PCUSA Backs House Democrats’ Health Bill
Alan Wisdom
November 18, 2009
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On Wednesday, November 4, the Presbyterian Church (U.S.A.) Washington Office sent out an email alert asking Presbyterians to “[c]ontact your member of Congress before Saturday, November 7th, and urge him/her to support H.R. 3962—'The Affordable Health Care for America Act.'" This was the bill, put forward by the House Democratic leadership, that passed at November 7. It would:
- Require all Americans to purchase health insurance;
- Require businesses with a payroll of more than $500,000 to provide health insurance for their employees;
- Expand Medicaid coverage to include those with incomes up to 150 percent of the poverty level;
- Establish a government-run “public option” to compete with private insurance plans (and possibly, eventually drive them out of business);
- Provide subsidies to help middle-income people buy government or private insurance;
- Empower government officials to define “essential benefits” that must be covered under any insurance plan;
- Prohibit private insurance plans from excluding people based on “pre-existing conditions” or from charging higher premiums for groups at higher risk;
- Pay the $1 trillion bill mainly through a surtax on the wealthy and hypothetical future Medicare cuts.
A last-minute amendment to the bill prohibited the federal government from offering or subsidizing any insurance plan that paid for abortions.
The Washington Office action alert enunciated principles of “universal accessibility,” “equity,” and “responsible financing” for health care. It declared that the House Democrats’ proposal “reflects these values and will move the U.S. health care system in the right direction to provide access to quality, affordable health care for all.”
A Break in the Pattern
This push for a particular bill represented a break with the PCUSA office’s recent practice of generally refraining from such endorsements. As recently as October 5, a Washington Office newsletter kept its guidance more general: “Let your Senators know that you support health care reform that is: Inclusive …. Accessible …. Affordable …. Accountable ….” It did not anoint a specific piece of legislation as the church’s choice. It left individual Presbyterians to weigh the pros and cons of different proposals and form their own judgments.
We in Presbyterian Action had praised this pattern of “wiser witness in Washington” earlier this year. We were hopeful that the Washington Office was breaking its old habit of taking a side in every big partisan debate—almost always the side of the liberal wing of the Democratic Party.
Unfortunately, it looks as if we will have to retract part of that praise. When push came to shove and every vote counted in the House health care debate, the Washington Office once again rallied to the side of the liberal Democrats. It apparently could not trust Presbyterians to make up their own minds.
Of course, if Presbyterians were to be consulted, they probably would be deeply divided on the health care issue—as is the general public. Polls such as a recent survey by the Pew Research Center show most Americans skeptical of the bills in Congress, even though they favor some major elements of those bills. We do not have poll data that separate out Presbyterians; however, PCUSA members tend to lean in a conservative direction.
Going Beyond General Assembly Policy
The Washington Office alert cited General Assembly policies in justifying its endorsement of H.R. 3962; however, those policies come nowhere close to specifying the provisions included in the House Democratic bill. General Assembly resolutions do not require mandates for individuals to purchase health insurance or for businesses to cover their employees. Nor do they call for Medicare cuts as a major means of paying for expanding health care coverage.
Indeed, the General Assembly has blessed a very different approach to health care. The most recent assembly, in 2008, “endorse[d] in principle the provision of single-payer universal health care reform in which health care services are privately provided and publicly financed … as the program that best responds to the moral imperatives of the Gospel.”
This government-controlled “single-payer” system is a far cry from the complex contraption now approved by the House. If the PCUSA Washington Office had been strictly faithful to General Assembly policy, it should have joined extreme liberals such as Rep. Dennis Kucinich in opposing H.R. 3962. The only justification for backing the bill is the supposition that its Republican critics are right: that its limited “public option” is only a way station on the road to the kind of government monopoly that the 2008 General Assembly favored.
The Washington Office alert is selective in its citations of General Assembly policies. It focuses on resolutions—some dating as far back as 1976—highlighting the need for “quality care for all.” By contrast, it does not mention parts of a 1991 policy statement emphasizing principles of “choice,” “cost containment,” and “innovation and creativity” in health care. Many critics charge that H.R. 3962, while extending care to more people, is weak in these other areas.
The Washington Office minimizes the importance of containing rapidly rising health care costs. It goes back to a 1988 resolution insisting, “The sacrifice of access and quality at the shrine of cost containment is too high a price to pay and should not be tolerated.”
A Curious Coincidence
There is a curious coincidence regarding this Washington Office lobbying for H.R. 3962. Within a day of receiving the PCUSA alert, the IRD office received similar messages from the Episcopal Church Washington Office and the United Methodist Board of Church and Society. All three denominational offices had previously advocated only general principles for health care reform; all three suddenly fell in line behind H.R. 3962.
One suspects that there had been some conversations inside the United Methodist building, where all three offices are located. It appears that the Presbyterian office can be swayed by its religious left allies in other denominations—more so, perhaps, than by the PCUSA members it supposedly serves or the General Assembly policies to which it is supposedly accountable.