WASHINGTON—Today the United StatesSupreme Court issued a decision upholding as a tax the provision of theAffordable Care Act (ACA) that requires individuals to purchase a healthplan—the so-called "individual mandate."

Fornearly a century, the Catholic bishops of the United States have been andcontinue to be consistent advocates for comprehensive health care reform toensure access to life-affirming health care for all, especially the poorest andthe most vulnerable.Although the UnitedStates Conference of Catholic Bishops (USCCB) did not participate in thesecases and took no position on the specific questions presented to the Court,USCCB's position on health care reform generally and on ACA particularly is amatter of public record.The bishopsultimately opposed final passage of ACA for several reasons.

First,ACA allows use of federal funds to pay for elective abortions and for plansthat cover such abortions, contradicting longstanding federal policy.The risk we identified in this area hasalready materialized, particularly in the initial approval by the Department ofHealth and Human Services (HHS) of "high risk" insurance pools that would havecovered abortion.

Second,the Act fails to include necessary language to provide essential conscienceprotection, both within and beyond the abortion context.We have provided extensive analyses of ACA'sdefects with respect to both abortion and conscience.The lack of statutory conscience protectionsapplicable to ACA's new mandates has been illustrated in dramatic fashion byHHS's "preventive services" mandate, which forces religious and other employersto cover sterilization and contraception, including abortifacient drugs.

Third,ACA fails to treat undocumented immigrant workers and their families fairly. ACA leaves them worse off by not allowingthem to purchase health coverage in the new exchanges created under the law,even if they use their own money. Thisundermines the Act's stated goal of promoting access to basic life-affirminghealth care for everyone, especially for those most in need.

Followingenactment of ACA, the U.S. Conference of Catholic Bishops (USCCB) has notjoined in efforts to repeal the law in its entirety, and we do not do sotoday.The decision of the Supreme Courtneither diminishes the moral imperative to ensure decent health care for all,nor eliminates the need to correct the fundamental flaws described above.We therefore continue to urge Congress topass, and the Administration to sign, legislation to fix those flaws.

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Keywords: U.S. Conference of Catholic Bishops, AffordableCare Act, ACA, bishops, Supreme Court, conscience

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Sr. Mary Ann WalshO: 202-541-3200M: 301-325-7935 Email