More on the ACA and the Right to Health Care
Five years ago, President Obama signed into law the Affordable Care Act. This year the Department of Health and Human Services reports that nearly 11 million people have gained coverage under the bill. Twenty-eight states have expanded Medicaid and CHIP programs to cover nearly 10 million more Americans. While taxpayers have seen the lowest rate of cost increase since 1960, 7 out of 10 Market Place users declared their satisfaction as excellent or good. ("The Affordable Care Act is Working," DHHS, http://www.hhs.gov/healthcare/facts/factsheets/2014/10/affordable-care-act-is-working.html)

Even with these results, court challenges and a rocky website dominate the news coverage while controversy reigns in the halls of the Capital. President Obama states that it "is working even better than anticipated," while Speaker of the House John Boehner disagrees, saying it's a "legacy of broken promises." ("CDC: 11M Fewer Uninsured Since Obamacare," USA Today, March 24 2015). Whichever way one falls on the political spectrum, we have a long way to go until all Americans have access to health insurance. National Public Radio finds that 13.2 percent of Americans are still without coverage at the beginning of 2015. Meanwhile very many of the nearly eight million new Medicaid recipients "must wait for months or travel long distances to see a doctor" due to network inadequacy and the lack of primary physicians according to the New York Times. ("For Many New Medicaid Enrollees, Care is Hard to Find, Report Says," New York Times, September 27 2014). These are hurdles large enough to question whether the willpower of our lawmakers can overcome political differences. It demands a renewed effort by our leaders to push for continued expansion.

Meanwhile, the ACA is fighting an uphill battle for acceptance. The most recent challenge making its way through the U.S. Supreme Court could have a major impact on the affordability of health insurance for those using Federal Exchanges. The Washington Times reporting from the Department of Health and Human Services estimates that nearly 8 million Americans could lose their subsidies if the justices rule against the Administration. Commonweal Magazine urges the justices and political leaders to keep federal subsidies intact with their piece titled, "We Would Miss Obamacare." The writers highlight the positive shifts to insurance affordability and accessibility while expanding the conversation to questions about the common good and the needs of the poor (https://www.commonwealmagazine.org/we-would-miss-obamacare).

In 2013 the United States Conference of Catholic Bishops' Department of Justice, Peace, and Human Development produced a report titled "Access to Health Care." In it, the bishops remind the faithful that health care "is a basic human right" and "an affirmation of human dignity." ("Access to Health Care," USCCB, http://www.usccb.org/issues-and-action/human-life-and-dignity/health-care/upload/2013-02-Health-Care-backgrounder.pdf) The chairman of this group, Most Reverend Thomas G. Wenski, recently wrote another letter to the U.S. Congress concerning the budget. The Archbishop reminds leaders that the "moral measure of the federal budget is not which party wins or which powerful interests prevail, but rather how those who are jobless, hungry, homeless, or poor are treated." ("Letter To Congress On Federal Budget Resolution For Fiscal Year 2016," USCCB, http://www.usccb.org/issues-and-action/human-life-and-dignity/federal-budget/letter-to-congress-from-archbishop-wenski-bishop-cantu-on-federal-budget-fy-2016-02-27-2015.cfm).

Catholic magazines and online forums have brought this conversation to the wider faith community. The cover of US Catholic's March issue highlight this very concern with Murphy-Gill's piece, "Uncovered: Who's Still Not Getting Health Insurance." She brings to light the neediest in our communities: migrant workers, undocumented families, and those with mental illness. These populations remain outside the umbrella of the ACA. Another concern exists for those who do qualify but are "still on the hook for deductibles that can top $5,000 for individuals and $10,000 for families" ("Unable to Meet Deductibles or the Doctor," New York Times, October 17 2014). These recipients are then unable to afford the deductible cost while still paying for the monthly premiums - a very difficult financial situation for those in need. No doubt readers and others in the ministry continue to see members of these groups enter their facilities without proper health insurance or the inability to pay their deductible. It is a population with unique challenges, but one that deserves our attention. For resources on how to help in one's local facility, see CHA's e-module "Welcoming the Stranger."

America Magazine questions the current discussions happening within Congress. The website recently printed a piece titled, "Bishops Say, Protect the Poor." The Jesuit online publication reports the cuts to Medicaid and CHIP programs proposed by current Congressional leaders. The writers of the article remind us all, "that the needs of hungry, homeless and unemployed people must be the country's highest priority." ("Bishops Say, Protect the Poor," America Magazine, April 2015, http://americamagazine.org/issue/bishops-say-protect-poor)

The Catholic Health Association continues to lead the charge for broader access. CHA recently filed a friend-of-the-court brief urging the U.S. Supreme Court to maintain health care subsidies. (CHA, http://ncronline.org/news/politics/cha-brief-urges-us-supreme-court-maintain-health-care-subsidies).

As the lawyers battle in the courts and the politicians in the legislatures, American Catholic leaders stand behind the call to heal the sick and help the poor. However the Affordable Care Act lives on, Catholic health care must continue to find ways to provide the healing ministry of Jesus entrusted to us, especially to those most in need.

Nathaniel Hibner
Graduate Student
Albert Gnaegi Center for Health Care Ethics
Saint Louis University

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