time for the nation to find the political will to defend the principles that defined the Affordable Care Act.
Affordable care for all. Access for all. Lower costs for all. That is the recipe for a decent society and any continued obstruction is properly called indecent.