Conscience Clauses in Health Care Reform

This is a continuation of my commentary on the Bishop of Arlington’s call to fast March 15, 2010 to influence health care reform negotiations.

This Bishop and the US Conference of Catholic Bishops are under the mistaken impression that it is more important to not be tainted by having any taxpayer money fund any abortion than the provide health care to everyone who needs it, even though providing health care will likely make abortion less likely because the working poor will be better off. In other words, they would rather we all commit a sin of omission rather than one of commission.

The fact is that most abortions are paid for with cash, and will continue to be so after health care reform. Anytime one patronizes an establishment that employs low wage workers, they are likely contributing to someone’s abortion since this is often the only alternative the working poor have without good insurance. Passing reform, even without abortion protection, is more likely to stop the working poor from going to such lengths.

Much is made currently of the types of conscience clauses present in the legislation as drafted, with a preference for the Stupak language over the Nelson language. (For the record, both bills prevent direct federal funding of abortion, with Nelson requiring segregated funds with an additional payment for such coverage). You can protect the employer from contributing to the plan of an employee who wants abortion coverage or you can protect employees by offering them a plan that does not cover abortions. You cannot protect both the employer and employee, however. Someone gets the final say. I favor employee conscience protection, since it is an employee benefit, not an employer benefit. There would be no company without the workers doing the work, so unless the firm is almost totally automated (which is not really the case for low wage work), the worker deserves to autonomy in this matter.

If an employee really cares about this issue above all other employee benefit questions, he or she will not work for an employer whose insurance plan covers abortion, since otherwise their work will result in productivity which eventually funds someone else’s abortion. I doubt that this issue is so important to most workers that they will let it influence where they wish to work – especially in this economy. Given this lack of concern, there is no reason to hold up health insurance reform for another generation over it.