WASHINGTON — The prospect of American Catholic leaders urging their congregations to actively oppose an overhaul of the nation’s health-care system is becoming increasingly likely.

The U.S. Conference of Catholic Bishops promised to “vigorously” oppose health-care legislation under consideration in Congress if changes were not made to bar public funding of abortions and provide universal access to care, including for immigrants.

The pledge came in an Oct. 8 letter sent by the conference’s three bishops working on health-care reform to every member of Congress.

“If final legislation does not meet our principles, we will have no choice but to oppose the bill,” wrote the bishops, including Cardinal Justin Rigali, archbishop of Philadelphia and chairman of the Committee on Pro-Life Activities.

The letter came just a few days before the Senate Finance Committee approved the latest health-care reform measure on Oct. 13. That panel at the beginning of the month rejected conscience-protection and abortion-defunding amendments. One such amendment, by Sen. Orrin Hatch, R-Utah, would have barred penalties for health-care workers and religiously affiliated hospitals that refused to perform procedures to which they were morally opposed.

“Without this amendment, I believe that health-care providers who object to abortion could face discrimination,” Hatch said, before the panel rejected the amendment 10-13.

Abortion supporters, including Sen. Debbie Stabenow, D-Mich., countered that health insurers would use the provision to refuse to cover abortion under any circumstances, including cases where the mother’s life was in danger.

The bishops explicitly referenced the failed conscience amendment in their letter.

“No one should be required to pay for or participate in abortion,” the bishops wrote.

Also rejected by the Senate panel was an amendment to bar the use of taxpayer funding for abortions provided through new publicly subsidized insurance plans. The amendment, which would have required women with such insurance who wanted abortion coverage to purchase a separate rider, was rejected 10-13.

Sen. Max Baucus, D-Mont., said the amendment would discriminate against women.

Escalated Debate

The bishops’ threat to oppose the legislation ratchets up the rhetoric in an ongoing war of words over abortion’s role in health-care reform. It follows several weeks of abortion opponents warning that all of the reform bills would vastly expand abortions by requiring public funding and mandating that more health-care workers provide them, while Democratic leaders countered that the bills would “preserve the status quo.”

“It is essential that the legislation clearly apply to this new program long-standing and widely supported federal restrictions on abortion funding and mandates, and protections for rights of conscience,” wrote the bishops. “No current bill meets this test.”

The Obama administration responded twice the week of Oct. 5 that none of the health-care reform bills would change federal policy banning taxpayer funding for elective abortions. During a press conference Oct. 7, CNS News reporter Fred Lucas asked White House spokesman Robert Gibbs about the bishops’ statement that the health reform bills have not met the president’s challenge of barring the use of federal dollars for abortion.

“There’s a law that precludes the use of federal funds for abortion that isn’t going to be changed in these health-care bills,” Gibbs insisted.

Abortion opponents warn that the current abortion-funding ban, controlled by the Hyde Amendment, applies only to federal health-care money flowing through the Health and Human Services Department. The amendment is subject to annual renewal. A new funding structure that would be created by the health-care reform bills — as identified in an Aug. 31 letter by the nonpartisan Congressional Research Service — would circumvent this long-standing federal-funding ban.

There was a follow-up exchange Oct. 9, in which Lucas clarified that “the Hyde amendment is only for direct appropriations for HHS.” Gibbs nonetheless explicitly repeated his denial.

The potential effect of the bishops’ opposition to the health-care overhaul effort could be serious, according to others critical of the bills.

The conference has urged Catholics to contact their members of Congress at other critical junctures in the health-care reform debate, said Don Clemmer, assistant director of media relations for the conference. And millions of Catholics could be urged to oppose a final health-care bill on moral grounds.

“Ultimately, it’s the voice of the bishops on the record,” Clemmer said about the bishops’ letter warning of their potential opposition.

The bishops have not provided a timeframe of when they would issue a final decision on whether they oppose the health-care overhaul legislation.

But the bishops are not the only longtime supporters having second thoughts.

The lobbying group for the health insurance industry released an analysis this week conducted by PricewaterhouseCoopers that concluded the Finance Committee’s health-care bill would add thousands of dollars in annual cost increases to the average private insurance plan when it is fully implemented. The report caused serious consternation among Democratic supporters of the health-care overhaul, although they were unable to counter it with their own research. Nonpartisan congressional auditors have been unable to provide their own cost estimates that the average taxpayer would face under any of the health-care overhaul bills.

The critical research paid for by insurers followed months of support by that industry for health reform, including millions of dollars spent on pro-reform television ads. An insurance industry spokeswoman said it will continue to urge changes that will allow members to eventually support an overhaul.

Other recent concerns have been raised by the American Medical Association, which has been a high-profile supporter of the health-care overhaul. The association formally endorsed a version approved by three House committees in July. However, the physicians’ group recently raised concerns that a relatively small costs-saving measure in the Senate Finance Committee bill could result in negative effects for millions of seniors.

The provision would require a 5% cut in reimbursements for all physicians who are among Medicare’s top 10% with the highest reimbursements.

Rich Daly writes