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Special Focus: Federal Health Insurance Reform

Each year the Church and Society Mission Team has surveyed the Pastors and Elders in the MUP about what they consider the most important issues we face. Providing health care to children and poor families has consistently been the top issue. It seems that many in the MUP have taken to heart the Christian duty to help the sick and the poor.

The efforts of the Church and Society Mission Team have focused on State issues and in Missouri, the health care issue came to the forefront when more than 100,000 Missourians including nearly 50,000 children were cut from the state Medicaid program in 2005. The C&S Team has been tracking state attempts for the succeeding four years to reverse those cuts.

In the last four years, attempts to expand health care coverage in Missouri have had very limited success. However in the last four months Congress has began action which may result in significant expansion of the availability of affordable health insurance in our State and Nation. Although national issues are generally beyond the scope of the MUP C&S Team, we have decided to provide some factual information to the members of the Missouri Union Presbytery.


Why do we need it?

Nationally, there are an estimated 25 million very poor and working poor who are uninsured. There is a need to provide “affordable choices” for those without insurance.  At the state level there have been proposals to expand Medicaid or establish a state subsidized private plan. The new national proposal will likely include a new “insurance exchange” or a public option.

Reform at the national level is intended to

  • Provide more security and stability to those who have health insurance.
  • Prevent insurance companies from dropping people or not renewing coverage when a person gets sick.
  • Provide coverage to those unable to buy insurance because of preexisting conditions. It is estimated that 6 million uninsured people work where insurance is available Most often they do not participate because of pre-existing conditions or costs.


A stated goal of the national proposal is to slow the growth of healthcare costs.


Myths and Facts


Proposed legislation will empower a panel to decide end-of-life care for Americans.

This is a myth that has unfortunately been spread far and wide by defenders of the status quo. There is no such panel in any of the bills being considered in Congress, period. To the contrary, the House bill gives Americans and their families more choice and will pay for a visit to your doctor for counseling and information on end-of life decisions if, and only if, they choose to pursue it.


The House legislation (“section 1177”) puts off care for the disable pending “further study.”

This is a myth: for the disabled or their families can keep whatever care and coverage they currently have, but they will have additional options through Medicare for other voluntary programs. There will be a study to see how best to integrate care of the disabled into the health insurance structure.


Reform will mean children with disabilities will not get the care they need.

To the contrary, reform will make insurance more affordable, provide more options, and eliminate discrimination in purchasing health insurance so families won’t be turned down if a parent or child has a pre-existing disability or other health condition.


Free health care for illegal immigrants

Some refer to part of Section 152, which includes a generic nondiscrimination clause saying that insurers may not discriminate with regard to “personal characteristics extraneous to the provision of high quality health care or related services.” The section says nothing about “non-US citizens” or immigrants, legal or otherwise. In fact, the legislation specifically states that “undocumented aliens” will not be eligible for credits to help them buy health insurance, in Section 246 on page 143.


Reform has “death panels” to encourage suicide or to pull the plug on elderly.

At issue here is a 10-year-old VA-funded pamphlet on end-of-life issues called “Your Life, Your Choices: Planning for Future Medical Decisions.” The pamphlet encourages vets to think about the kind of advanced care they’d like to receive in various situations, to communicate those wishes to loved ones, and to formally put them into writing (including steps on how to prepare a personalized living will). With regard to the issue of suicide, the pamphlet is quite clear: Q: Can I specify that I want assisted suicide in my directive? A: No. Assisted suicide is currently illegal.


The plan for comparative effectiveness research would be used to ration services.

The issue is the part of the House bill that establishes a Center for Comparative Effectiveness Research within the Agency for Healthcare Research. They would do studies to find out which medical treatments and medications work better than others, and which are most cost-effective. The idea is that this would help doctors and patients make better-informed decisions about the most effective treatment strategies. Payment for some drugs or treatments might be limited because the studies showed a more effective alternative. It’s also expected to save money over time. To help assure that this does not lead to rationing the bill provides “Nothing in this section shall be construed to permit the Commission or the Center to mandate coverage, reimbursement, or other policies for any public or private payer.”


The government run plan will allow taxpayer funds to pay for abortions:   or

Health care reform would mandate abortion coverage in all publicly offered options.

Nothing in any of the current health care reform bills mandates insurance coverage for abortions.

Further existing federal law know as the Hyde Amendment, first passed by Congress in 1976,  prohibits the use of federal funds to pay for abortions except in the case of rape, incest, or when a pregnant woman’s life is endangered. None of the insurance reform proposals changes the Hyde amendment so this limitation will apply to any government run health plan.

The issue appears to hinges on the fact that private insurance companies do sometimes cover abortions and to the extent the health insurance reform proposals help women qualify for or pay for private insurance; they may have insurance coverage for abortions. Also, under the exceptions in the Hyde amendment there are currently a limited number of abortions provided under public plans.

Health insurance reform does not change the rules limiting abortion; it does provide more accessible and affordable health insurance which already may include abortions procedures.


Health Insurance reform will add nothing to the federal deficit.

Expanding health care coverage to many millions of additional Americans and subsidizing the cost of health insurance for many millions more will be very costly. The President has claimed that there will be enough cost savings to offset the increased costs and the proposal will not add to the deficit. The three areas of cost savings are reduced payments due to errors, waste and fraud; lower treatment costs due earlier diagnosis and more preventive care and overall “bending the cost curve” to provide an lower cost of health care.

While most experts agree there are billions in savings that can be gained from numerous changes being adopted in the health insurance reform measure, many experts also estimate that the costs savings will not be sufficient to cover all the expansion costs. It is very likely there will be a net additional cost to the taxpayers. Estimates of the additional net cost vary widely because first we do not yet know which provisions will be included in the final law and second, experts disagree on the estimated out year costs and savings associated with the various provisions. As the final bill is draft, look for the Congressional Budget Office (CBO) estimate as it is often consider the final word although not all will agree.