Via Grant Gallicho, Bart Stupak looks back at his role in healthcare reform. In my book, Stupak is a hero – his dual commitment to the unborn and to universal healthcare was unwavering, and he fought an extremely tough fight to secure an expansive healthcare reform that kept its distance from abortion. It is because of him and his band of pro-life Democrats that we got healthcare reform, and we got reform that is more pro-life than anybody could have possibly imagined.
And yet, today he sounds like a broken man. On the left, he was derided for merely interjecting abortion into the debate. On the right, he was attacked as a traitor, a Judas, who had the gall of actually believing in healthcare reform. And in the current poisoned atmosphere on the right, Stupak now faces a constant flood of hate mail, harassment, and death threats.
Through all of this, I am most disappointed by the role of the USCCB. In line with the Church, Stupak and his pro-life Democrats supported universal healthcare and opposed abortion – just like the USCCB. But in today’s society, there are far too few people in this camp, even among Catholics. And the USCCB ended up pulling the rug from under its erst-while ally, because he crossed a line in the sand drawn by those who opposed healthcare reform in any event. Here is his take:
“We also put in a final call to the U.S. Conference of Catholic Bishops, which had been among my strongest supporters during the fall. I was disappointed by what I heard. No, no, no, no, they said. We need statutory law. But an executive order can have the full force of law, I said. Lincoln used one to free the slaves. George W. Bush used one to block stem-cell research using human embryos. And President Obama assures me that this is “ironclad.” Besides, I said, it’s time to negotiate or lose our chance to shape the bill. Help me with it? No, they said. Won’t you at least look at it? No.
That call changed my relationship with the pro-life movement. In the 18 years I’ve been in Congress, pro-life Democrats like me have delivered, working out compromises that protect human life. Now we had the most important piece of legislation for our movement yet—with pregnancy prevention, prenatal and postnatal care, and care for kids—and we couldn’t get support.”
What went wrong? A number of issues.
First, the USCCB elevated a prudential judgement – on how the final bill would affect abortion – to a point of principle.
The USCCB read it one way, others (including Prof. Timothy Jost and, importantly, Sr. Carol Keehan) came to another conclusion. Many times, I argued in favor of the latter:
- The legislation banned federal funds from covering abortions, using tried-and-tested accounting techniques – funds must be strictly segregated and audited by state insurance commissioners using GAP, OMB, and GAO accounting standards.
- The real difference came down to either a supplemental policy (Stupak) or a supplemental premium in the same policy (the legislation) covering abortion, with an identical fungibility issue;
- States can prohibit all plans that offer abortion from accessing the exchange – a more radical idea than even Stupak had suggested, as it would even ban coverage for people who do not receive subsidies;
- The forced separate premium for all plans that cover abortion will discourage people from taking these plans, and companies from offering them;
- There must be at least one plan in every exchange that does not offer abortion;
- The community health centers have never offered abortion and will not be able to offer abortion, as the newly appropriated funds will not be segregated from existing funds under the auspices of the Hyde amendment;
- These protections are cemented by executive order;
- There is a clear connection between abortion (which is highly related to poverty) and access to healthcare – after all, what is a pregnant uninsured woman to do when childbirth costs $25,000 and up, while an abortion costs a mere $400? Indeed, there seems to be a strong link between universal healthcare and lower abortion – even after the Romney experiment in Massachusetts which is eerily similar to the current reform.
When you look at the facts, it seems pretty clear that this was a pretty decent bill on pro-life grounds, and that the protections are light-years ahead of what is available to those with employer-sponsored insurance (and where the abortion coverage is fully subsidized through the tax system). But, even with the seal of an executive order, the USCCB refused to budge.
Remember, this is a prudential issue, one based on the application of principle to fact and circumstance. The debate quickly became rather technical and complicated, related to the reading of obscure legislative language. It may well be that they are right, and I am wrong. But I firmly believe the balance of evidence is on my side.
That said, I’m not necessarily saying the USCCB should have supported this bill. They could have laid out the principles clearly and left prudence to the faithful. After all, that is what they did with the Iraq war, when the prudential case for it being just was far less certain. To put in differently, the facts and circumstances indicated that the probability of a just war was far smaller than the probability of the current healthcare reform leading to a surge in tax-payer funded abortion.
Second, the USCCB failed to distinguish valid and invalid reasons for opposing healthcare reform.
The bishops stated their principles clearly – affordable universal healthcare, no funding for abortion, no discrimination against immigrants. And yet, the Catholic opponents of healthcare readily mixed moral issues with arguments from American liberalism in ways that were often impossible to distinguish. Just peruse these sites, and you will find the abortion argument intermingled with attacks on“socialized medicine” and “government-run healthcare”, as well as hyperbola about rationing and death panels. Pro-life arguments were always suffused by other, darker, arguments – arguments stemming from a tradition alien to Catholic social teaching, from an Enlightenment -era liberalism that glorifies the supremacy of individual freedom and pours cold water over notions of solidarity.
These people were never on the same page as Stupak, as he quickly realized. They never wanted this healthcare reform to pass. They were using him, and the unborn too. It is for this reason that they turned on Stupak, and in such a nasty and vicious manner. The bishops could have taken a stronger position here. They could have put more stress on the Catholic insistence that healthcare is a right, and the government might have a valid role in this provision. They could have corrected the misinterpretation of Catholic teaching on solidarity and subsidiarity doing the rounds.
On a related point – the bishops also did not do enough to damp down the flames that engulfed the whole healthcare debate. Is it any surprise that Stupak is receiving death threats when the Palinesque tea-partiers first began combining hateful and incendiary rhetoric with lies and misinformation almost a year ago? The bishops knew as well as everyone else that the ideas behind this healthcare bill came from the right – from Romney in Massachusetts to the Republican opponents of the Clinton healthcare reform in 1994. The ideas were relatively conservative (and I use that term in its correct sense). They could have been out in front in calling for a more civil debate.
To sum up – the first mistake was to raise prudence to principle, and the second was insufficient clarity on principle.
Not exactly a recipe for success. Still, I impute no bad motives to them, and my disappointment goes along with continued respect. Like Nicholas Cafardi, I fear they were more inclined to follow rather than lead on this issue,a dn to follow the most dubious participants in the debate. For following the disingenuous National Right to Life Commitee (NRLC)- which has in the past supported government funding for private abortion plans that cover abortion – is a recipe for disaster. And the result? Bitterness among the pro-life Democrats and all who desire a consistent ethic of life. Association of the pro-life cause with an angry, bitter, and increasingly violent, fringe. A setback in the ability to persuade those open to persuasion on the abortion issue.
Of course, a “pro-life Democrat” is anathema to the NRLC and is political machinations, so they and their supposedly “pro-life” allies will no doubt appreciate this outcome (and are already exploiting it). But for the Church, for the commonweal in general, and for the unborn in particular, it’s bad news. We need more Bart Stupaks, not less.
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