By Christie L. Chicoine
CS&T Staff Writer

As chairman of the U.S. Conference of Catholic Bishops’ Committee on Pro-Life Activities, Cardinal Justin Rigali has stated repeatedly in public that it is a moral imperative and urgent national priority that comprehensive health care reform protects the life and dignity of all, especially the poor and the vulnerable.

He has also urged President Barack Obama to stand by his promise that reform will not finance abortions and to back efforts in Congress to ensure legislation will not force Americans to support the taking of human life at any stage through their taxes or health premiums.

In a question-and-answer format on the USCCB web site (, the U.S. Catholic bishops state that all people should have access to comprehensive, quality health care they can afford and that access should not depend on people’s stage in life, where or whether they or their parents work, how much they earn, where they live or where they were born.

The bishops also advocate for coverage of legal immigrants who pay taxes and contribute to the U.S. economy and social life in the same manner as U.S. citizens.

According to the bishops, achieving such equality means repealing the five-year ban currently in effect for legal immigrants to access Medicaid, and ensuring all pregnant women in the United States who will give birth to U.S. citizens are eligible, along with their unborn children, for health care.

The site also cites staggering statistics: one out of three Americans under the age of 65 went without health insurance at some time during 2007 and 2008. Of these, four out of five were from working families.

In addition, 64 percent of the uninsured are employed full time, year-round.

The bishops have called such states of affairs unacceptable and that, in the Catholic tradition, health care is a basic human right – not a privilege – and a fundamental issue of human life and dignity.

For low-income families who lack the resources to meet their health care expenses, significant premiums and cost-sharing charges can serve as barriers to obtaining coverage or seeing a doctor, the bishops said.

In that regard, they recommend that Medicaid cost-sharing protections be maintained and new coverage options protect the lowest income enrollees from burdensome cost-sharing.

The bishops have urged Congress to limit premiums or exempt families earning less than 200 percent of the federal poverty level from monthly premiums. They also recommend limiting co-payments and other costs that could discourage needed care and increasing eligibility levels for Medicaid and CHIP (the Children’s Health Insurance Program.)

In addition, the bishops have urged Congress to provide states with resources to expand coverage and ensure sufficient funding for safety net clinics, hospitals and other providers who serve those who will continue to fall through the cracks even after the system is reformed.

The Archdiocese’s Catholic Human Services, which includes Catholic Health Care Services (CHCS) and Catholic Social Services (CSS) is also keeping a watchful eye on reform.

“Despite the swirling issues regarding the future of health care delivery in our country, Catholic Human Services remains undistracted from its core mission to be the face of the Church to the thousands who seek help and support during these difficult times,” said Joseph J. Sweeney Jr., Secretary for CHS.

Catholic Health Care Services, which provides eldercare, is particularly interested in the impact reform will have on Medicaid funding for long-term care, as 75 percent of the senior citizens in its six nursing facilities receive Medicaid.

Because Medicaid does not cover the full cost of care – it currently reimburses the nursing homes approximately $30 less than the cost of care per day per resident – CHCS subsidizes the residents. “Any diminution of those funding streams would put further pressure on us,” Sweeney said.

“We’re very hopeful that the state and federal government continue to provide adequate funding for long-term care. We’re watching that very closely.”

The Medicare program is also a significant component for CHCS’ nursing facilities. It covers residents after an acute event, generally a hospital stay. Although it provides a limited window of coverage – typically a number of days or weeks – Medicare covers the full cost of care for a period of time until the resident is stabilized. After that, care is compensated through Medicaid, private insurance or private pay.

Approximately 6 percent of the nursing home residents are receiving Medicare at any given time; Medicare makes up 9 percent of the nursing homes’ total operating revenue. “Any kind of cutback in coverage would impact us severely,” Sweeney added.

Medicare also covers physical, occupational and speech therapy services for nursing home residents. “It basically helps the residents to live to their full potential,” Sweeney said. Any reduction in that component would also be problematic, he added.

As more and more elderly are opting to remain in their homes or move into assisted living facilites, Sweeney said he would like to see increased governmental supports for seniors in their homes as well as the extension of Medicaid coverage to inspaniduals in assisted living facilities.

CSS is also assessing the impact health care reform will have on Medicaid coverage. Sweeney said that in the United States today, 68 million children, parents and pregnant women are covered by Medicaid.

CSS serves more than 150,000 clients annually. Even though they are not coming to CSS for health services per se, CSS strives to help provide access to the safety net of Medicaid services for those who need it, Sweeney said.

“We’re in the trenches, so we see it every day,” he added.

Assessing health care reform is about adhering to the Gospel values, Sweeney said. “We’re reaching out to those most in need. It’s building on our expertise of many, many years of caring for the most helpless, the most sick and the elderly.”

In assessing health care reform, CHS has a number of resources at its ready, among them the USCCB and the Pennsylvania Catholic Conference (PCC), where Sweeney serves in the social concerns department.

The PCC follows the lead of policy experts at the USCCB, the Pennsylvania Catholic Health Association (PCHA) and Catholic Charities USA.

The PCC and the PCHA have sent a letter to the Pennsylvania congressional delegation detailing their concerns and sharing a copy of the document, “A Vision for Health Care Reform by the Catholic Church in Pennsylvania.”

“We try to keep our network of advocates up to date as the debate unfolds so they themselves can evaluate each proposal with an eye on Catholic values,” said A. B. Hill, spokesperson for the PCC.

The PCC also advises advocates to contact congressional leaders to lobby for a universal health policy that promotes respect for human life and dignity and grants access for all with a special concern for the poor.

“Reform must pursue the common good and preserve pluralism by including freedom of conscience and a variety of options, and costs should be restrained and applied equitably across the spectrum of payers,” Hill said.

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CS&T Staff Writer Christie L. Chicoine may be reached at 215-587-2468 or