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Why this pro-life congressman opposed the failed health care bill

Banner dawn at the us capitol building credit ipbrian via flickr cc by nc sa 20 cna

Dawn at the U.S. Capitol Building. Credit: IPBrian via Flickr (CC BY-NC-SA 2.0).

Washington D.C., Apr 1, 2017 / 11:57 am (CNA).- When last week’s health care bill failed, it wasn’t just Democrats who fought it. The GOP-led American Health Care Act drew bipartisan resistance for numerous reasons. One of the Republicans who opposed the proposal was Rep. Chris Smith, chair of the House Pro-Life Caucus.

In a statement explaining his decision, Smith said that although the bill included positive pro-life protections, he ultimately could not give the legislation his support because of how other provisions would “likely hurt disabled persons, the elderly and the working poor.” He cited concerns about how the House bill would have cut Medicaid expansion and canceled essential health benefits for children and pregnant women, as well as for those struggling with addictions and mental health issues.

The American Health Care Act would have made significant changes to the Affordable Care Act, the massive health care law passed in 2010. However, the new health care bill failed to gain enough support to be sent to the House Floor for a vote, and was ditched at the last minute before a planned vote last Friday.

In a letter to members of Congress on Thursday, the U.S. bishops voiced their opposition to the proposed replacement bill, while at the same time making clear that the current health care law has serious flaws that need to be corrected. “It was widely accepted that the AHCA contained serious deficiencies,” three leading bishops wrote. “Yet, other problems and barriers to access and affordability within the current health care system still remain.”

Cardinal Timothy Dolan of New York, chair of the bishops’ pro-life committee; Archbishop William Lori, chair of the Ad Hoc Committee for Religious Liberty; and Bishop Frank Dewane of Venice, chair of the bishops’ domestic justice and human development committee, were all signatories of a March 30 letter for Congress calling for bipartisan health care reform that would help lower health care premiums and expand access, especially for undocumented immigrants.

With these ongoing problems of increasing premiums and “barriers to access” of health care, along with a lack of conscience protections for health professionals and protections against federal funding of abortion coverage, “lawmakers still have a duty to confront these significant challenges,” the bishops wrote.

While long pushing for health care reform, the U.S. bishops’ conference had ultimately opposed the Affordable Care Act, in part because it lacked legal safeguards against federal funding of abortion coverage. The late Cardinal Francis George, then-president of the U.S. Bishops’ Conference, wrote at the time of the law’s passage that “there is compelling evidence that it [the ACA] would expand the role of the federal government in funding and facilitating abortion and plans that cover abortion.”

Now, the bishops said in their letter, if full-scale reform is not possible, targeted legislation for specific policies – like the Conscience Protection Act – should be passed, they added. “We urge members of Congress to seize this moment to create a new spirit of bipartisanship and make these necessary reforms.”

In his explanation of opposing the bill, Rep. Smith singled out its proposed cuts to Medicaid and to the Medicaid expansion, noting that according to a Congressional Budget Office report, it would cut Medicaid funding by $839 billion over ten years. It would also eventually curtail the expansion of Medicaid, a key part of the Affordable Care Act.

Under current law, the federal government has increased Medicaid funding to states on the condition that they expanded the Medicaid rolls. It has been credited with expanding Medicaid coverage by 14.5 million since 2013, according to a March 2016 HHS report. The House plan phased out that Medicaid expansion and would ultimate have cut almost a trillion dollars from Medicaid in ten years according to the CBO, Smith pointed out.

“For years, I have supported Medicaid expansion as a meaningful way of providing access to health care for struggling individuals and families living above the poverty line but still poor despite being employed,” Smith stated, noting that “80 percent of all Medicaid enrollees in New Jersey are families with at least one working adult in 2017.” He added that in New Jersey, where his congressional district is located, “the bulk of Medicaid funds are spent assisting the disabled and the elderly,” and that most of enrollees in the state were new.

“These people are in need and deserve our support,” he said, pointing to opposition to the AHCA Medicaid changes from the U.S. bishops’ conference and disability advocate groups. He cited the Consortium for Citizens with Disabilities, a coalition of over 60 groups who wrote that states, when left with the bill for Medicaid, would start cutting costs beginning with programs benefitting the disabled. The consortium stated that “people with disabilities are particularly at risk because so many waiver and home- and community-based services are optional Medicaid services and will likely be the first services cut when states are addressing budgetary shortfalls.”

Smith also opposed the bill because it “cancels essential health benefits such as maternity and newborn care, hospitalization, pediatric services, and mental health and substance use treatment.” The Affordable Care Act mandated these services. All this, he said, “will likely hurt disabled persons, the elderly and the working poor.”  

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