This policy "must extend to any relevant health care plan," the bishops insisted on Wednesday. No federal subsidies for health insurance coverage – or even tax credits for coverage – should pay for any "health care plans that cover abortion," they stated.
While President Barack Obama signed an executive order stating that an enforcement mechanism must be found to ensure no abortion funding under the Affordable Care Act, a 2014 report by the Government Accountability Office found that this might not have been the case.
The report found that 15 insurers and one state exchange were not itemizing abortion coverage in health plans offered on the exchanges and did not indicate that such abortion coverage was billed separately. Thus, federal subsidies could very well have paid for abortion coverage.
Also, in five states, all the health plans offered on the exchanges covered abortions, offering no alternative to those conscientiously objecting to paying for abortion coverage in their plans.
The U.S. bishops' conference had originally opposed the Affordable Care Act because they believed the executive order would not be enough to prevent abortion funding. Cardinal Francis George of Chicago, then-president of the U.S. bishops' conference, had stated of the bill that "there is compelling evidence that it would expand the role of the federal government in funding and facilitating abortion and plans that cover abortion."
Changes in coverage
Universal access to health care, including for those immigrants left out of coverage under the Affordable Care Act, must also be part of new legislation, the bishops insisted.
"Any modification of the Medicaid system as part of health care reform should prioritize improvement and access to quality care over cost savings," they added.
Some of the biggest changes under the proposed bill would be to federal subsidies, ending the expansion of federal Medicaid grants to states after several years, and determining Medicaid grants to states based on their numbers of Medicaid patients.
The Affordable Care Act's Medicaid expansion had helped those caring for elderly parents and drug addicts, argued Rep. Richard Neal (D-Mass.), ranking member on the Ways and Means Committee. This would be cut in the new health care bill.
The Medicaid expansions provided many low-income Americans with coverage and these expansions should not be erased, the U.S. bishops said, noting that "those who are essentially the working poor or who find themselves one crisis away from falling into deep poverty" were covered "for the first time" under the Medicaid expansion.
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If the expansion is rolled back, these families should be exempt from premiums "through some other means," they said.
Furthermore, the bishops advocated for health-sharing ministries, saying, "Those who choose to participate in alternative approaches like health sharing ministries should retain the ability to do so and be further supported."
Louis Brown, director of one such Catholic ministry, called CMF Curo, stressed that health-sharing ministries must have "equal access to health savings accounts" so participants can save like everyone else for out-of-pocket medical expenses.
Other concerns in health care
A number of policies in the Affordable Care Act remain in the bill, or will be phased out over the period of several years. Young adults are still allowed to remain on their parents' health insurance plans until age 26, and insurers are still prohibited from denying coverage based on pre-existing medical conditions.
Brown told CNA that the plan "is a first step to restoring an American health care system where the dignity of the person is at the center, not the mandates of the government."