U.S. bishops maintain unity on health care

Analysis

In detective novels, an important clue is often “the dog that didn’t bark.” The idea is that sometimes it’s the thing that didn’t happen, but that under ordinary circumstances would have been expected to happen, that holds the key to unraveling a mystery.

Surveying the role of the U.S. bishops in the national debate over health care reform, one could say that so far, we’ve got a dog that hasn’t barked.

In recent years, the script for the bishops’ involvement in American politics has become distressingly predictable. The U.S. Conference of Catholic Bishops hammers out a balanced statement purporting to represent a consensus; a few bishops take much more sharply defined positions, often with clear partisan overtones; those statements breed counter-statements; voilà, faux unanimity gives way to obvious division, blunting the church’s political effectiveness because it seems to lack a clear message.

For a moment in early September, it seemed things might go according to script once more. A handful of Midwestern prelates issued statements sounding alarms about “socialized medicine,” which seemed at odds with the bishops’ official support for health care reform, assuming that protections for human life and dignity can be assured. Catholic policy wonks held their breath, waiting for the familiar cycle to kick in.

Yet in the wake of a Sept. 14-16 meeting in Washington of the powerful Administrative Committee, the main supervisory body of the bishops’ conference, the story seems rather to be that the center is holding.

Bishop William Murphy of Rockville Centre, N.Y., chair of the Committee on Domestic Social Development, told NCR that fear of a slippery slope towards socialism “didn’t play at all” in the meeting. Archbishop Donald Wuerl of Washington said there was a “strong consensus” in favor of “letting competent lay professionals” worry about the right mix of public and private options, while the bishops focus on “core moral and ethical concerns.”

Instead of new division and confusion, a growing number of analysts believe that even if the bishops ultimately lose on their substantive concerns, they can point to three key breakthroughs related to the health care debate:

• A president who campaigned on signing the “Freedom of Choice Act” has instead vowed to make health care reform abortion-neutral -- arguably reflecting, at least in part, the political importance of Catholic sentiment;
• A bishops’ conference that not long ago seemed fated to isolation has instead chosen the path of constructive engagement, working diligently with the administration and Congress to craft a bill the bishops can support;
• Likewise, a conference that has sometimes struggled to hold its pro-life and social justice messages together has managed to remain strikingly compact. The U.S. bishops, almost in unison, have emerged as prominent defenders of two groups whose interests are rarely asserted by the same lobby: the unborn and immigrants.

At least to some bishops, all that spells progress.

“At our meeting last November, and again last June, we talked about how important it is that we speak with one voice,” Wuerl told NCR. “What we’re seeing now is that actually playing out.”

Of course, the bishops have always attempted to project an air of unity, even when their underlying divisions were crystal clear. Observers say that in this case, two forces have helped them not only to seem united, but actually to stay more or less on the same page.

The first is the fact that the bishops have been on record in support of health care reform since at least 1993, based on assertions in both the Catechism of the Catholic Church and papal social teaching that access to health care is a “fundamental right.” Frustration over earlier failures, observers say, has produced a fairly widespread desire to get something done.

The most recent example of constructive engagement came Sept. 16, when Archbishop Timothy Dolan of New York, often seen as a leader of the bishops’ more conservative wing, made an unannounced visit to President Barack Obama in the White House. Though billed as a courtesy call, resulting from an invitation when Dolan was appointed to New York last February, sources say the two men talked about health care, with Obama reiterating his pledge to support abortion neutrality.

The second factor shaping the bishops’ approach, sources say, is a recent overhaul of the conference itself. Though driven in part by economics, the restructuring also had the aim of breaking down barriers between committees and fostering a more collaborative working style.

“It was a conscious decision to change the way our conference does business,” Wuerl said. “We wanted to be sure that whatever comes out of the conference isn’t just the work of a committee, but that it truly reflects the thinking of the bishops.”

One symbolic expression of that new dispensation is that virtually all the official statements from the bishops on health care have been cosigned by Murphy and Cardinal Justin Rigali of Philadelphia, chair of the Committee on Pro-Life Activities. In the past, that committee and the one led by Murphy have not always seen eye to eye. This time, members and staff of both groups say the effort is much more united.

“It’s been to the advantage of us all that the staffs in Washington and the bishops of the committees have worked together,” Murphy said. “It’s helped make clear to people” that pro-life and social justice concerns “can’t be separated from one another.”

It remains to be seen, however, whether these breakthroughs will come in defense of a losing cause.

For one thing, none of the current reform proposals, including the “Baucus Bill,” meets the bishops’ standards for being abortion-neutral. While many bishops say they’ve been encouraged by Obama’s pledge not to fund abortions, most agree with Murphy that the proper stance is “trust, but verify.”

The current House bill could permit a public option to cover all abortions, and would also permit federal subsidies to be used to purchase private insurance that covers abortions. Under a provision in the House bill, participants in private plans would be required to pay a surcharge to fund abortions, which, according to critics, violates the legal status quo.

There’s also a mounting possibility that immigrants could be excluded from new health care initiatives -- including, under some proposals, legal immigrants.

Murphy told NCR that coverage of immigrants may be the “hard nut” in the health care debate, warning that “it sounds and looks ... as if they’re going to be thrown under the bus.”

For a recent expression of the bishops’ core concerns, many analysts point to a Sept. 16 column by Wuerl on the Politics Daily Web site. It laid out three principles for reform:

• Upholding existing restrictions on abortion funding and conscience protections;
• Universal coverage, including immigrants;
• A mix of public, private and nonprofit options respecting the “mission and identity” of religious providers.

Among other things, that piece helped cement Wuerl’s profile as a voice of the conference’s mainstream. One bishop, speaking on background, put it this way: “Where Wuerl is, there’s the center.”

John L. Allen Jr. is NCR senior correspondent. His e-mail address is jallen@ncronline.org.