Love-Hate Relationship: Congress, USCCB, and the Affordable Care Act

I have a love-hate relationship with both the Congress and the United States Conference of Catholic Bishops (USCCB).  I sometimes think I grew up in the government and that I love it like a parent and yet hate it like a teenager.  As a U.S. Public Health Service officer working in a federal prison I experienced bad policy.  I saw a practice that disturbed me on both moral and health outcomes levels.  Later, as a senior officer I worked on a project with Catholic Charities, USA and realized that Catholic Social Teaching was the foundation of many of the best policies I had encountered.  It is therefore no surprise that I do not look at policy implications in isolation.  I weight them against the moral implications.  As much as one may try to take an analytical approach sometimes emotions overwhelm reason.

The Patient Protection and Affordable Care Act (ACA), the real name of what is inappropriately called Obamacare, has been a great concern for many Catholics and those of other faith traditions because of the perception that it funds abortion, abortion causing drugs, and contraception.  These issues are opposed for both theological and philosophical reasons.  In essence, it is because of the nature of our relationship as human beings to God.  Explaining the Church teaching is beyond the scope of what I want to say, but would recommend Contraception and Chastity, by G.E.M. Anscombe as an excellent explanation.

 In contrast, those that do not share this faith or reject the specific teaching on contraception will point to the woman’s right to control her own body.  It is easy to find information on unplanned pregnancy and the long-term impacts from the Centers for Disease Control and Prevention or to explore the Supreme Court rulings and arguments in favor of contraception at the Center for Reproductive Rights.   A simple Google search will reveal that the vast majority of Catholics and the nation support the contraceptive mandate of the ACA and do not agree with the Catholic prohibition on contraception.

The Controversy

On Septermber 26, 2013 two Bishops sent a letter to Congress.  It expressed there concerns about the ACA and requested:

We have already urged you to enact the Health Care Conscience Rights Act (H.R. 940/S. 1204). As Congress  considers a Continuing Resolution and debt ceiling bill in the days to come, we reaffirm the vital importance of incorporating the policy of this bill into such  “must pass” legislation.

The result was that the House included this in the continuing resolution with absolutely no hope of it passing.  Many Catholics posted the letter from the bishops on Facebook and other social media saying the USCCB supported the shutdown of government.  This caused a minor public outcry against the bishops.  The majority of women, and indeed Americans, are opposed to the contraceptive mandate being removed.  It is highly unlikely that the Democrats would be willing to alienate women and there is no doubt that this would alienate many women.  And so, the bishops found themselves in the middle of the shutdown debate and being partially blamed by their flock.

The USCCB responded that they did not support the shutdown of the government.  Clearly, no large organization can control what every member, bishop or otherwise, may say, but it was not their intent.  Sr. Walsh then made a blog post clearly stating the USCCB concern about conscience, but that they do not support a shutdown which harms the poor.

 Some have falsely interpreted this as a call for the government shutdown or a default on our nation’s debts. The bishops have done nothing of the kind. The bishops have been urging Congress to enact legislation like the Health Care Conscience Rights Act for two and a half years. Since July 2012, the bishops have been asking that this protection be included in “must-pass” bills such as the appropriations bills funding the government, which have long been vehicles for a number of important federal policies on conscience rights.

The bishops clearly stated that the work must continue and the needs of the poor and the rest of the nation needs to be meet.  Unfortunately, intent, interpretations, and outcomes are not always the same.  What is said and what is intended can sometimes be a distinction without a difference. That is why it is vitally important to be precise when interacting at a national policy level.

What Went Wrong

Here is what went wrong with the USCCB messaging.  If one attaches a contentious issues to a piece of “must pass legislation” then that attached issue can cause the “must pass legislation” to fail.  The result can be disastrous as it was in this case.   The bishops failed to say how far they wanted to push the issue.  Nor did they address the underlying moral issue of a government closure and the impact on the poor in their original letter.

Good people tried to do what they perceived as the morally right thing.  It was taken up by people who are not as good and not as interested in the moral as they are the purely political issues. Congress took the bishops letter as supporting the delay of the ACA mandate and the shutdown.  The not so good people do not share the view of the bishops about the poor.  Consequently, it didn’t bother them that the poor are adversely impacted.

In my experience the moral and the policy outcome must be considered in unison.  When the moral is pushed without considering the reality of the world in which we live  and its appropriateness and an unrelated piece of legislation it can have unintended consequences on the overall policy outcome.

What happens when a contentious moral issue and the political collide in a “must pass” piece of legislation is predictably – stalemate.  It is also predictable that those with the least power – the poor – are the most adversely impacted.  It is good that bishops work to protect the faith, but they need to realize that their actions may have adverse impacts on those that are vulnerable.  If they are going to use the power of their position, which they should, then they absolutely must work to better understand that not all people mean well and they will use any vagueness without hesitation to advance a purely political agenda.  They will not for a moment care that their actions harm the poor or anyone else.

Policy is a precise business where words matter.  What isn’t said in a letter and a policy statement can be every bit as important as what is said.  In the end our good intentions matter very little because it intentions don’t feed the poor, pay the workers, or provide healthcare.

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One thought on “Love-Hate Relationship: Congress, USCCB, and the Affordable Care Act

  1. Kurt

    I think you are being too kind to the bishops. If one is demanding a non-germane amendment to a must pass bill, one is certainly at least using the threat of a shutdown or default to get ones’ way. The bishops also have not explained why not ask that immigration reform or a minimum wage hike be added to the CR? Why does this bill get the singular status of an episcopal call for inclusion on the CR or debt ceiling bills?

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