In the wake of President Barack Obama's speech to Congress outlining a plan for comprehensive health care reform, Catholic groups that have long strived to ensure the coverage of all Americans -- especially the poor and vulnerable -- say they are finally seeing a light at the end of the tunnel.

The president's Sept. 9 address to a joint session of Congress detailed plans for a health care system that would provide "security and stability" to those who already have health insurance while offering "quality, affordable choices" to the millions of Americans who are uninsured. Although Obama readily admitted that there are still plenty of details yet to be ironed out in the plan, Catholic leaders in the struggle for health care reform saw the speech as an encouraging step in the right direction.

'Great start'

"I think the key points that he focused on are very important and constructive pieces to get this done," said Daughters of Charity Sister Carol Keehan, president of the Catholic Health Association. "I don't think this country has ever put out a perfect piece of legislation ... but I think the outline that he's proposing is very, very good."

The president's plan includes the creation of an exchange that would give small businesses and uninsured individuals the opportunity to buy insurance at competitive prices, which he said would take effect in four years. It would also include a public health insurance option for the uninsured and tax credits to help people buy insurance who otherwise could not afford to do so.

For those who are insured, Obama said the plan would set out-of-pocket spending limits to prevent individuals from going bankrupt due to illness. It would also stop insurance companies from discriminating against those who have pre-existing health conditions and dropping coverage of people when they become ill and are most in need of assistance with their medical costs.

Kathy Saile of the U.S. Conference of Catholic Bishops told OSV that the speech signaled a "great start" in working toward reform of the health care system.

"There were statements in there that we agreed with quite strongly, including that no one should go broke because they get sick," said Saile, director of Domestic Social Development in the USCCB's Department of Justice, Peace and Human Development.

"I think that we saw a lot of opportunity to work out some details that would get us to where we think we should be with health care," she added. "And that is a truly accessible health care policy for all with respect for human life and dignity and access for everyone with a special concern for the poor."

No abortion funding

For Catholics, one of the most encouraging statements made by the president was that "no federal dollars will be used to fund abortions and federal conscience laws will remain in place."

In a statement released by the USCCB, Richard Doerflinger, associate director of pro-life activities for the bishops' conference, applauded Obama's commitment to excluding abortion funding from health care reform.

"We believe that incorporating essential and long-standing federal laws on these issues into any new proposal will strengthen support for health care reform," Doerflinger said. "We will work with Congress and the administration to ensure that these protections are clearly reflected in new legislation, so no one is required to pay for or take part in abortion as a result of health care reform."

Saile added that the president has been very open on the issue and that the influence of groups such as the U.S. bishops and pro-life Democrats has helped to convince Obama to keep abortion funding out of health care reform.

But others, including Catholic House Rep. Chris Smith (R-N.J.), have been more skeptical of the president's claims on abortion funding. Smith and other pro-life supporters have cited the fact that H.R. 3200, the health reform legislation under consideration in the House of Representatives, does include provisions for abortion funding.

"President Obama must be held accountable for his words. If he intends to support the pro-life amendments that have thus far been deleted by pro-abortion members of his party, we will welcome that," Smith said at a Sept. 10 news conference with pro-life organizations, including National Right to Life Committee and Democrats for Life. "But the truth is that he seeks to cover up his intention to use the government-run public plan to send checks from the U.S. Treasury to abortionists around the country."

But Sister Keehan said that Obama was very deliberate in his statements on abortion and that the president must be taken at his word in promising that he will not sign any health care legislation that includes federal funding for abortion.

She said she was also encouraged to hear Obama firmly deny claims that his health care plan would include so-called death panels that would make end-of-life decisions for the elderly.

Another item the president said would not be in the bill is coverage for illegal immigrants. That is one area where the U.S. bishops disagree with the president's proposal, Saile said.

"The bishops' position is that health care is a basic human right and that everyone is entitled to health care -- it is a moral issue," she said. "When you have that position, you can't start carving groups of people out of coverage."

While she acknowledged that providing health care for undocumented persons is a controversial issue politically, she said that the bishops still believe there should be some provisions in place for ensuring that they have access to medical treatment.

"They are human beings and deserve health care, so we need to make sure that the basic safety nets are still in place," she said.

Urgent need

In his speech, Obama traced attempts at health care reform back to Theodore Roosevelt and said that the country has reached a "breaking point" at which there can be no further delays in repairing the health care system.

Sister Keehan said that while some members of Congress have differing opinions on health care reform that will be constructive in drafting and passing successful legislation, the need is far too urgent to consider the proposal of critics who wish to start from scratch in building a new system.

"How many times can we keep starting over?" Sister Keehan asked. "Last year, one out of every six people in this country who have health care through their employer lost it. So how much longer can we wait?"

"It is just unconscionable to let people be so insecure in their health right now, particularly children," she said. "And so I think to say we scrap it and start over, no, and to say it is going too fast ... it is certainly not too fast if you talk to the people who are hurting right now."

Report shows urgent health care needs

Less than 24 hours after President Barack Obama's address on health care reform, the U.S. Census released a report illustrating the urgent need for health care reform across the United States.

The report found that the median household income dropped last year by 3.6 percent and the number of people in the United States without health care coverage increased to 46.3 million. The report is based on data collected in 2008, meaning it does not include additional losses suffered as unemployment figures have grown in 2009.

"Today's census figures show I think more clearly than ever how important good health reform is, not just for the poor but for the middle class," Sister Carol Keehan, president of the Catholic Health Association, told Our Sunday Visitor.

"People's wages have gone down. The median household income has gone down. Wages are depressed today not only because of the recession but because health care expenses are costing employers so much that if they are able to keep health care coverage for their employees, they end up having to give smaller raises than they would otherwise give."

The census report found that while the numbers of citizens covered by private insurance and employment-based insurance both declined in 2008, those receiving health care through government programs increased to 87.4 million.

Scott Alessi writes from New Jersey.