Lawmakers struggle with moral choice on health care

Congressman Anh "Joseph" Cao (CNS)

WASHINGTON -- As President Obama mounts a full-court press to push his health care bill through Congress, his latest target is a Louisiana Republican whose Catholic faith finds him torn between restricting abortion and expanding access to health care.

Obama asked Rep. Anh "Joseph" Cao -- the only Republican to vote for the health care bill in either the House or Senate -- to take a fresh look at the bill March 17.

Obama asked Cao, a former Jesuit seminarian, to study the language on abortion in the Senate version that's currently before the House to see whether he could, in good conscience, support the landmark bill that's now days from a final vote.

"He's asked if I would restudy the Senate language and ... approach it with an open mind," Cao said after meeting with Obama in the Oval Office for about 10 minutes. "And I promised that I would go back and study the Senate language again."

Cao said he appreciated the president's sensitive approach in seeking his vote on an issue that many observers say could make or break Obama's presidency.

"He fully understands where I stand on abortion, and he doesn't want me to vote against my conscience because he, like me, believes that if we were to vote against our conscience, our moral values, there is really nothing left for us to defend," Cao said. "I'm glad that the president is very understanding. He really shows his own moral character."

The effort to court Cao comes amid an increasingly vocal -- and public -- dispute among prominent Catholic voices over whether the Senate bill contains enough safeguards to prevent federal funding of abortion.

The U.S. Conference of Catholic Bishops, led by Cardinal Francis George of Chicago, says the legislation is fatally flawed because it "expands federal funding and the role of the federal government in the provision of abortion procedures."

But Sr. Carol Keehan, president and CEO of the Catholic Health Association of the United States, which represents about 2,000 Catholic health care facilities and organizations, wrote members of Congress vouching for the anti-abortion language in the Senate bill, and asking for a "yes" vote.

NETWORK, an umbrella group claiming to represent about 59,000 sisters, wrote an even more pointed letter to members of Congress March 17, contending that "despite false claims to the contrary, the Senate bill will not provide taxpayer funding for elective abortions." Moreover, they wrote, it "will uphold long-standing conscience protections and it will make historic investments -- $250 million -- in support for pregnant women. This is the REAL pro-life stance, and we as Catholics are all for it."

Not to be outdone, a spokeswoman for the bishops conference issued a terse statement March 18, saying that the letter was "signed by a few dozen people, and despite what NETWORK said, they do not come anywhere near representing 59,000 American sisters."

Caught in the middle are Catholic lawmakers like Cao, Michigan Democrat Dale Kildee and Minnesota Democrat James Oberstar, all of whom have reservations on the abortion issue. Kildee and Oberstar (a former co-chairman of the House Pro-Life Caucus) have indicated they will vote to support the bill.

The only vote likely to come from the Republican side of the aisle, however, is Cao's.

Cao has said the only thing stopping him from voting "yes" on a bill that he believes is vital to his district is the abortion language. Cao spent six years as a Jesuit seminarian and has been in close touch with the Catholic bishops and with Archbishop Gregory Aymond of New Orleans on the issue. Until now, like the bishops, he has viewed the Senate language as unacceptable.

After his meeting with Obama, Cao said his decision will not depend on what the bishops' conference or the Catholic Health Association say, or even the opinions of those flooding his office with phone calls.

"At the end of the day, it's me facing my own conscience," he said.

"I was a moral philosophy professor. I taught the issue for many years. I fully understand the moral issue," he said. "I do believe that we need health care reform, that we need to address the issues of pre-existing conditions, of accessibility and affordability in health care. At the same time, I am holding onto the principle that we should not kill the unborn."

Timothy Stoltzfus Jost, a professor of health law at Washington and Lee University School of Law in Virginia, has analyzed the Senate and House language from an anti-abortion perspective, and said if Cao examines the Senate language carefully, he will find his principles are not in conflict.

"We don't have a choice right now between the House and Senate bills," Jost said. "It's between the Senate bill and a status quo in which ... 45,000 people are dying prematurely every year for lack of health insurance. We can save a lot of those lives if we pass this bill, and that's pro-life in my book."

[Jonathan Tilove is a Washington correspondent for The Times-Picayune in New Orleans.]

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