December 26, 2009
WASHINGTON — In an apparent split with Roman Catholic bishops over the abortion-financing provisions of the proposed health care overhaul, the nation’s Catholic hospitals have signaled that they back the Senate’s compromise on the issue, raising hopes of breaking an impasse in Congress and stirring controversy within the church.
The Senate bill, approved Thursday morning, allows any state to bar the use of federal subsidies for insurance plans that cover abortion and requires insurers in other states to divide subsidy money into separate accounts so that only dollars from private premiums would be used to pay for abortions.
Just days before the bill passed, the Catholic Health Association, which represents hundreds of Catholic hospitals across the country, said in a statement that it was “encouraged” and “increasingly confident” that such a compromise “can achieve the objective of no federal funding for abortion.” An umbrella group for nuns followed its lead.
The same day, the United States Conference of Catholic Bishops called the proposed compromise “morally unacceptable.”
The divide frames one of the most contentious issues facing House and Senate negotiators as they try to produce a bill that can pass in both chambers.
For months, the bishops have driven a lobbying campaign to bar anyone who receives insurance subsidies under the proposed overhaul from using them to buy coverage that included abortion. Citing the bishops, a group of House Democrats forced their liberal party leaders to adopt such a provision and threatened to block any final legislation that fell short of it. Abortion rights supporters, in response, have vowed to block any bill that includes such a measure.
Officials of the Catholic hospitals’ group and the nuns’ Leadership Conference of Women Religious declined to comment.
Catholic scholars say their statement reflects a different application of church teachings against “cooperation with evil,” a calculus that the legislation offers a way to extend health insurance to millions of Americans. For the Catholic hospitals, that it is both a moral and financial imperative, since like other hospitals they stand to gain from reducing the number of uninsured patients.
And in practical political terms, some Democrats — including some opponents of abortion rights — say that the Catholic hospitals’ relative openness to a compromise could play a pivotal role by providing political cover for Democrats who oppose abortion to support the health bill. Democrats and liberal groups quickly disseminated the association’s endorsement along with others from the nuns’ group, other Catholics and evangelicals.
“I think it is a sign that progress is being made, that we are getting there,” said Representative Steve Driehaus of Ohio, one of the Democrats who forced the House to adopt the stricter restrictions in its bill. The hospitals’ statement, he said, recognized the Senate’s compromise as a meaningful step, making him “optimistic” that Democrats could find a bill that he and other abortion foes could support.
Other abortion opponents argue that liberals are overstating the hospital association’s influence. “They don’t carry the same sway,” said Representative Bart Stupak, the Michigan Democrat who led the effort that resulted in the House bill’s including a full ban on abortion coverage in any subsidized health insurance plan.
Mr. Stupak said he still had commitments from at least 10 Democrats who voted for the House bill and pledged to vote against the final legislation if it loosened the abortion restrictions — enough to keep the bill from being approved. “At the end of the day we are going to have something along the lines of my language,” he said. Abortion rights supporters said the signs of openness from Catholic groups were helping some Democratic abortion foes accept the Senate compromise.
“We have known for quite some time that the Catholic hospitals and also the nuns are really breaking from these hard-line bishops and saying, ‘This really is our goal: to get more people into health care coverage,’ ” said Representative Diana DeGette, Democrat of Colorado.
The abortion rights faction of the House Democrats was initially dubious about the Senate bill’s provision but has warmed up to it after reassurances from their Senate counterparts, Ms. DeGette said. President Obama and Democratic Congressional leaders say they aim to follow 30-year-old rules blocking the use of federal money for elective abortions, but lawmakers have fiercely disagreed over how to do so.
Like most Catholic groups, the Catholic Hospital Association has echoed the bishops’ opposition to any federal financing of abortion in health care proposals. But its officials also stood at the White House last spring to endorse Mr. Obama’s plans as part of an administration deal with the hospital industry.
After the Catholic Hospital Association’s endorsement of the proposed compromise, Catholic conservatives and some abortion opponents accused the group of selling out to the Democrats.
“The Catholic Health Association does not represent the teaching of the Catholic Church on the non-negotiable defense of innocent life,” the conservative Catholic activist Deal Hudson said in a statement, calling the association’s move “utterly offensive.”
Catholic ethics experts said the groups evidently disagree about how far to go in avoiding even remote complicity in abortion.
“The Catholic Health Association seems to be using traditional principles of cooperation with evil,” said Prof. M. Cathleen Kaveny of the Notre Dame University Law School.
Such principles, she said, could permit support for “imperfect legislation,” as long as one’s intent was not to “further abortion,” one made every effort to “minimize the harm,” and one achieved “an extremely important good that can’t be achieved any other way.”
In contrast, she said, “some bishops have adopted a prophetic stand against abortion that wants to eliminate any form of cooperation with evil no matter how remote.”
The United States Bishops Conference has not responded to requests for comment. But in a letter to the Senate before its vote this week, the bishops’ group argued that the bill still made some level of support for abortion the default position of the federal government, requiring states to actively “opt out” to avoid participating in insurance plans that offered indirect subsidized coverage of abortion.
Citing the abortion provisions and limitations of the coverage of immigrants, the bishops wrote, “Until these fundamental flaws are remedied, the bill should be opposed.”