"We are not among those pushing for repeal of the healthcare act," said said Richard Doerflinger, associate director of the U.S. bishops' Secretariat of Pro-Life Activities in an April 3 interview with CNA.
Instead, the conference hopes that Congress can fix "the moral problems that we saw when it was enacted."
The Affordable Care Act, commonly called "Obamacare", is a 2010 healthcare law reforming parts of the nation's health care system and requiring health care coverage for all U.S. citizens.
The legislation, as well as mandates issued by the Obama Administration during its implementation, have been disputed for a range of reasons, including contentions over its conscience protections and allowance of abortion funding.
Doerflinger wrote a March 28 article in America Magazine, a publication of the Society of Jesus, addressing some of the bishops' concerns.
"The bishops conference opposed the final bill for three reasons," Doerflinger explained, saying that the act "did not have the restrictions against funding of abortion," "did not have sufficient protections for conscience" and "did not really promote universal coverage in one key respect: it did not extend coverage to immigrants."
These issues, he continued, “have become more urgent for two reasons.”
“One is that we have some history of the act being implemented and we're seeing now some of the problems appear visibly," and also the bishops are "now trying to promote a legislation which is at the House, which is the 'No Taxpayer Funding For Abortion Act,' which would correct some of the problems" with abortion funding and conscience rights protections.
However, the bishops conference faces a challenge in trying to promote this possible solution.
There are "people who in good faith don't understand the problem," Doerflinger said, because they think "there's no abortion problem in the healthcare act: President Obama said there wasn't."
Instead of abortion being explicitly funded by the law, he explained, "the problem with abortion funding is a problem of omission." The Affordable Care Act does not explicitly prohibit abortion funding, and includes kinds of services that have typically covered abortion under a "family planning" program.
"Those are all going to include abortion unless you say otherwise," he said, adding that in "every other program, Congress has said otherwise, but not this one."
This means that in the Affordable Care Act "there are many different provisions that provide money for healthcare and appropriate money for healthcare without any language that stops that money from going to abortion."
Also, while there are laws that stop the federal funding of abortion for many government programs, such as the Hyde Amendment, they do not apply to the Affordable Care Act because it has has its own sources of funding, rather than seeking funding through the annual appropriations bills.
In addition, the law does not adequately protect conscience rights, he said. Pointing to individuals' health care plans, Doerflinger explained that once a given plan decides to cover abortion, insurance companies cannot exempt subscribers of that plan from its abortion surcharge. The law, he said, effectively says "you may not respect people's conscience on abortion."
In addition, the HHS mandate "covers drugs and devices that constitute an abortion," even if it violates an employer's deeply held religious beliefs to provide those drugs and devices.
"The precedent set by the HHS mandate could require people to have abortion in their coverage down the road," he warned, citing arguments by the government from a March 25 Supreme Court case.
In addition, the law does not provide adequate coverage for immigrants- particularly those who are undocumented, Doerflinger said.
"People have a right to basic healthcare, not because they're citizens, but because they're human beings," he said. "Society's obligation to those who cannot help themselves extends to those who are newly in our country as well."
He added that excluding immigrants from health care protection, even if they pay for it, is "so short sighted," because allowing immigrants to receive health care coverage from their employers or to allow them to buy it for themselves makes "good economic sense."
With no health care coverage, "immigrant families can't do anything except to fall on the emergency rooms and get care when they are most direly in need," he said, adding that taxpayers will pay for this emergency care "and it's much more expensive than just letting people buy insurance."
In general, Doerflinger said, "the bishops are very supportive of universal health coverage."
"If not for these moral problems, we might have been able to support this act," he added.
However, "things that are really not healthcare at all, like abortion, are getting elevated to this status."
"At that point we really have to say, 'this has taken a wrong turn.'"
A spokesman for pro-life activities at the U.S. Bishops' conference explained that the bishops hope to see grave concerns with the Affordable Care Act's permission of abortion funding and lack of coverage of immigrants fixed.