Editorial: The Moral Mandate for Affordable Health Care for All

October 21, 2009  |  Washington Post On Faith Blog

By Fr. Joseph Schad SJ,
Hospital chaplain, Portland, Maine

When Sen. Olympia Snowe, who has represented my home state for 14 years, voted in favor of the Senate Finance Committee's health care reform bill last week, health care reform came one step closer to becoming a reality and pundits of all stripes debated whether or not the committee's accomplishment could be described as truly bipartisan.

While this question is worthy of discussion, many others are of far more consequence, such as coverage for immigrants, respect for life, conscience protections, and whether reform makes health coverage truly affordable for low-income and working families. Affordability is unique among these issues, in that it is a priority proclaimed by Senators of both parties. 

As a hospital chaplain, I'm heartened to see affordability get the attention it deserves. Over the years I have met countless families who struggle and falter under the weight of medical bills and health insurance costs that increase far faster than their income. Many have no coverage, while others have bare-bones plans that don't cover the care they need and come with high out-of-pocket costs for deductibles, co-pays and steep premiums. Even many middle-class families are concerned about losing the coverage they have due to rising costs or being bankrupted by unforeseen medical expenses. I can attest that these difficulties affect Democrats and Republicans alike.

But as of now, the bipartisan Senate Finance Committee bill does not effectively address the problem of affordability for low-income families, and if the Senate doesn't remedy the Finance Committee bill's flaws, it will not fulfill the moral mandate that has driven so many people of faith to work for health care reform. In current form, the bill's individual coverage mandate, combined with insufficient premium subsidies and inadequate expansion of Medicaid, will require too many Americans to buy insurance that costs too much and covers too little. Forcing low-income families and individuals to buy coverage they cannot afford imposes an oppressive burden and fails to alleviate one of the problems that reform is supposed to solve. Health care reform that saves some Americans from bankruptcy but forces others into it just isn't good enough. We can and must do better.

Fortunately, the Senate has the opportunity to fix these shortcomings as it melds the Finance Committee bill with the HELP Committee's legislation, and people of faith are encouraging Senators of both parties to make good on their claim that affordability is a top priority.

Together with allies in the faith community, including Catholics United, PICO National Network, Catholics in Alliance for the Common Good, Faithful Reform in Health Care and Faithful America, as well as consumer and advocacy groups, we in the Maine religious community have been saying for months that, in order for health reform to succeed, it must make coverage truly affordable for families.

As legislation continues to make its way through the Senate and House, four key areas still need to be addressed:

*Subsidies to low- and moderate-income families should be increased so that no family is expected to pay more than they can afford on premiums; *Out-of-pocket expenses for families should be capped along a sliding scale that keeps families from being underinsured; *The value of the plans offered to families should be increased in order to ensure lower cost-sharing for families; *And the age rating should be limited to 2:1 to guarantee that older adults are not charged any more than twice what younger adults pay for premiums.

While health reform legislation still has a ways to go in order to make insurance truly affordable for families, momentum is building and affordability is becoming a unifying argument amidst what has otherwise become a divisive debate. Amidst an increasingly ideological debate, we firmly believe that families of all political orientations will support reform if it actually makes their insurance more affordable. Our faith calls us not only to bear witness to the suffering we see in our communities, but to transcend our differences and work together constructively to alleviate this suffering.

Fr. Joseph Schad SJ, is a hospital chaplain in Portland, Maine.