The House of Representatives is poised to vote on a proposal to reform the Affordable Care Act. The new bill, called the American Health Care Act, is being pushed forward under a procedural rule that permits a bill to pass by only 50 votes in the Senate, to evade the usual Senate rule that 60 votes are required to close debate and vote on the substance of the bill itself. The bill is going to be yet another major piece of legislation that will be supported only by one of the parties, and opposed by the other — there will be virtually no bipartisan support for the bill in either the House or the Senate.
This bill has some significant reforms that are very positive developments for the cause of human life:
- Restriction of Federal Funding for Abortion — The bill will not permite federal tax credits to be used for any health plan that covers elective abortions.
- Codifying the Hyde Amendment — This very important measure limitats federal funding for abortion to those cases involving rape, incest, or to preserve the life of the mother. While we do not consider this to be ideal in principle, it is a recognition that taxpayer money should not be used for the vast majority of abortions.
- Limits on Funding for Planned Parenthood — The bill would prohibit Medicaid funding for Planned Parenthood clinics for one year. Murder Incorporated gets over half a billion dollars a year in grants and reimbursements, so anything that would cut any part of their money stream is a good idea.
- Supporting Pregnant Women — The bill would retain the requirement that insurance plans cover maternity care, which would be deemed an “essential health benefit”.
However, there are problems with the bill, also from a pro-life perspective:
- Caps on Medicaid funding — The bill would convert Medicaid from an open-ended entitlement that is guaranteed federal funding into a block grant to the states with a fixed upper limit. The argument for this is that it will encourage the states to increase efficiency and control costs. However, it is basic economics that any time the supply of any kind of commodity (such as health insurance payments, in this case) the result can be rationing enforced by the government. This is very troubling. The great bulk of Medicaid expenditures is for elderly, handicapped, and terminally ill patients. Our concern is that a cap on Medicaid spending may lead to pressures to limit life-sustaining treatments that are morally obligatory — which would lead to involuntary euthanasia (causing death by omitting treatments) and increased pressure for people to choose assisted suicide.
- Continued Mandatory Contraception Coverage — Contraception would continue to be included as a required benefit. This is both immoral and unnecessary. Since some forms of “contraception” actually cause early abortions, it also undercuts the bill’s limitations on funding for abortion.
- Lack of Conscience Protection — Current federal conscience protections are not adequate either in substance or in enforcement. Greater protections have to be enacted into law that will prevent discrimination against individuals and institutions that decline to participate in morally offensive activities, such as abortion, contraception, sterilization, assisted reproduction, suicide and euthanasia.
- Large Numbers of People Losing Health Insurance — The Congressional Budget Office has estimated that as many as 24 million people will lose insurance coverage under this bill. While those numbers have been disputed, there is no disagreement that fewer people will have coverage. This is very troubling, since the most likely people to lose access to health care will be poor and disabled people, and may increase incentives for women to have abortions.
The current Affordable Care Act is deeply flawed in many ways. But any reform effort should be sure to correct those problems and not cause other problems. The USCCB has written to Congress about these concerns. We have to press Congress to address those concerns and guarantee true and morally acceptable health insurance coverage to all Americans.