After the Supreme Court of the United States last month ruled to affirm generally the constitutionality of the “individual mandate” in President Barack Obama’s signature Affordable Care Act, the president declared the decision a victory for the American people. 

But just as significantly, he acknowledged that flaws remain in the health care reform law, and he pledged to take action. “We’ll work together to improve on it where we can,” he said in front of television cameras in the White House’s East Room after the court ruling. “With today’s announcement, it’s time for us to move forward — to implement and, where necessary, improve on this law.” 

What sort of necessary improvements does the president have in mind? He offered no clues. 

But the U.S. bishops, joined by Catholics across the country, consistently have identified at least three “fundamental flaws” with the law. And as advocates for nearly a century of comprehensive health care reform “to ensure access to life-affirming health care for all, especially the poorest and the most vulnerable,” the Catholic bishops of the United States have a unique and valuable voice to add to this critical public policy discussion. 

“The U.S. Conference of Catholic Bishops has not joined in efforts to repeal the [Affordable Care Act] in its entirety, and we do not do so today,” the bishops’ conference said in a statement released after the ruling. “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. ... We therefore continue to urge Congress to pass, and the Administration to sign, legislation to fix those flaws.” 

Religious Liberty pamphlet

The flaws are, first, that the law “allows the use of federal funds to pay for elective abortions and for plans that cover such abortions, contradicting long-standing federal policy.”  

Second, the Affordable Care Act contains grossly inadequate conscience protections, even beyond the abortion question. One dramatic demonstration of that failure is the Department of Health and Human Services’ “preventive care” mandate, that would force religious and other employers to facilitate coverage of sterilization and contraception, including abortion-inducing drugs. Our Sunday Visitor and 42 other Catholic dioceses and organizations have filed a lawsuit against the federal government to seek relief from the government coercion and violation of conscience. 

Third, the law treats immigrants unfairly. It “leaves them worse off,” the bishops’ conference notes, “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.” 

Demanding these critical corrections to such a historic piece of legislation is our right and duty as Catholics and as Americans. The Christian faith is outward-looking, seeking to right injustices and protect the weak — as first lady Michelle Obama noted last month in a speech to black Christian leaders: “To anyone who says that church is no place to talk about these issues, you tell them there is no place better — no place better. Because ultimately, these are not just political issues — they are moral issues.” 


Editorial Board: Greg Erlandson, publisher; Msgr. Owen F. Campion, associate publisher; Beth McNamara, editorial director; John Norton, editor; Sarah Hayes, presentation editor.