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USCCB: "Deficiencies" in conscience protections
Three major points considered
The United States Conference of Catholic Bishops (USCCB) Secretariat of Pro-Life Activities, Richard Doerflinger, suggests that following the passage of health care reform, "there's still a number of deficiencies in conscience protection."
"One [deficiency] is that many Americans will be required to take abortion coverage in federally subsidized health plans as a condition for getting the health coverage they want, and will not have the option to exclude the abortion coverage," Doerflinger notes.
"There is a provision in the law for dividing the funding, so that when you are forced to pay for the abortion, you pay for it as a premium, instead of through taxes; but the abortion coverage in many federally subsidized plans will still be an integral part of what you are required to pay for," he says. "That's not true now in any federally subsidized health plans."
In this case, under health care reform, "the insurer decides whether to cover elective abortions, and then they are still allowed to get federal funds for their entire plan. And anyone who buys that plan must pay the abortion fee," he says.
A second "deficiency" he cites regards the lack of protection under health care reform that is typically afforded under the Weldon Amendment, which has been part of the U.S. Department of Labor/U.S. Department of Health and Human Services appropriations bills since 2004, he says. The new health care reform law appropriates funds outside the bounds of the Labor/HHS appropriations bills, meaning that they are not covered by the Weldon Amendment's conscience protections.
"So, it's not that this law overrides or deletes the Weldon Amendment, but what it fails to do ... is apply the policy of the Weldon Amendment to these new funding streams that are created by the legislation," Doerflinger explains.
All other major federal health programs are covered under these protections, he says, since they all are funded through the Labor/HHS appropriations.
Although health care providers who decline involvement in abortion will not be required to provide abortions via the new qualified health plans, "they're not protected from discrimination on the part of governmental entities," he says.
"So, you cannot have discrimination by the health plans, but providers and overall plans may be discriminated against by some of these new governmental entities that are being set up under the new law," he says.
The third "concern goes beyond the abortion issue into other areas where Catholic employers and Catholic institutions have had the freedom until now to exclude from their coverage procedures that are against Catholic teaching . . . things like sterilization, contraception, and in vitro fertilization."
HHS to develop policy, implement
Doerflinger explains that under health care reform, the law "creates a new broad list of essential health benefits that are ultimately going to have to be in all health plans . . . The broad categories are very sweeping, related to prescription drugs, physician services, and so on. We think it likely that a lot of those categories will end up including things that we've been able to exclude from our coverage until now."
While health care reform is law, there are still "many, many provisions" that will require policy development and implementation by HHS, he says.
When dealing with employer health plans, "there's nothing in the law now that says that HHS should make any accommodation for religious freedom concerns, when they're dealing with employer health plans."
"So, that's our third concern . . . In this broader area of religious freedom, we don't have any protection against a sort of straitjacket, one-size-fits-all list of essential benefits that even Catholic institutions will have to provide and pay for," Doerflinger notes.