BALTIMORE — The U.S. Catholic bishops approved a letter to supplement their voting document on Tuesday — but not without controversy during debate on the “preeminent priority” of abortion.

During discussion at the bishops’ annual fall meeting in Baltimore on a letter to accompany the bishops’ document on voting, “Forming Consciences for Faithful Citizenship,” the bishops considered whether to include an entire paragraph from Pope Francis’ 2018 apostolic exhortation on holiness, Gaudete et Exsultate.

Bishop Robert McElroy of San Diego said that paragraph should be included to make clear that Pope Francis prioritizes other issues at the same level as abortion.

The U.S. bishops’ inclusion of the word “preeminent” before mention of abortion in another part of the letter, he said, “is a statement that I believe is at least discordant with the Pope’s teaching, if not inconsistent,” and one that “will be used to, in fact, undermine the point Pope Francis is making.”

“It is not Catholic teaching that abortion is the preeminent issue that we face in the world of Catholic social teaching. It is not,” Bishop McElroy said, adding that to teach otherwise would provide “a grave disservice” to the faithful.

After Bishop McElroy spoke, Bishop Joseph Strickland of Tyler, Texas, said, “I absolutely think ‘preeminent’ needs to stay.”

Archbishop Charles Chaput of Philadelphia rose to say that he did not oppose the inclusion of the full statement of Pope Francis and added that teaching that abortion is a “preeminent” issue is not contrary to the magisterium of Pope Francis.

“I am certainly not against quoting the Holy Father’s full statement. I think it’s a beautiful statement. I believe it,” he said.

“But I am against anyone stating that our stating it [abortion] is ‘preeminent’ is contrary to the teaching of the Pope. That isn’t true. That sets up an artificial battle between the bishops’ conference of the United States and the Holy Father, which isn’t true,” Archbishop Chaput said.

“I think it’s been a very clearly articulated opinion of the bishops’ conference for many years that pro-life is still the preeminent issue. It doesn’t mean the others aren’t equal in dignity,” he said.

Many bishops in the audience applauded after Archbishop Chaput finished his statement.

The U.S. bishops on Tuesday met for the second day of their annual fall meeting in Baltimore, Nov. 11-14. The meeting agenda included the elections of a new conference president and vice president and six committee chairs.

On Tuesday morning, the bishops elected standing vice president Archbishop José Gomez of Los Angeles as the conference’s first Hispanic president. Archbishop Allen Vigneron of Detroit was elected as the vice president on the third ballot.

Later on Tuesday, the bishops voted to approve both a script for a short video on their voting document, “Faithful Citizenship,” as well as a short letter to accompany the document, amendments to which were considered by the U.S. bishops’ working group on “Forming Consciences on Faithful Citizenship.”

Cardinal Blase Cupich had proposed an amendment to add the whole Paragraph 101 from Gaudete et Exsultate into the letter.

The amendment had been accepted by the working committee with the changes that some, but not all, of the language of the paragraph would be included.

The reason the entire paragraph was not included was the need for brevity in the letter, Archbishop Gomez — the incoming president of the conference — later said, in the discussions on the language.

A footnote to the exhortation was included to draw attention to the Holy Father’s message, Archbishop Salvatore Cordileone of San Francisco later said.

While the original discussion centered upon the inclusion of Cardinal Cupich’s amendment, it triggered a debate over the inclusion of the word “preeminent” in mentioning abortion among other issues. Archbishop Joseph Naumann, chair of the U.S. bishops’ Pro-Life Committee, had successfully included an amendment inserting the word “preeminent” before the mention of the word “abortion” in the letter, to recognize its special gravity when considered with other issues voters are considering.

Cardinal Cupich said that Pope Francis, in his exhortation on holiness, “makes sure that we do not make one issue that a political party or a group puts forward to the point where we’re going to ignore all the rest.”

The Pope’s warning against the coexistence of consumerism with poverty, for instance, was not included in the voting letter, Cardinal Cupich said, and the entire paragraph should be included for that reason.

Bishop Frank Dewane, who led the working group on “Faithful Citizenship,” proposed a compromise to include more language recognizing those issues Pope Francis mentioned in his exhortation, but Cardinal Cupich said that he wanted the entire paragraph included.

“This is the magisterial teaching of Pope Francis put in a very succinct way, and I think we can all benefit from it as we speak to our people about the issues,” Cardinal Cupich said.

Bishop Robert McElroy of San Diego then made his intervention, with Bishop Strickland and Archbishop Chaput responding.

The bishops then voted to keep the letter as is — without Cardinal Cupich’s amendment to insert the entire paragraph into the text — with 143 members of the conference in support. Sixty-nine members voted in favor of Cupich’s motion, with four abstentions.

After that vote, the bishops voted on the final text of the letter, with 207 conference members voting in favor, 24 voting against and five abstaining.