Health care bill diagnosis: never had input from those who care for sick

IMAGE: CNS photo/Jonathan Ernst, Reuters

By Carol Zimmermann

WASHINGTON (CNS) — Sister Carol
Keehan, a Daughter of Charity, who is president and CEO of the Catholic Health
Association, doesn’t mince words when it comes to the American Health Care Act, which was short of votes and withdrawn by House Republicans late March 24.

Two days before the GOP
legislation was set for an initial vote in Congress and then delayed due to
last-minute wrangling and efforts to gain support, she described the bill as
a disgrace, a pro-life disaster, a huge step back, catastrophic for Catholic
social teaching and something that would do incredible damage.

The woman religious, who heads
an organization of more than 600 hospitals and 1,400 long-term care and other
health facilities in the United States, has a vested interest in the nation’s
health care and she also knows the ins and outs of health care legislation from
working behind the scenes “forever” — as she describes it — on the
Affordable Care Act.

At the time that the ACA was
being drafted, some Catholic organizations opposed key elements of the measure.
Once it became law, more than 40 lawsuits were filed to challenge the
subsequent Department of Health and Human Service’s mandate requiring that
insurance plans include coverage for artificial birth control, sterilization
and drugs that lead to abortions.

Sister Keehan is quick to point
out that the health care legislation signed into law seven years ago is far
from perfect, but she says it was an “incredible step forward.”

“I do recognize the
political conflict and the imperfections in the bill, but when you can make
insurance that much better for people who have it and give 20 million Americans
insurance, that is a huge step forward,” she told Catholic News Service
March 21 in her Washington office.

At a 2015 Catholic Health
Association gathering in Washington, President Barack Obama thanked Sister
Keehan for her steadiness, strength and “steadfast voice.”

“We would not have gotten
the Affordable Care Act done had it not been for her,” he said.

The immediate repeal and replacement
of the ACA was a key promise of President Donald Trump’s campaign, but the GOP
health care measure has faced opposition from both conservative and moderate Republicans.
Trump told House Republicans that he will leave ACA in place and move on to tax
reform if they do not support the new health care legislation.

Watching the GOP efforts to
repeal and replace the ACA has been hard for Sister Keehan mainly because she
and other health care leaders were not consulted in the process.

“We should never, ever
throw together a bill that’s going to be such a profound impact on the people
of this country in this short of time and without any input from those who care
for them,” she said.

The work on these two health
care bills couldn’t have been more different, she pointed out, noting that
prior to the ACA launch she felt like she “lived in committee rooms”
because she was constantly meeting with committees, groups and subgroups at the
White House and Congress.

With the GOP health care plan,
she said there wasn’t any opportunity for hospital groups or the American
Medical Association to give any advice.

“We’ve just been
dismissed,” she said, noting that she attended a few small group meetings
on Capitol Hill but “they were not meetings to get our input on what ought
to be done with the bill but meetings to tell us what was going to be
done.”

“This has just been
railroaded through Congress,” she added.

While the U.S. bishops have
applauded pro-life elements of the American Health Care Act, they also have criticized other elements and expressed concern for its impact on the
disadvantaged.

In a March 17 letter to House
members about the GOP measure, Bishop Frank J. Dewane of Venice, Florida,
chairman of the bishops’ Committee on Domestic Justice and Human Development,
said the inclusion of “critical life protections” in the House health
care bill is laudable, but other provisions, including those related to
Medicaid and tax credits are “troubling” and “must be
addressed.”

He said the bill’s restriction
of funds to providers that promote abortion and prohibiting federal funding for
abortion or the purchase of plans that provide abortion “honors a key
moral requirement for our nation’s health care policy.” But he also
criticized the absence of “any changes” from the current law
regarding conscience protections against mandates to provide certain coverage
or services considered morally objectionable by employers and health care
providers.

“The ACA is, by no means, a
perfect law,” Bishop Dewane said. “The Catholic bishops of the United
States registered serious objections at the time of its passage. However, in
attempting to improve the deficiencies of the ACA, health care policy ought not
create other unacceptable problems, particularly for those who struggle on the margins
of our society.”

Main provisions of the new House
bill include: eliminating the mandate that most individuals have health
insurance and putting in its place a new system of tax credits; expanding
Health Savings Accounts; repealing Medicaid expansion and transitioning to a
“per capita allotment”; and prohibiting health insurers from denying
coverage or charging more money to patients based on pre-existing conditions.

Sister Keehan said she thanked
Bishop Dewane for his letter to Congress and said the bishops had carefully
gone through the legislation measure by measure on a number of issues. She also
noted that she knows people in the pro-life community either think the new bill
is strong enough or not doing enough.

As she sees it, the bill is
“a pro-life disaster in the fact that when you take health care away from
people, you take life.”

“If you want to really,
really strengthen the pro-life culture in this country, you make sure people
know that their lives and the lives of their children are so valued by our
country,” she said, which means providing quality maternity and pediatric
care and offering programs like Head Start and food stamps.

Although she said under the ACA
no federal funds could be spent on abortion, a nonpartisan government agency in
an assessment of the law in 2014 said abortion coverage was available in some
plans. Sister Keehan also said the law included help for pregnant mothers to
get drug rehabilitation, housing and maternity care, which are not included in
the new bill.

“I don’t find this a
pro-life bill at all from every perspective,” she added about the new
measure.

When asked if there was a silver
lining with people at least talking about the need to provide insurance for all
Americans, Sister Keehan said the health care crisis for so many people doesn’t
give “the luxury of time.”

“To be the only
industrialized nation in the world that does not guarantee all its citizens
health care is a disgrace,” she said, adding: “We are at a real
crossroads in our country’s sense of its responsibility to its people.”

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Follow Zimmermann on Twitter:
@carolmaczim.

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