Supreme Court ruling both good and problematic

As with so many political issues, the Catholic response to the U.S. Supreme Court’s recent ruling on the Patient Protection and Affordable Care Act is far more complicated than the response of politicians and their respective parties. With all of our teachings, it is not easy for Catholics to respond with a quick "good decision" or "bad decision." In terms of Catholic belief, the Supreme Court ruling is bad and good, as is the law itself.

The Catechism of the Catholic Church recognizes health as a necessity for a life of dignity. It also notes that "it is the proper function of authority to ... make accessible to each what is needed to lead a truly human life: food, clothing, health, work, education and culture, suitable information, the right to establish a family and so on." In light of this and other church teaching, the United States Conference of Catholic Bishops for decades has advocated for health care for all.

In the context of this teaching, the Patient Protection and Affordable Care Act (PPACA) is good. It provides several important protections for the poor and vulnerable, including ensuring coverage despite pre-existing conditions, covering preventative measures such as cancer screenings, extending coverage to young adults who may not have found a job with benefits by age 21, and consumer protection provisions that address unreasonable premium increases and require benefits summaries that consumers might actually be able to understand.

But the Act is also problematic in significant ways. The greatest concern raised by the USCCB is the law’s failure to implement the long-standing federal policy of restricting federal funds from being used to pay for elective abortions. Tied to this is the Act’s lack of protections for rights of conscience. The Department of Health and Human Services would not have been able to impose its prescription contraception mandate and extremely narrow religious exemption had Congress recognized religious liberties within the Act. This issue could be at least temporarily addressed by HHS without waiting for congressional action, but Congress must also amend the law to protect freedom of conscience from future departmental interpretations of the Act.

The bishops point out, too, that the PPACA also needs to be expanded to allow immigrants to purchase insurance through the required health exchanges. As it now stands, the law leaves a vulnerable population, the undocumented, worse off than they were before the law was enacted.

These are fundamental flaws from the Catholic perspective, but not fatal. Despite its long-standing objections to the provisions of the law mentioned above, the Church, as represented by the USCCB, has not joined in calls for its repeal. As the USCCB stated, "The decision of the Supreme Court neither diminishes the moral imperative to ensure decent health 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."

Though the Church has serious concerns about some of the PPACA provisions, Catholics also recognize that complete repeal, without offering alternatives for ensuring the poor and vulnerable have adequate access to care, is not a real solution. It seems more prudent to repair the obvious problems in the law than to give up entirely on providing options for the poor and protecting the most vulnerable from preventable diseases.

If only Congress were willing to pursue such a prudent path.