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HEALTH CARE ENDGAME

How the Bishops Lost, Even as Their Cause Prevailed

4 years ago
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The Catholic bishops of the United States held the best cards of all in the high-stakes showdown over health care reform, and yet remained the odd men out in the political gamesmanship on the pivotal issue of abortion. So perhaps it was inevitable that as the legislation passed the House in a historic vote, the bishops were on the outside looking in, with their soul mates in Congress abandoning them and foes thumbing their noses.

How did this happen? The paradoxes were evident from the start. Universal, affordable health care has long been considered a pro-life priority for the Catholic hierarchy; indeed, the church considers universal health care a fundamental human right. Yet the man most responsible for making that long-held hope a real possibility was Barack Obama, whom the most vocal and prominent bishops have excoriated in the harshest terms since the 2008 campaign.

Moreover, as the debate wore on, the U.S. hierarchy and its Washington staff allied itself with some of the most die-hard opponents of not only the health care bill, but of President Obama himself; they spent day after day in the trenches with Tony Perkins and the Family Research Council and the National Right to Life Committee.

In the end, the self-imposed contradictions of their position collapsed on the bishops.

Perhaps the Catholic hierarchy was riding a bit too high after their paladin in the House, pro-life Democrat Bart Stupak of Michigan, won a stare-down with Speaker Nancy Pelosi and the pro-choicers last November and succeeded in having strong language against abortion financing inserted into the bill that passed the House -- barely -- thanks to Stupak and his allies. Members of the bishops' staff were literally in the room with Stupak during the negotiations, and they had every reason to think that their new-found influence would continue to shape the legislation's route through Congress.

But when the Senate bill passed with language on abortion financing the bishops did not like, their indignation seemed exaggerated even to some of their allies. Others saw it as a sign they were intent on using a winner-take-all approach once again. But they may have showed their hand too early, and been a little too confident.

The victory of Republican Scott Brown in the Massachusetts special election to fill the Senate seat of the late Ted Kennedy stunned not only the Democrats but also meant that the Catholic bishops would have little opportunity to press for a change in the Senate bill. That's because Brown -- a supporter of abortion rights -- had vowed to vote against health care reform and thus gave the GOP 41 votes and the ability to block the legislation from coming to the floor again.

That in turn revealed another serious political weakness for the bishops -- namely, their inability to convince even one Republican in the Senate to allow the bill to go to a vote even if only to toughen the abortion language. For decades the bishops have pointed to the Republican Party as representing the pro-life position in American politics, and the Democrats the "party of death," as many of them put it. Yet when the chips were down and the bishops needed a vote, they could not summon a single Republican to support them, either in the Senate or, in the end, in the House.

Still, the pro-life line of attack that the Senate bill would lead to "massive" taxpayer underwriting of abortion-on-demand carried the day, as did many conservative complaints about the bill. Until, that is, earlier this month, as experts and pro-life supporters of health care reform began questioning the assumptions about abortion financing in the Senate bill and discovered they were based on mistaken or greatly exaggerated assumptions.

As those critiques began to gain traction and notice, at Politics Daily and elsewhere, and as it became clear the bill was headed to a vote, various players in the process began to show their hands.

On March 13, the Catholic Health Association and its president, Sister Carol Keehan, gave its backing to the Senate bill, which the House was preparing to vote on, thereby splitting with the Catholic bishops over an interpretation of the legislation's abortion provisions -- which was not, Keehan insisted, a split on their shared pro-life beliefs. A few days later a prominent coalition of nuns representing most women's religious orders in the United States also backed the bill and decried "false claims" about the its abortion funding provisions.

Those actions led many in Congress to begin re-thinking their position even as the criticism against the sisters from bishops and right-wing opponents of the bill became so sharp that it led to a backlash.

Steadily, inexorably, pro-life Democrats who had been against the Senate bill over the abortion issue began to peel away from the opposition forces, and at the same time Pelosi and the White House continued courting Stupak and the few holdouts whose votes would be critical to passage.

At the same time, however, the Catholic bishops kept digging in their heels. They began coordinating their efforts more obviously with the Family Research Council and other conservative groups close to the Republican right wing, to the extent that it wasn't clear whether the point was to oppose the abortion provisions in the Senate bill, or the bill itself.

By Sunday, when Stupak announced that he and his handful of allies would support the health care bill after receiving a guarantee that Obama would issue an executive order -- drafted by Stupak -- barring any taxpayer money from going to abortions, the bishops were left isolated and defeated. Richard Doerflinger, point man for the bishops in the pro-life effort and health care negotiations, had e-mailed congressional staffers telling them the executive order solution would not fix the bill's problems, but by then it was too late.

Stupak was their last, best hope, yet he finally decided to take "yes" for an answer.

So who are the winners and losers?

Before all this, Bart Stupak was a little-noticed congressman from northern Michigan, and while it's clear he gained an enormous amount of national recognition in these past months, it is also clear that among conservative pro-lifers his reputation has been seriously tarnished. The "Judas" charge quickly zipped around the anti-abortion blogosphere, as well as other jabs: "Bart Stupak Trusts the Promise of the Infanticide President," Deal Hudson, who has advised Republicans on Catholic outreach, wrote in one of the more literary skewerings Stupak suffered.

It was just as ugly on the floor. An unidentified congressman from the Republican side of the House shouted "Baby killer!" as Stupak was explaining his support for the measure. And of course it may take Stupak a good bit of time to repair his relations with the Democratic leadership as well as with moderate pro-lifers. Many still hold Stupak responsible for stringing the drama out for so long and nearly killing a once-in-a-generation moment with eye-popping claims that seemed to some to compare the bill's abortion provision to eugenics. Count Stupak as a winner, and a loser -- a draw.

The passage of health care reform could also quite easily be read as a serious setback for the many lobbies that oppose abortion. If their apocalyptic warnings come true -- which appears more unlikely than ever -- then they have lost the greatest battle in the abortion wars since Roe v. Wade. In addition, they could begin to see the Democrats take some of the pro-life mantle from the Republican Party, which could potentially lead to a significant electoral shift.

But groups like the Family Research Council, National Right to Life Committee and Americans United for Life have often worked most effectively when they were in the minority, much like their Republican allies. And even in the run-up to the historic bill's passage, these groups were capitalizing on fears about the legislation to raise money. They are sure to pursue that strategy with even greater fervor as the fall campaign approaches.

As for the Catholic bishops, the other central player in this drama, there appear to be few redeeming elements.

Their run as political dealmakers was cut short by their own miscalculations, and within the church they did little to burnish their already strained credibility. Politically conservative Catholics were already angry that the bishops supported such a repellent idea as universal health care in the first place, and many blame them for not succeeding in killing the bill altogether. The more liberal members, including pro-life elements, of the church, on the other hand, saw the greater (and common) good of health care reform as so obvious that they just shrugged the bishops off.

"Catholic members of Congress showed that they will not bow to the bishops when it comes to something that is outside their area of expertise -- namely the interpretation of legislative language," said Father Thomas Reese, a Jesuit priest and longtime observer of politics both inside the church and the Beltway.

And in the background, of course, is the other dominant Catholic story line of the last decade, that of the sexual abuse of children by clergy, which is emerging again in Europe and even the Vatican, doing the reputation of the hierarchy no favors.

Then again, at the end of the day Congress took a major step toward universal, affordable health care that will not finance abortions and will likely go a long way toward reducing abortions by supporting pregnant women and financing adoptions.

So the bishops won in the end, even if they don't know it. The problem is, no one else does either.

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