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A UMNS Report
By Heather Hahn*
12:00 P.M. ET June 28, 2012
The U.S. Supreme Court upheld the Patient Protection and Affordable Care
Act in a ruling announced Thursday, June 28. Jim Winkler, general
secretary of the Board of Church and Society, which filed an amicus
brief in the case, spoke at a rally in Washington in March 2012. A
Web-only photo courtesy of the United Methodist Board of Church and
Society.
The U.S. Supreme Court, by a 5 to 4 majority, largely upheld the
Patient Protection and Affordable Care Act, President Obama’s health
care legislation.
Some United Methodists hailed the decision, saying the law’s
provisions will help extend health insurance to the poor and even save
local churches money. But, even proponents agree the legislation
likely will need improvements.
The majority ruling, announced on the morning of June 28, held that
the much-contested mandate that all Americans buy insurance is
constitutional under the U.S. government’s taxing authority.
The top court, in the opinion, National Federation of Independent Business v. Sebelius,
also upheld most of the provision requiring states to comply with new
eligibility requirements for Medicaid. The court ruled that states
could lose only new federal funds – not their entire funding – if they
did not comply with the new requirements.
“My first reaction is pleasant surprise and a sense of relief,” said
Dr. Wayne J. Riley, president and chief executive officer of Meharry Medical College School of Dentistry
in Nashville, Tenn. “The Medicaid expansion we feel is a very
important first step toward extending health insurance toward minority
and underserved communities.”
Meharry, a United Methodist-related medical, dental and research
university, is the United States’ largest private, historically black
medical school and, according to a 2010 study, one of the nation’s top producers of primary-care physicians.
“Since our business is training physicians and dentists to serve
low-income communities in part, we think this is very good for our
potential patients,” he said.
The United Methodist Board of Church and Society, the agency charged
with advocating for the denomination’s social teachings, was among
more than 60 religious groups that joined in an amicus brief in support of the Medicaid expansion.
Also joining in the same brief was the United Methodist Women unit at Biltmore United Methodist Church in Asheville, N.C.
“I think this is great day for thinking about health care in this
country and how it’s going to cover 33 million more Americans,” said
the Rev. Cynthia Abrams, who directs the health care advocacy program
for the Board of Church and Society.
She applauded the court’s limitations on how the federal government
can withhold Medicaid funding. If states lost all their federal
matching Medicaid funds, the people most affected would be low-income
people, Abrams said.
Impact on local church
Among the beneficiaries of the new law, Abrams said, will be local United Methodist churches.
She said some annual (regional) conferences are planning to use the
state-based insurance exchanges that are scheduled to be operational by
2014.
“If they do that,” she said, “then clergy and local church employees
will be in a larger risk pool, which will include a healthier
population than just the United Methodist clergy. That will decrease
costs in terms of health insurance premiums.”
Surveys repeatedly have found United Methodist pastors in the United States have a higher incidence of health problems than their peers.
Abrams said many local churches also will be able to take advantage
of a new small-business tax credit under the health-care law.
Lonnie Chafin, the treasurer of the Northern Illinois Conference,
estimates the law will reduce the conference’s annual budgets from
$15,500 to $6,000 per appointment. “I believe that many of the
associate pastor positions that went to lay people to shed benefits can
transfer back to elders,” he said. “I reckon we will gain 20
appointments in associates and small church pastorates.”
Abrams added that fewer dollars spent on health benefits would leave
more resources for programming at the local church.
Differing opinions
United Methodists, like most Americans, have taken varying positions on the health care legislation.
When the law was approved in 2010, the majority of United Methodist
lawmakers in the U.S. House of Representatives voted against the plan.
However, then-Speaker Nancy Pelosi, D.-Calif., referred to The United
Methodist Church as one of many organizations “sending a clear message to members of Congress: Say yes to health care reform.”
More specifically, the United Methodist Board of Church and Society
was included on Pelosi’s website in a list of organizations supporting
reform.
A June 21-24 survey
by the Public Religion Research Institute found a plurality (43
percent) of Americans opposed the U.S. Supreme Court overturning the
health care law. The same poll found white mainline Protestants divided
with 44 percent in favor of overturning the law and 34 percent
opposed.
On June 28, United Methodist lawmakers’ reactions split largely
along partisan lines, with Republicans decrying the decision and
Democrats hailing it.
“I am disappointed in today’s Supreme Court decision,” said U.S.
Rep. Kay Granger, a Republican from Texas, in a statement. “The court
decided the health care law was constitutional. It did not decide it was
good policy.”
U.S. Rep. Emanuel Cleaver II, a Democrat from Missouri, and an
ordained United Methodist elder, said in a statement that the decision
marks “an historic day in this country — but not a day to deepen our
divisions or throw up our hands and say our work is done.
“For all Americans, Republicans and Democrats, the states and the
federal government must continue to work together to make sure health
care is functional, full and fair.”
Good News, an evangelical caucus, has criticized how the Board of
Church and Society advocated for the legislation. The Rev. Keith
Boyette, the chair of the board of Good News, said the caucus saw the
agency’s lobbying tactics as too partisan. However, Good News never has
taken a position on the legislation itself.
Boyette, an attorney and former member of the United Methodist
Judicial Council, said he sees the June 28 ruling as momentous as the
U.S. Supreme Court’s decision to uphold Social Security.
“Now the principle that the government is going to be involved in
insuring health care has been established,” said Boyette, the founding
pastor of Wilderness Community Church in Spotsylvania County, Va. “Now
the question will be the mechanics of that, and that will be where the
battles are fought.”
The ruling on June 28 did not address the legal challenges against
the requirement that employers provide workers with contraception
insurance coverage. Those lawsuits filed by at least 55 individual
plaintiffs are just beginning to work their ways through the courts.
United Methodists, including Boyette, have varying views on whether the requirement related to birth control violates religious freedom.
An historical position
Going back to its founder John Wesley, the Methodist movement has historically supported access to health care for all.
Wesley preached on the biblical mandate to care for the sick, and he set up the first free public clinic in London, which he ran until it became too expensive for his limited resources. Later, he wrote “Primitive Physick,” a self-help primer on health and medicine for individuals too poor to pay for a doctor.
“It’s kind of neat that on the day of John Wesley’s birthday
we’re celebrating something that I think he would be justifiably proud
of because of his commitment to make sure poor people were taken care
of,” Abrams said.
United Methodists have continued Wesley’s commitment to ministry
with the sick with church-supported health clinics, hospitals and
nursing homes. The United Methodist Association
today represents more than 380 United Methodist-affiliated health and
welfare ministries, including hospitals and retirement communities.
But the denomination’s official position is that the church and its members cannot provide comprehensive health care alone.
“Providing the care needed to maintain health, prevent disease, and
restore health after injury or illness is a responsibility each person
owes others and government owes to all, a responsibility government
ignores at its peril,” asserts the Book of Discipline, the
denomination’s lawbook.
Resolution 3201 in the United Methodist Book of Resolutions, which
contains the denomination’s pronouncements on social issues, also tasks
the United Methodist Board of Church and Society with “primary
responsibility for advocating health care for all in the United States
Congress.”
General Conference — the denomination’s highest legislative body — approved the resolution in 2008. However, the assembly has not endorsed any specific U.S. legislation.
More work to be done
Even proponents of health care law say more work needs to be done to
ensure the nation’s poor have access to health care.
Dr. Ted Hill, a physician and ordained United Methodist deacon, is the medical director of the Salvus Center, a faith-based health center in Sumner County, Tenn., that serves working uninsured.
Assuming the law stays intact, Hill said many of his current
patients will be able to access insurance by 2014. But that does not
mean that they will able to find enough primary-care doctors who can
serve them, Hill said.
“There will still be a gap of people of who have minimal coverage but they won’t have anybody to take care of them,” he said.
He added that there will still be about 17 million people in the
United States, including immigrants, who have no health insurance.
Riley of Meharry Medical College said he shares the concern that the
Patient Protection and Affordable Care Act does not do enough to
help reduce the costs of medical care. According to the Robert Wood Johnson Foundation,
which researches health policy, the United States spends a larger
share of its gross domestic product on health care than any other major
industrialized country.
Riley said some of the drivers of those costs are unnecessary tests and treatments.
Still both Riley and Hill see the health care law as an improvement to the status quo.
“Is every part of the law exactly what we need? I don’t know, and I
don’t think anybody knows,” Hill said. “But I do know there is
something on the table; there is now something to work with. If we find
that there are some things that aren’t working, my gosh, we’ve got
smart enough people to tweak those.”
*Hahn is a multimedia news writer for United Methodist News Service.
News media contact: Heather Hahn, Nashville, Tenn., (615) 742-5470 or newsdesk@umcom.org.
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