The Devil in the Details

In the important and seemingly endless health care debate, a crucial item that has rightly received much attention here is whether the Senate bill provides sufficient safeguards in the matter of not funding abortion on the part of the federal government.Despite the strong counter-position taken by the Bishops Conference, I am sufficiently impressed by the careful analyses of people like Peter Nixon and Matthew Boudway to think that in this prudential judgment of how pro-life principles may be preserved and hopefully strengthened, I can, in conscience, support the Senate bill in this respect.But I think it important to underline that this is a prudential judgment, based in part upon a personal, non-expert, reading of the material, but also on personal trust placed in those who seem to be both extremely knowledgeable and deeply committed to moral principles in keeping with the Catholic tradition. I certainly do not escape responsibility for that prudential judgment. May I also, respectfully, suggest that those who advocate for such a decision, in favor of the Senate bill, also bear an added responsibility for their advocacy.It might be of help, then, if all sides were to acknowledge the fallibility of their prudential judgment, and that it is entered upon with a certain salutary "fear and trembling," since so much is at stake.That said, there are other aspects to the bill that also merit attention, as this story from today's Washington Post indicates:

virtually everything House Democrats want to achieve in their package costs money. For example, Obama and House leaders have promised to increase government subsidies to help lower-income people purchase insurance, to fully close the coverage gap known as the doughnut hole in the Medicare prescription drug program, and to extend to all states the deal cut with Nebraska Sen. Ben Nelson (D), under which the federal government would pay for a proposed expansion of Medicaid.Meanwhile, House leaders want to dramatically scale back one of the most powerful deficit-reduction tools in the Senate bill: a 40 percent excise tax on high-cost insurance policies. Obama has proposed to delay implementation of the tax until 2018 and to limit the number of policies that would be subject to the tax.Obama and House Democrats have proposed to pay for their changes by raising Medicare taxes on the wealthy. They were hoping to reduce deficits further by incorporating Obama's plan to overhaul the federal student loan program to cut out private lenders.Those changes are unlikely to match the long-term savings proposed in the Senate bill, aides and lawmakers said, leaving House leaders scrambling to come up with additional sources of cash. Failure to comply with the reconciliation rules would imperil the package in the Senate and could cause big problems in the House, where the votes of many fiscally conservative Democrats hinge on the ability of health-care legislation to rein in soaring budget deficits.

Robert P. Imbelli, a long-time Commonweal contributor, is a priest of the Archdiocese of New York. A book of essays in his honor, The Center Is Jesus Christ Himself, edited by Andrew Meszaros, was published this year by The Catholic University of America Press.

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