Catholics Torn Over Kasich Healthcare Proposal

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Two of every five Ohio births are paid for by Medicaid. Would expanding Medicaid mean expanding public funding of immoral, elective drugs and medical procedures? Are the a necessary evil or something that must be fought? Photo by Fernando Audibert, courtesy stock.xchnge.

What are Catholics to think about Gov. John Kasich’s proposed Medicaid expansion to cover 275,000 more people?

In January, a letter to the governor from Archbishop Dennis Schnurr on behalf of Ohio’s bishops supported expanding Medicaid to 600,000 Ohioans, and yesterday Jim Tobin, Associate Director of the Catholic Conference of Ohio’s Department on Social Concerns, visited the Statehouse with representatives of the United Methodist Church, the United Church of Christ, Temple Israel, the Ohio Council of Churches, and other religious organizations to urge the expansion.

But on Monday, Right to Life of Greater Cincinnati officially opposed the expansion because, says Executive Director Paula Westwood, new directives from the US Department of Health and Human Services mean that the controversial rule mandating that employer-paid healthcare plans fully fund contraceptive drugs and procedures, elective sterilizations, and “morning after” pills be extended to Medicaid.

“Any say states once had in what these funds cover will be lost,” she says. “Medicaid in these states will be an arm of the federal government.”

The very drugs and procedures that Catholic churches, schools, organizations, and businesses are protesting in the HHS mandate, she says, are already paid for in most or all cases by Medicaid. While states have some discretion in what they will pay for, in most states Medicaid already pays 90% of the costs for contraceptive drugs, IUDs, contraceptive implants and injections, and diaphragms; and for abortions in case of rape or incest. In 36 states it also pays for elective tubal ligations and vasectomies, and in 26 (Ohio is not currently one) it pays for “morning after” pills.

“Medicaid expansion will expand these services, which are not only immoral, but also elective and medically unnecessary, and which raise suspicion of population control efforts among the underprivileged,” Westwood says. “Through our taxes, each of us is paying for this free coverage for lower-income people, regardless of our moral and religious convictions. This is a serious ethical dilemma. What is needed is Medicaid reform, not expansion.”

The Catholic Conference of Ohio, Ohio’s bishops’ conference, says that Medicaid is the only thing that makes it possible for Ohio’s poor to have “life-saving and health-saving” care.

“The expansion isn’t changing what Medicaid already does,” says CCO spokesperson Carolyn Jurkowitz. “Is Medicaid perfect? No. We would never want it to be used for things the Church does not and would not approve. But in our state Medicaid pays for two out of every five births, particularly births for Hispanic and African-American mothers. It pays for nursing homes and mental health services and other services the poor could otherwise never, ever afford.

“We understand where Cincinnati Right to Life is coming from, but we believe that the benefits for Ohio’s poor will come from expanding Medicaid, strengthening it, and making it better,” she says. “That’s what the Archbishop’s letter is about — he’s as pro-life as they come.”

The Jan. 28 letter to Gov. Kasich says the bishops of Ohio support Medicaid expansion “because of our concern for the poor and vulnerable…. Through the Affordable Care Act, this expansion will increase access to health care and health care coverage to… uninsured eligible Ohioans who are below 138 percent of the federal poverty level.” The letter further urges the governor to “safeguard the existing comprehensive benefits package for current Medicaid beneficiaries and maintain Medicaid provider reimbursements.”

Several conservative political groups have announced opposition to the expansion, saying it would add to the national debt, make a dysfunctional bureaucracy worse, lead to more Medicaid fraud, and make Ohio’s budget unsustainable. Currently, at about $15 billion a year, Medicaid is Ohio’s largest annual budget item.

Several liberal political groups, as well as the Ohio Council of Churches and several hospital organizations, have announced support of the plan.

Neither the liberal supporters or conservative opponents of the plan mention the controversial services that are part of the HHS mandate debate. Many of Christian groups sending representatives to Columbus yesterday, most of which are generally considered politically liberal and which have other, larger, theological difference with the Catholic Church, are not opposed to them. In his State of the State address, Gov. Kasich said Christian principles required him to expand Medicaid.

Ohio Right to Life, which has differed from Right to Life of Greater Cincinnati on other issues in the past (Right to Life organizations are each run independently) supports the the CCO, as do many Catholic hospitals, nursing homes, mental health facilities, and other healthcare providers.

”We would never want faithful Catholics to think we’ve backed of on our opposition to abortion and related issues,” says Jurkowtz, adding that the Ohio bishops’ support of expanding Medicaid should not be read as capitulation on the HHS mandate for employers.

“We continue to chip away at these things as the opportunities come up,” she says. “It’s never okay for abortions to be funded. But it’s not okay to take away all services because we don’t live in a perfect world and we can’t get everything we want all at once.”

UPDATE: On Friday, Ohio ProLife Action announced a resolution against Medicaid expansion in Ohio and called for Medicaid reform.

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