Catholic teaching on the right to health care is by now well-known. Pope St. John XXIII declared the right in Pacem in Terris and Pope St. John Paul II reaffirmed the right in Centesimus Annus.
Pope Francis, unsurprisingly, has followed Catholic teaching—insisting that we are morally obligated to take special precautions to make sure health care is available to the most vulnerable.
Enter President Donald Trump and the GOP’s attempt to reform health care. Everyone agrees that the current system needs to be fixed, but the American Health Care Act recently passed in the House is simply not consistent with Catholic teaching.
The bill would mean that over 20 million Americans would lose their health care coverage — a large majority of whom are the poor, currently covered by the Affordable Care Act’s Medicaid expansion.
The bill also threatens those who have the most serious and expensive illnesses — not only by allowing states to refuse to cover those with preexisting conditions, but by allowing insurance companies to reinstate annual and lifetime caps in coverage.
Are you so sick that you overrun your cap or insurance companies deem you too expensive to cover? Too bad. Figure it out.
What kinds of things count as pre-existing conditions? Mental and physical illness due to sexual violence. Diabetes. Pregnancy. And much more.
Furthermore, the new bill also permits states to opt out of the Affordable Care Act’s insistence that all insurance plans have certain pro-life provisions — like coverage for pregnancy, maternity, and newborn care.
All that said, it is clear that the Affordable Care Act is in trouble and needs to be fixed. In several states, there is only one insurance company left for people to “choose.”
Many millions have been forced to give up their plans and doctors. (Politico called Obama’s promise to the contrary the lie of the year for 2013.)
Premiums are unaffordable for many people, and health costs continue their meteoric rise, causing many millions of people to simply ignore the ACA mandate to buy insurance. Dozens of millions of undocumented persons remain uncovered as well.
And it must be said that there are many good things in the GOP replacement. It at least tries to drive medical costs down by encouraging competition between insurance companies, allowing more flexibility in the kinds of plans available, and giving states more freedom to experiment with their Medicaid programs in being more creative and efficient in delivering adequate health care to the poor.
This general trajectory is all to the good, and ought to be supported. In addition, it is very good that the bill at least temporarily defunds the nation’s largest abortion provider, Planned Parenthood, and defends the Hyde Amendment’s prohibition of federal government funds supporting abortion.
The bill just passed by the House will now be considered in the Senate, and there is good reason to think it has little chance of passing in anything like its current form.
Many changes will have to be made, and those who support Catholic teaching on health care have a particular opportunity to make their voice heard in a way that will not only make the bill morally defensible, but actually give it a chance to pass.
Here are five changes I suggest ought to be made, particularly in light of Catholic teaching:
- Keep Medicaid expansion and fund it. Those covered by Medicaid have the face of Christ as the least among us. The United States found a way to pay for a trillion dollar war in the Middle East. How much harder should we work to find a way, for pennies on the dollar, to make sure the poor can see the right doctor when they get sick?
- Keep nondiscrimination provisions with regard to those who have pre-existing conditions and continue to ban annual and lifetime limits on insurance. Again, this enacts our concern for the least among us.
- Keep pro-life-friendly mandatory coverage, especially for pregnancy, maternity, and newborn care. Expand funding for the Pregnant Woman Support Act provisions of the Affordable Care Act.
- Triple the money for women’s health currently given to Planned Parenthood, and give it instead to (far more numerous) nonviolent, federally-qualified community health centers.
- Cover undocumented persons. The Church teaches that health care is the right of every person, documented or undocumented. Some parishes are trying to deliver care to this population on their own, but they simply cannot meet the need.
Please call or write your senators and tell them what you want to see (and not see) in the new health care bill. This is especially important if your senator will play a key role in the coming debate.
Now is the time to be heard if you want to make a difference.
Charles C. Camosy is Associate Professor of Theological and Social Ethics at Fordham University and author of Beyond the Abortion Wars.