Today the United States Supreme Court issued a decision upholding as a tax the provision of the Affordable Care Act (ACA) that requires individuals to purchase a health plan—the so-called “individual mandate.”
For nearly a century, the Catholic bishops of the United States have been and continue to be consistent advocates for comprehensive health care reform to ensure access to life-affirming health care for all, especially the poorest and the most vulnerable.Although the United States Conference of Catholic Bishops (USCCB) did not participate in these cases and took no position on the specific questions presented to the Court, USCCB’s position on health care reform generally and on ACA particularly is a matter of public record.The bishops ultimately opposed final passage of ACA for several reasons.
First, ACA allows use of federal funds to pay for elective abortions and for plans that cover such abortions, contradicting longstanding federal policy.The risk we identified in this area has already materialized, particularly in the initial approval by the Department of Health and Human Services (HHS) of “high risk” insurance pools that would have covered abortion.
Second, the Act fails to include necessary language to provide essential conscience protection, both within and beyond the abortion context.We have provided extensive analyses of ACA’s defects with respect to both abortion and conscience.The lack of statutory conscience protections applicable to ACA’s new mandates has been illustrated in dramatic fashion by HHS’s “preventive services” mandate, which forces religious and other employers to cover sterilization and contraception, including abortifacient drugs.
Third, ACA fails to treat immigrant workers and their families fairly.ACA leaves them worse off by not allowing them to purchase health coverage in the new exchanges created under the law, even if they use their own money.This undermines the Act’s stated goal of promoting access to basic life-affirming health care for everyone, especially for those most in need.
Following enactment of ACA, the U.S. Conference of Catholic Bishops (USCCB) has not joined in efforts to repeal the law in its entirety, and we do not do so today.The decision of the Supreme Court neither diminishes the moral imperative to ensure decent health care for all, nor eliminates the need to correct the fundamental flaws described above.We therefore continue to urge Congress to pass, and the Administration to sign, legislation to fix those flaws.