Affordable Care Act's anti-abortion rules need to be enforced

Thomas Reese  |  Sep. 26, 2014Faith and Justice

http://ncronline.org/blogs/faith-and-justice/affordable-care-acts-anti-abortion-rules-need-be-enforced

I wish this was the last column I had to write about the Affordable Care Act and abortion, but I doubt it will be. As you recall, when the ACA was debated in the House of Representatives, the U.S. bishops opposed it because they thought it would support insurance plans that paid for abortions. The bill's supporters denied this. 

On Sept. 15, the U.S. Government Accountability Office published a report, "Health Insurance Exchanges: Coverage of Non-excepted Abortion Services by Qualified Health Plans." The report details how in 28 states, 1,036 qualified plans cover abortion. This is 49 percent of the plans in the nation.

The GAO also found that many of these insurance companies were not following the law and were listing the cost of abortion coverage at less than $1 per enrollee, the minimum amount required by ACA. Nor were many insurance companies billing beneficiaries separately for abortion coverage, as required by the law.

The report said nothing about whether the issuers segregated portions of the premium into a separate account to pay for abortions, as required by law. Nor did the report directly address the question of whether federal funds are being used for abortion. This is a study GAO should do.

The response from the U.S. Conference of Catholic Bishops was swift and strong. On Sept. 16, a USCCB press release quoted Cardinal Sean O'Malley, chair of the bishops' Committee on Pro-Life Activities: The GAO report "confirms the U.S. bishops' longstanding concern about abortion coverage" in the Affordable Care Act.

The press release continues, but now the staff is speaking, not the cardinal:

Despite repeated claims by President Obama and other supporters that the ACA would not promote abortion, the report identified over a thousand health plans eligible for federal premium subsidies that cover elective abortions. On five state exchanges, every plan covers such abortions in 2014; in another three large states, 95 to 98 percent of the plans do so. The Act's alleged requirements regulating abortion coverage do not exist or are widely ignored. Many health plans do not inform enrollees about their inclusion of abortion coverage; they do not tell them how much they are being charged for such coverage; and they do not charge a "separate payment" for abortions that is distinct from the premium payment eligible for federal tax subsidies. While state insurance departments are supposedly tasked by the federal government with ensuring that these health plans maintain segregated accounts for abortion funds to keep them separate from federal funds, the report indicates that this is not taking place.

O'Malley concludes, "This report confirms the U.S. bishops' longstanding concern about abortion coverage that we raised both before and after enactment of the Affordable Care Act by Congress."

O'Malley is one of my favorite cardinals, so I am not eager to disagree with him in public. But I fear that the USCCB staff has led him astray. In fact, the GAO report proves exactly the opposite of what he says. It proves that the bishops' concerns about the ACA were unwarranted.

The GAO found no ambiguity in the ACA. The law is clear. What they found is that insurance companies and state insurance commissioners are not following the law. The fault is not in the ACA; the fault is in its implementation.

This distinction matters. The Republican Party continues to campaign against the ACA. Two years ago, most of the pro-life Democratic members of Congress up for re-election were defeated because they were branded as pro-abortion if they supported the ACA. NETWORK and the Catholic Health Association were condemned as supporters of abortion because they supported the ACA.

The USCCB should stop being part of the Republican Party propaganda machine in attacking the ACA. There is nothing wrong with the ACA with regards to abortion.

If the bishops want to condemn the insurance companies for not following the law, go ahead. If they want to condemn the state insurance commissioners for not following the law, go ahead. If they want to condemn the Department of Health and Human Services for not making sure that the insurance companies and insurance commissions follow the law, go ahead. But don't blame the ACA, which the GAO found clear enough to know when it was not being observed.

The Catholic Health Association is also concerned about the findings of the GAO report. In a Sept. 17 press release, the association notes that with 50 states, 50 different state insurance commissions, and over 2,000 plans, it is "a real challenge for monitoring, but it must be done. The ACA law requires it."

The CHA explains: "The ACA law explicitly forbids the use of federal funds for abortion except in the cases covered by the Hyde Amendment. This critical provision must be adhered to in every state, irrespective of how challenging it is to monitor."

But unlike the USCCB, CHA explains that "the reason often given for getting an abortion is the inability to afford health care for the mother, unborn infant and later the child. The ACA has already taken that challenge away for millions and has the possibility to do it for millions more if fully implemented. The lives of mothers, unborn babies and children in this country must have the protection of their health. No mother should ever feel she has to abort her unborn child because she cannot afford health care."

Like every law, the ACA can be improved, but it should not be attacked as promoting abortion, not when it does so much good and helps women have their babies.

Meanwhile, the Centers for Medicare & Medicaid Services (CMS) has promised to issue better guidelines and encourage insurance companies and state insurance commissions to comply with the law. CHA says it "will diligently monitor the efforts of CMS to assure that the law is implemented as written." The bishops should also keep on CMS until every insurance company and state insurance commission in the country is following the law, but they should stop attacking the ACA.

What the USCCB continues to ignore is the fact that it is state law that mandates abortion coverage, not federal law. States like New York and California have for years required insurance companies to cover birth control and abortion. The dirty little secret is that Catholic institutions and Catholic insurance companies have been quietly complying with these state laws at the same time that the bishops have been screaming about the ACA. No wonder their critics accuse them of partisanship. 

When the Affordable Care Act was being voted on in the House of Representatives, the bishops opposed passage because of their fears about abortion while NETWORK and CHA supported passage, saying there was not a problem. At that time, I wrote column wondering if the bishops were paranoid or the sisters were naive. The GAO report proves that the law is clear. The bishops were paranoid and the sisters were not naive.

[Jesuit Fr. Thomas Reese is a senior analyst for NCR and author of Inside the Vatican: The Politics and Organization of the Catholic Church. Follow him on Twitter: @ThomasReeseSJ.]

200th Anniversary Mass

Pope Francis will Preside over the Thanksgiving Liturgy of the Reconstitution Anniversary

On the occasion of the 200th Anniversary of the Universal Reconstitution of the Society of Jesus, the Holy Father, Pope Francis will be presiding over the Thanksgiving Liturgy (vespers) held at the Church of Gesù, Rome, on 27th September 2014 at 4.50 pm (Roman time).

The event will be live telecasted by the Vatican Radio for the universal participation of Jesuits, friends and benefactors of the Society of Jesus. Here is the YouTube link for the standby telecast:    https://www.youtube.com/watch?v=u1tmyy3sl_g

You can also download the Booklet from sjweb following the link: http://sjweb.info/documents/2014Restoration/libretto12.pdf

Classes are Rolling Along

Wow. I’m back in school. I love it. I realize I bring a different dimension to study than I did as a college-age student. The classes have an interesting mix of students. Most of them have taken these courses and instructors previously and many tend to do their own thing. I simply intend to follow the promptings on the instructors because (a.) I don’t know better and (b.) they do.

In the first class, we are spending time with live models. It is fascinating to draw in this way because of the rare gift of stillness for an agreed upon period of time. The drawing feels authentic because a person is standing before us. I’m amazed at what others see as they draw and at the techniques they use.

Our primary exercise was a blind contour drawing, which is examining an object so fully that we do not even look at what we are drawing. The idea is to move the hand/pencil when our eyes move. Most of the time we hasten through this process very quickly. During my time with the models, I used this approach for twenty-five minutes. I began to understand the process with my body as I moved my eyes slowly to soak in the details of the image. What made it work was using my yoga prayer breath to slow me down and keep me focused.

During the next class, we painted from still life. Only two other students and I followed the instructors, which confused me a bit, but it helped me understand what the professor wanted. Most people went to class to paint their own projects while the instructions were to paint from observation. This means that the project must be complete in one sitting, which I did not understand until the end of class. I’m getting used to a whole new vocabulary.

We painted apples in the watercolor class. It was fun because there was no pressure, nothing to learn intellectually. It was just a chance to get together in a studio and paint with others who are learning techniques just like me.  

I set up my easel. It was like a Do-It-Yourself project from IKEA. It feels good to have a proper workspace for my activities.

Other notes:

I went apple picking in Stow the other day. It is so nice to be in nature and to pick from the bounty.

As I was driving down the road, three cars passed me. Each of the women drivers was texting and their heads were not looking at the road. What are we doing?

When I was taking the subway, I notice a service dog sitting in the middle of the aisle next to a blind man who spent his entire time texting.

I keep meeting extraordinarily kind people. I like that. I've always liked the word admire (ad- to mire- to look). I look to people whose traits I want to acquire as part of my personality.

Filipina, Filipina, Everywhere

I presided at mass today and I enjoyed it so much. Prayer was easy and the quiet times at mass were filled with the presence of Christ.

I loved the music because it enhanced and complemented the liturgy. I wish I could have brought respectful liturgy to Jordan. It will take a long time to get it there because you have to wait until people are finally educated in music and liturgy. Liturgy and church traditions are so rich, but people have to finally let go off what they can control in order to trust someone who is trained in the field. Education really is essential for growth.

Anyways, after mass a Filipina came up to me and said, "I have been praying to God to give me an answer to my dilemma and you've given it to me in your homily. I took my friend's hand and I squeezed it because it was just so right." I took this woman's hand and raised it to my forehead and she squealed in delight. Five other Filipina came over to me and gave me their hands to raise and then we took photos.

Last week, I acknowledged the great number of Arabs in Boston. The Filipino community is just as numerous. I love to see their families as they are out at picnics. I always wished that the Filipinos in Jordan had their families with them because that would have been a major support for them.

Anyways, we are having a great time conversing in the Boston area - and taking photos. I think they felt at home in mass because they made a larger connection.

Today, I remembered the Filipino community as I went apple picking with some friends who were in Jordan. Since it was a little cold, I brought along the sweaters I received from the Filipinos as Christmas gifts. I appreciate their thoughtfulness and generosity. It is always so consoling to know of the enormous generosity of the Filipinos. I'm also delighted the Pope is going to visit them soon.

Iraqi Refugee Assistance

Iraqi refugees in Jordan can seek protection and assistance from the United Nations High Commissioner for Refugees (UNHCR).  The UNHCR refers a small number of refugees for resettlement.  I'll note that refugees are individuals who are outside of their home country fear persecution in their home country for particular reasons.

IRAP provides free legal assistance to help some refugees navigate resettlement processes. 

The US also has a special "Direct Access Program for US-affiliated Iraqis and their family members".  The official US government information about the program is available in English and Arabic:

http://www.wrapsnet.org/Portals/1/SIV-IraqiP-2/Direct%20Access%20Program%20for%20US%20Affiliated%20Iraqis%20in%20Jordan,%20Egypt%20and%20Iraq%20(Fact%20Sheet,%20English).pdf

http://www.wrapsnet.org/Portals/1/SIV-IraqiP-2/P2%20FY%202011/Direct%20Access%20Program%20for%20US%20Affiliated%20Iraqis%20in%20Jordan,%20Egypt%20and%20Iraq%20(Fact%20Sheet,%20Arabic).pdf

First Day of School

My first day of formal art classes was quite fun. As I walked to class, I asked myself, "What am I doing? I'm the age of these students' parents," but I kept walking. When I finally arrived in the classroom, I realized I am the median age. Seven women appear to be older than me, several students are in the college level, and three are high school seniors.

Class started out with a bar of ginger-chocolate. The second half began with a bar of orange-chocolate.

The first half of class was instructive as we saw various prints on a slideshow that revealed different aspects of drawing. I enjoyed it a great deal as I was able to see what the instructor pointed out.

The second half of class was to do live drawing, which is sketching a model who strikes different poses. We began the session by doing six 2-minute drawings, followed by five 5-minute poses, then several 10-minute poses, and ending with one 150 minute pose. This was the first time I ever used a live model. The professor was impressed and encouraged by my first-time efforts.

A nearby student, who has been painting for most of his 22-years of life, was very accomplished in his style. It was great to see how quickly he could set and form and image and then fill in the nuances in short order. I enjoyed seeing the techniques the other students used.

At the end of the day, I feel encouraged and grateful.

I came home and ate a pumpkin cookie. Tis the season. It matched my pumpkin latte the other day.

Last night I attended choral rehearsal for an Advent concert. It was so good to sing again. The downside is that I have to drive an hour to get there. Boo. Drawing comes easier, but singing likewise cleanses the mind of all distractions. These things just make me happy.

Yoga class stretched me today. I loved it. I cannot believe the difficulty my body has in making certain poses. I don't know if I will ever master an Eagle pose. I can't seem to wrap my ankles around the back of my leg while contorting my arms in the opposite way. I do my best, but it must be quite a sight.

Today's limber instructor had us do an abdominal routine. He took off his shirt so we could see how it is rightly to be done. For a guy in his 60's, he has a six-pack abdomen. He inhaled it so deeply that his skin must have sunk six inches. Then he rolled the muscles down systematically in succession. I've never seen anyone in control of his abdomen so skillfully. Fortunately, he did not laugh as we tried it and struggled. The nice part is that this is the first time I've ever seen anyone show us abdominal exercises. Wow. I'm impressed. The yoga exercise is called Enya Crea (Fire in the Trash) and it is designed to cleanse the intestinal tracts.

All in all, I've had an uplifting twenty-four hours.

The makeup of Synod of Bishops on the Family is disappointing

Thomas Reese  |  Sep. 9, 2014NCR Today

Synod on the Family

http://ncronline.org/blogs/ncr-today/makeup-synod-bishops-family-disappointing

The list of those attending the Synod of Bishops on the Family is a disappointment to those hoping for reform of the curia and for those who hope that the laity will be heard at the synod.

The appointment of 25 curial officials to the Synod on the Family is a sign that Pope Francis still does not understand what real reform of the Roman Curia requires. It makes me fear that when all is said and done, he may close or merge some offices, rearrange some responsibilities, but not really shake things up.

According to current law, moto proprio Apostolica Sollicitudo, an extraordinary synod is made up of major episcopal leaders of the Eastern Catholic churches, presidents of episcopal conferences, and three religious chosen by the Union of Superiors General. It also states, "The cardinals who head offices of the Roman Curia will also attend." The pope may also appoint additional bishops and clerical and lay observers.

Having curial officials as members of a synod fails to recognize that they should be staff not policymakers. They could attend the synod as staff but should not be voting members. For the most part, they should be observers and not speakers. They have all the other weeks of the year to advise the pope. This is the time for bishops from outside Rome to make their views known.

If Francis and the Council of Cardinals is not willing to change the makeup of the synod of bishops, it is hard to believe they will really fix the Roman Curia.

The American prelates at the synod will be Louisville Archbishop Joseph Kurtz and Cardinals Timothy Dolan, Donald Wuerl, and Raymond Burke. Kurtz is attending because he is president of the U.S. Conference of Catholic Bishops. Dolan and Wuerl attend as members of the council of the ordinary synod. And Burke attends because he is prefect of the Supreme Tribunal of the Apostolic Signatura.

Besides the bishops who are members of the synod, there are collaborators (experts) and auditors. Half the experts are clerics, which seems strange at a synod on the family. None of the 16 experts is from the U.S., 10 are from Europe (including five from Italy), three from Asia, and one each from Mexico, the Lebanon, and Australia.

There are more lay people among the observers, including 14 married couples, of whom two are from the United States. Many of the observers are employees of the Catholic Church or heads of Catholic organizations, including natural family planning organizations.

For example, one couple from the United States is Mr. Jeffrey Heinzen, director of Natural Family Planning in the diocese of La Crosse, and Mrs. Alice Heinzen, member of the Natural Family Planning Advisory Board of the U.S. Conference of Catholic Bishops.

The other U.S. couple is Steve and Claudia Schultz, members of the International Catholic Engaged Encounter.

We will have to wait and see whether the auditors will represent to the bishops the views of lay Catholics, but it is hard to argue that they are representative of Catholics at large. Certainly any who think natural family planning is the church's great gift to the laity will not. And those who are church employees could fear losing their jobs if they spoke the truth.

At the 1980 Synod on the Family, the lay participants were remarkable for how totally out of touch they were with the views of average Catholics. I fear this is a rerun. 

Most of the collaborators and auditors were chosen on the recommendation of episcopal conferences, and this is the fundamental contradiction of Francis' papacy. He wants to change things, but he also wants to defer to local bishops on many things.

There is also some irony here. In the decades following Vatican II, Catholic progressives constantly called for decentralization in the church. Now that they like what the pope is doing, they want him to do things by executive order. Meanwhile, conservatives are beginning to see the advantages of subsidiarity in the church. God does have a sense of humor.

[Jesuit Fr. Thomas Reese is a senior analyst for NCR and author of Inside the Vatican: The Politics and Organization of the Catholic Church. Follow him on Twitter: @ThomasReeseSJ.]

Arabs, Arabs, Everywhere!

Everywhere I go in Boston, I see someone from the Arab community. I really did not even know many were here before I spent two years in the Middle East. Now, I see them everywhere and there are lots of them. I also see hookah bars, shawarma houses, and kebab restaurants.

The other night as I walked along South Boston's waterfront park, I saw three skunks on the side of a path hidden among shoulder-high decorative grass. I saw two young men approaching from the other direction and I tried to get them to stop and circle around the path where the skunks were hidden, but they did not stop. The men were probably around 19 years old and they had little English. This one man was offended that I was trying to stop him, so he stopped two feet away from the skunk and started yelling at me. I kept waving him closer to me, but he did not understand. Eventually, they passed by the skunks without incident. They probably do not even know what skunks can do.

As I walked a few steps further, a very large photo with a Palestinian head covering caught my eye. I did not know whose image was on the poster and I did not dare to peer any closer because two Arab men were sitting on the deck smoking cigarettes.

The week was fun because a friend of mine was visiting from Amman to get her son settled into an apartment in Boston as he attends university. His good friend from Jordan and his sister came to visit as he settles in.

As I reached my 10,000 daily steps with a nightly walk, I took a shortcut across the lawn of Castle Island. This one man came out to greet me because I think he thought I was crossing the law to speak with him. His family was having a picnic, smoking shisha, and just soaking in the evening's last light. He told me about his family and his ventures then he noticed his three-year old daughter was missing. After he went running for her, I said, "Marhaba." Her eyes lit up and she started speaking in Arabic with words I understood. I felt happy to speak - even though it was at a toddler's level. We exchanged goodbyes as I continued with my walk.

Walking is still therapeutic. It is better than ice cream. It lifted my spirits for a week that was merely O.K., but left me feeling a little down. The exercise and the connection helped me get my energy back. The whole school week begins in earnest this week and somehow I'll get myself going.