Pro-life problems remain after Obamacare decision

The following analysis from pro-life leaders in Congress is helpful in sorting out yesterday's Supreme Court decision:

The Supreme Court has issued a decision in the cases related to the Affordable Care Act. The decision is available here. Abortion-related issues remain. Examples of pro-life objections include:

1. Taxpayer funding for abortion coverage through the exchange premium assistance credits—complete with an abortion surcharge and secrecy clause.
2. The abortion surcharge and secrecy clause established in Section 1303 were added as the mechanism for abortion funding under the Affordable Care Act.  Any subsidized plan that includes abortion will charge a surcharge of at least $1 per person to go into an abortion fund, and insurance companies are only allowed to disclose the surcharge at the time of enrollment. 
3. Multi-state plans run by the federal Office of Personnel Management and subsidized, in part, by taxpayer subsidies, will still be allowed to cover abortion (except one must not include abortion as required in the ACA). 
4. Preventive services mandate.  This mandate is currently being used to mandate sterilization and contraceptive coverage including the morning-after-pill.  In the future it could be used to mandate surgical and RU-486 abortion coverage. 
5. Funding for abortion training is not excluded from the Teaching Health Graduate Medical Education (THCGME) program.
6. Possible future abortion funding through Community Health Centers, High Risk Pools and other directly funded programs. 
7. Potential funding for Planned Parenthood school-based health clinics.
8. Lack of strong conscience protections to stop the government from forcing health care entities to participate in abortion. 

Click on these links for more resources about these cases which argued the constitutionality of the individual mandate, severability, applicability of the Anti-Injunction Act, and whether Medicaid funds can be tied to compliance with the ACA:

·        Department of Health and Human Services v. Florida

·        National Federation of Independent Business v. Sebelius

·        Florida v. Department of Health and Human Services

CMA physicians: health care ruling keeps door open to "faith fines"

The nation's largest faith-based association of physicians, the Christian Medical Association (CMA, www.cmda.org), today lamented the Supreme Court's ruling on the Affordable Care Act, saying the decision threatens health care choice and "sounds an alarm across the country to people with faith-based and pro-life convictions."

CMA CEO Dr. David Stevens observed, "The high court unfortunately could not muster enough justices willing to uphold the Constitutional principles of limited government and separation of powers that have guided our nation since its founding. This ruling sounds an alarm across the country to people with faith-based and pro-life convictions, to poor patients who depend on physicians with these values and to all patients who value choosing their own health care.

"Who will stop U.S. Health and Human Services political appointees from forcing employers and individuals with faith-based convictions to subsidize abortion or life-ending contraceptives and imposing huge 'faith fines' on those of us who resist? What will stop this administration, with its radical pro-abortion agenda, from further undermining conscience rights and pursuing policies that effectively force out of medicine physicians with life-honoring convictions? Who will keep government panels from effectively denying physicians and patients choice about what are the most effective and appropriate medicines, surgeries and treatments?

"While court battles will continue over other aspects of the Affordable Care Act not addressed in today's decision, we have learned that we cannot simply rest in the hope that our courts will uphold Constitutional principles. We call on Congress to turn back this law's assault on our freedoms and restore American values and Constitutional principles in health care. Repeal this overreaching law and enact bipartisan, targeted health care reforms.

"Congress should demonstrate a new respect for the proper limits of government power, listen to the people and pursue a careful, measured approach of targeted reforms, including:

• protecting patient access to care by enacting strong conscience protections;
• providing a safety net for the poor and patients with preexisting conditions;
• containing the cost of health insurance by opening up competition across state lines;
• reducing cost and keeping physicians in medicine by reforming malpractice lawsuits and reducing bureaucracy; and by
• rooting out and prosecuting Medicare and Medicaid fraud.

CMA Executive VP Dr. Gene Rudd noted, "Compassionate and common-sense reforms like these offer hope for a health care system that cares for the most vulnerable among us while containing costs to make health insurance affordable for an ever-increasing number of Americans. It will also ensure that conscientious physicians who still hold to high ethical standards such as the Hippocratic oath will be able to remain in medicine and care for this increasing number of patients."

What next for health care reform?

The Supreme Court only tested the health care law's constitutionally, not its merits. That's for the people to decide, and a majority of Americans for the past two years have weighed the merits of the law and found it wanting.

Congress and the President now should take heed to constitutional and practical principles, stop trying to take over the world and focus instead on sensible, measured and bipartisan health care reforms:

• Instead of increasing taxes and bankrupting businesses, craft a sustainable safety net for the poor while cutting coverage costs by increasing competition across state lines. 
• Instead of trampling First Amendment rights with coercive contraceptives mandates, respect religious freedoms and strengthen conscience protections. 
• Instead of kowtowing to the trial lawyers' lobby, keep physicians in medicine by reforming malpractice lawsuit excesses. 
• Instead of cutting Medicare reimbursement rates, cut Medicare fraud. Instead of giving unelected bureaucrats the power to decide what medicines and surgeries patients receive, reduce bureaucracy and shift power away from the government and back to patients and physicians.

Given the partisan obtuseness in Washington that produced Obamacare in the first place, reforming health care may be challenging, but it's not brain surgery. Keep it simple, count the cost, follow the Constitution and listen to the people.

You are invited to a bipartisan panel, Religious Freedom and the HHS mandate

Rep. Buerkle

"Religious Freedom and the HHS Mandate: A Bipartisan Response to President Obama’s HHS Mandate"
Join U.S. Representatives:

• Jeff Fortenberry
• Ann Marie Buerkle
• Diane Black
• Dan Lipinski"

On Thursday, June 28 at 10:00 AM, Congressman Jeff Fortenberry (R-NE) will join Congresswoman Diane Black (R-TN), Congresswoman Ann Marie Buerkle (R-NY), and Congressman Dan Lipinksi (D-IL) for a public forum titled In Defense of Liberty: A Bipartisan Response to President Obama’s HHS Mandate at Georgetown University’s Gaston Hall. 

The forum will take place the morning of the expected Supreme Court ruling on the 2010 health care law’s constitutionality.

Dr. Tom Farr, Director of the Religious Freedom Project at the Georgetown University Berkley Center for Religion, Peace, and World Affairs, will moderate this thoughtful discussion analyzing President Obama’s Health and Human Services (HHS) mandate and its implications for individual liberty and religious freedom. Congressman Fortenberry will present and discuss his legislation, the Respect for Rights of Conscience Act (H.R. 1179).

CMA physicians compare Obama administration's position on births to China's

The 16,000-member ChristianMedical Association has filed official comments opposing as "unlawful, unprecedented, unwise and un-American" a U.S. Dept. of Health and Human Services (HHS) rule that forces virtually all health insurance plans in the country provide free contraceptive pills, devices and surgeries on demand regardless of users' ability to pay.

The CMA document deplores the fact that "The administration is instituting a decidedly un-American policy that (a) classifies pregnancy as a disease requiring mandated treatment and (b) advocates the prevention of child-bearing as a health care cost savings. Unlike communist leaders in countries like China, Americans historically have not viewed pregnancy as a disease or children as an unwelcome product posing a cost burden."

The comments of CMA and other groups were filed with HHS before the June 19 deadline for public comments on the rule, which has generated nationwide protests over what opponents consider a frontal assault on religious freedom, since the rule does not exempt most religious employers who object to the drugs on moral grounds.
CMA CEO Dr. David Stevens noted, "The contraceptives and sterilization mandate affects all people no matter what their faith is, and it is an attack on our first and most precious rights. Religious freedom and respect for conscience are among the most important issues that all people of faith face. This is a battle we dare not lose."
CMA Executive VP Dr. Gene Rudd added, "While researchers continue to debate whether certain mandated drugs labeled as contraceptive may actually end the life of a developing human embryo, the mandated drug Ella almost certainly has such a post-fertilization effect; it's the only way to explain the effectiveness rates claimed for the drug. What we have learned during this debate over the potential abortifacient nature of certain contraceptives is that those with a social agenda will deceive to achieve.”

The Christian Medical Association document asserted that the HHS mandate is unlawful and unprecedented in that it violates abortion-related provisions of the Patient Protection and Affordable Care Act (the law under which the mandate is enacted), federal laws protecting conscience rights and constitutional protections for religious liberty and just compensation.

CMA also noted that besides violating constitutional religious liberties, the mandate also "offers no accommodation options whatsoever to protect secular conscientious objectors.

The CMA comments conclude, "The administration retains only two realistic options regarding this unlawful, unprecedented, unwise and un-American policy: rescind the policy or face defeat in the courts. The CMA encourages rescission of this policy in its entirety."

More information on the mandate and comments from other organizations are available at http://www.freedom2care.org/learn/page/laws-obamacare-contraceptives-mandate

Faith-based physicians on contraceptives mandate: "unlawful, unprecedented, unwise and un-American"

The Christian Medical Association's comment submitted to the U.S. Department of Health and Human Services on the Obama administration's contraceptives and sterilization mandate is presented below.

June 13, 2012

Submitted Electronically

Centers for Medicare & Medicaid Services Department of Health and Human Services Attn: CMS–9968–ANPRM

P.O. Box 8016

Baltimore, MD 21244-1850

Re: Advance notice of proposed rulemaking (ANPRM), File Code CMS-9992-IFC2:

The Legal Necessity for Comprehensive Exemptions for All Religious Objections from the PPACA Mandate to Provide, Participate in or Pay for Health Insurance Coverage of Abortion, Abortifacients, Contraception, Sterilization and

Counseling and Information Regarding the Same

Dear Sir or Madam,

The 16,000-member Christian Medical Association (CMA, www.cmda.org), the nation's largest association of faith-based health professionals, strongly opposes the U.S. Dept. of Health and Human Services (HHS) contraceptives and sterilization rule as unlawful, unprecedented, unwise and un-American.

CMA views the mandate as violating constitutional and statutory protections of religious freedom and conscience. The mandate also undermines the American values of free enterprise and, more importantly, respect for human life.

Given the expressed unyielding determination of the administration to force the provision of controversial products and services virtually regardless of religious objections, our organization deems as wholly inadequate any scheme to "accommodate" conscience objections such as by simply reassigning the paperwork to health insurers or third-party administrators.

Specifically, CMA objects to the rule because:

1.     The mandate is unlawful and unprecedented in that it:

a.      violates the Religious Freedom Restoration Act (“RFRA”), by imposing a substantial burden on religious beliefs without employing the required least restrictive means, and by failing to demonstrate a compelling governmental interest (since as even the President has attested, contraceptives are readily available to virtually all women);

b.     violates the Weldon Amendment, which bans federal programs from requiring abortion coverage, by including drugs such as Ella that the Food and Drug Administration notes have the potential to end the life of a living human embryo;

c.      violates abortion-related provisions of the Patient Protection and Affordable Care Act (PPACA);

d.     violates the President's assurances expressed in his Executive Order 13535 that PPACA would in no way be used to require abortion coverage;

e.      violates the Free Exercise Clause of the First Amendment, by promulgating requirements that are not “generally applicable” to all, as demonstrated by many exemptions for secular, but not religious, reasons;

f.      violates the First Amendment rights of free speech, religion and association by compelling education, counseling and information supportive of the very products and services included in the mandate that are objected to by groups coerced into participating;

g.     violates the equal protection clause of the Fourteenth Amendment, by granting government bureaucrats virtually unlimited discretion in parceling out exemptions;

h.     narrowly defines “religious employers” with stipulations unprecedented in federal law--and this despite the 9-0 rebuke of the administration by the Supreme Court over a similar issue in the recent Hosanna-Tabor case;

i.       disregards the unambiguous, bipartisan will of Congress expressed in 16 laws, enacted over four decades, that specifically protect “religious beliefs and moral convictions” [emphasis added].

2.     The mandate is pragmatically unwise, in that it leaves conscientious objectors with no positive options whatsoever. We must either violate deeply held moral convictions, discontinue health care coverage for employees, or pay huge fines that will drain funds otherwise used to help the poor, the sick and other ministry beneficiaries.

3.     The administration offers no accommodation options whatsoever to protect secular conscientious objectors. Such discrimination against non-religious objectors--including employers, employees and insurers--disregards historical conscience protections and standards of medical ethics. Millions of individuals and organizations through the ages have based their moral convictions on secular ethical standards such as the millennia-old Hippocratic oath or the more recent Nuremburg code.

4.     The administration is instituting a decidedly un-American policy that (a) classifies pregnancy as a disease requiring mandated treatment and (b) advocates the prevention of child-bearing as a health care cost savings. Unlike communist leaders in countries like China, Americans historically have not viewed pregnancy as a disease or children as an unwelcome product posing a cost burden.

5.     No payment scheme developed to comply with the mandate can avoid moral compromise for faith-based objectors. If the insurer increases the premiums of objecting employers to recoup the costs of the mandate, faith-based employers clearly are forced to subsidize, through increased premiums, the items considered morally reprehensible. Increasing the premiums only of the non-objecting employers would unfairly force them to pay for the religious objections of objectors, and the government would essentially be compelling the subsidy of a religious group. Either option violates the First Amendment: "Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof...."

6.     The mandate tramples Fifth Amendment protections ("nor shall private property be taken for public use, without just compensation") by imposing costs on businesses while depriving them of the liberty to profit. The alternative to raising premiums that the administration advocates in the ANPRM--forcing insurers to cover the cost without raising premiums--is indefensible and an assault on the free enterprise system. The administration's assertion that providing contraceptives without cost-sharing is a break-even or profitable proposition for insurers is a highly dubious claim. A contraceptive implant offered through the billion-dollar "nonprofit" Planned Parenthood, for example, costs $800 every three years, and a sterilization surgery costs up to $6,000. Insurers apparently do not subscribe to the HHS calculus, as demonstrated by a recent Reimbursement Intelligence survey showing that no major insurers believed they would save money through the mandate, and by the obvious fact that insurers, who are quite competent at assessing risk and benefit, have not already implemented the practice.

7.     While administration officials have talked at length about compromise and promising accommodation of religious liberty, nothing has actually changed in the final rule.

The administration retains only two realistic options regarding this unlawful, unprecedented, unwise and un-American policy: rescind the policy or face defeat in the courts. The CMA encourages rescission of this policy in its entirety.

Sincerely,

Jonathan Imbody

Vice President for Government Relations

Christian Medical Association - Washington Office

P.O. Box 16351

Washington, DC 20041

_______________

Note: Other groups' submitted comments and more information on the mandate can be found on this Freedom2Care web page. Deadline for submitting comments is June 19, 2012. You will find the link to use to submit the comments, and also a petition to HHS, here.