The Morality Tale of Health Care Reform

By Marie Griffith | July 24, 2017

(Getty/Chip Somodevilla)

Few domestic political issues have gotten more recent airtime than health care. After years of denouncing the Affordable Care Act (ACA), congressional leaders from the party in power have been determined to repeal and replace it, and President Trump has repeatedly urged their efforts forward. But their replacement plan—the Better Care Reconciliation Act (BCRA)—garnered a national fury that its designers have not been able to assuage. Though the effort appeared dead last week after enough Republican senators signaled their refusal to vote for the secretly crafted and little vetted bill, revision efforts continued, and the Senate is slated to take it up once more this week. Fewer than 20 percent of Americans approve of these efforts, and large numbers have actively resisted by marching, tweeting, calling their elected officials and confronting them in town halls, demonstrating inside the Capitol Building, and otherwise making their voices heard.

Religious leaders have been at the forefront of this resistance to the GOP’s repeal and replace bills, all of which would drastically cut Medicaid and, according to the nonpartisan Congressional Budget Office, result in more than 20 million more uninsured Americans than under current law. Christian organizers like the Revs. William Barber II, Traci Blackmon, and Jennifer Butler have led myriad people of faith to object to provisions in the bill that would harm the poor and millions of other Americans, including women seeking contraception, maternity care, and other forms of sexual and reproductive health management. These leaders have repeatedly made the point, based on reams of evidence forecasting the bill’s outcomes, that the wellbeing and, indeed, the very lives of countless people are at stake. In Blackmon’s words at a July 13 protest outside Senate Majority Leader Mitch McConnell’s office, “If you can turn your backs on people who are suffering from conditions that are no longer able to be treated, don’t tell me you are pro-life.”

“Pro-life” is exactly what large numbers of Christians who voted for current GOP leaders, including President Trump, consider themselves to be. As polls consistently show, plenty of these voters do not approve of the BCRA’s deep cuts to Medicaid, but pro-life Christians generally approve of reduced access to abortion, and many hold a dim view of Planned Parenthood (which provides abortion services). The congressional leaders who crafted these recent bills likewise claim the mantle of “pro-life,” and many doubtless mean that sincerely. Perhaps they thought that Christians opposed to abortion would be so excited about the proposed congressional defunding of Planned Parenthood and other attempted restrictions on abortion that they would accept sweeping cuts to Medicaid and withdrawal of other popular ACA benefits—like insurance protections for pre-existing conditions—regardless of their own interests and concern for others.

But to Blackmon and many others, progressive Christian and otherwise, it is at best nonsensical—hypocritical and immoral, in fact—to focus so much more attention on the unborn than on those already born who are afflicted with poverty or illnesses that quality medical care could relieve. Progressive Christians might say: Why fixate on electing a president who, whatever his moral failings, would appoint a pro-life Supreme Court justice rather than a president who would support health care and other policies designed to improve the lives of the most vulnerable? Can it be that these lives are worth less than a just fertilized egg? Conservative pro-life Christians might say: Can’t we find ways to reduce abortions without a reverse Robin Hood trick that takes Medicaid from the poor and turns it into tax windfalls for the rich? Even as he urged greater protections for the unborn than what already appeared in the bill, a committee chair of the U.S. Conference of Catholic Bishops condemned the bill’s draconian cuts to the poor, arguing that government leaders should not “fundamentally alter the social safety net for millions of people” and that placing caps on medical coverage for the needy so as to give tax cuts to the rich was “unconscionable.”

In each of its iterations, the congressional bill forbids government subsidies that help people pay their insurance premiums from being used to purchase plans that cover abortion services. Now the Senate parliamentarian has ruled that certain abortion-connected provisions will need 60 votes to pass—a near impossible feat when the GOP is struggling to get 51 votes to pass any health care bill. The original Senate bill’s intent was to eradicate all federal health care funding to Planned Parenthood for one year—an action that many have shown would force millions of women who seek care and contraception there to look elsewhere, even where there are no alternatives. Cuts to Medicaid would also drastically affect gynecological and maternity care, especially since the program pays for about half of American births (in Arkansas, 67 percent of births are financed by Medicaid). States could decide to let insurers opt out of maternity coverage, and women would no longer receive no-cost birth control. Agree or disagree that the pending legislation is, as one critic notes, “a particularly bald expression of contempt for women,” it’s not difficult to see how this set of policies would worsen health care for women of childbearing age, increase rather than decrease the abortion rate, and thrust innumerable mothers and babies into poverty and illness. Even if Democrats are able to block the Senate provisions that target women’s health, a rollback of health care, whether a replacement of the ACA or a straight repeal, could have dire consequences for the most vulnerable among us.

Evidence has been mounting for some time that American Christianity itself, in its Protestant and Catholic manifestations (and arguably, though to a lesser extent, its Mormon manifestations as well), is profoundly divided about moral issues and about the very meaning of what it means to follow Christ. These differences are inevitably part of our divided politics. The current debate over health care gets to that divide in a way that many Christians see as remarkably simple, given the commands of Jesus on living a faithful life: to feed the hungry, welcome the stranger, clothe the needy, tend the sick, and visit the prisoner. For many Christians, offering affordable health care to all is inseparable from those directives. But some congressional leaders have presented eradication of the ACA as the only option, come what may. If only their pro-life ethic included the millions of lives, young and old, healthy and sick, who will lose insurance coverage if their party leaders have their way.


Marie Griffith is the director of the John C. Danforth Center on Religion and Politics and the editor of Religion & Politics. Her new book, Moral Combat: How Sex Divided American Christians and Fractured American Politics, will be out in December. Follow her @RMarieGriffith.

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