Was the Supreme Court decision mostly upholding President Barack Obama’s signature health care plan a victory or a defeat for the Catholic Church? At the risk of sounding whimsical, the best answer may be: neither thing directly, but indirectly a bit of both.
The Catholic bishops and other Catholic groups had a strong and obvious interest in the outcome, but they weren’t parties to the litigation. Forty-three dioceses and other Catholic institutions instead are pursuing separate lower court challenges to the Health and Human Services mandate — the Obama administration rule requiring many church-related institutions and programs to provide coverage for contraception, sterilization and abortifacient drugs in employee health plans.
The mandate wasn’t at issue for the Supreme Court, and those challenges will go forward. The Becket Fund, a public interest law firm involved in anti-mandate litigation, noted that those cases assail the Patient Protection and Affordable Care Act — popularly known as Obamacare — on “entirely different grounds … not part of the Supreme Court case.”
Leaving aside any hidden implications for the HHS mandate that have not yet appeared, the Church’s response to the Supreme Court decision is not easily pigeonholed.
|People for and against the administration’s health care reform law demonstrate in front of the U.S. Supreme Court building in Washington June 28. CNS photo/Bob Roller
The U.S. Conference of Catholic Bishops recalled in a statement that it opposed the Affordable Care Act before its final enactment by Congress in 2010. It had three particular grounds for that: Congress’ failure to exclude coverage for abortion; its failure to provide conscience protections; and its refusal to allow immigrant workers to buy coverage in the new insurance exchanges to be established under Obamacare, even using their own money.
The USCCB said it was not seeking repeal of the act, but it called on Congress to take action to remedy these “fundamental flaws.”
The bishops’ conference was among hundreds of groups issuing reaction statements after the Supreme Court ruling June 28. In an unusual move reflecting the importance of the case, the court had heard oral arguments last March totaling five and a half hours and extending over three days.
When the time came, Chief Justice John Roberts surprised observers by joining the court’s liberals to provide a narrow 5-4 majority upholding most of the act. Central to this result was Roberts’ conclusion that another mandate — the individual mandate requiring Americans either to have health insurance or pay a penalty — was constitutional. He reasoned that the penalty was a tax, thus an instance of Congress’ constitutional taxing authority, rather than a questionable extension of the Constitution’s Commerce Clause. His four liberal colleagues disagreed with that.
The issues at stake
To grasp the ruling’s implications for the Church, it’s important to bear in mind that the Church officially supports the principle of universal health care coverage. Last May the Holy See’s representative at the World Health Assembly in Geneva repeated that position and cited Pope Benedict XVI: “Real distributive justice … on the basis of objective needs guarantees adequate care to all.”
The U.S. bishops have held this position for decades. While working to keep abortion coverage out of Obamacare during the months preceding congressional enactment and ultimately opposing the bill in its final form, the bishops at no time repudiated their support for the universal coverage principle.
The 2,700-page bill ultimately enacted by Congress and signed into law by Obama says nothing specifically about the HHS mandate as such. As with many other matters covered by the act the law passed by Congress merely provides a framework for executive branch regulations spelling out specifics of how the law will work.
HHS Secretary Kathleen Sebelius, a pro-choice Catholic, announced the intention to require religious employers to cover contraceptives, abortifacients and sterilization last Aug. 1. Houses of worship and parochial schools would not be included, but otherwise most Church organizations would. Despite protests from the bishops and other religious sources, in January Obama declared his intention to move in this direction. While saying he wanted an “accommodation” with religious groups, Obama has stuck to that position since then, and the bishops, led by USCCB President Cardinal Timothy Dolan of New York, have stuck to theirs.
In congressional testimony last February, Archbishop William E. Lori of Baltimore, chairman of the bishops’ religious liberty committee, said it is “precisely [the] element of government coercion” that makes this a religious freedom dispute.
The court’s ruling came during a two-week period leading up to July 4, during which dioceses and parishes throughout the country conducted religious services and educational programs to inform and motivate Catholics about the issues.
Time will tell
The Supreme Court’s decision is far from being the end of the national debate about health care or the fight over the HHS mandate. On the political front, the months between now and November will ring with partisan rhetoric aimed at voters.
While Obama is pressing for full speed ahead on the plan’s implementation, Republican presidential candidate Mitt Romney has pledged to seek its repeal if he is elected. For its part, the Church will have its hands full protecting its religious liberty interests while working for reform that meets the nation’s needs.
Russell Shaw is an OSV contributing editor.