Missouri Right to Life (MRL) PAC Responds to Criticism By Other Pro-life Organizations of MRL PAC Opposition to Amendment 2 – Medicaid Expansion
1. Abortion is not health care. It is wrong to ask the people to pay for more abortions as the price for expanding Medicaid coverage in Missouri, as Amendment 2 does.
Criticism by other pro-life organizations of MRL’s first point does not deny that the current Hyde Amendment fails to protect against abortions caused by abortifacient contraceptives and “morning after pills.” It cannot deny the obvious: greatly expanding the number of women of childbearing age who are eligible for Medicaid is likely to greatly expand Medicaid payments for abortifacients. Further discussion of the point is found in #3 below.
Most of the criticism of MRL’s position stresses the benefits of Medicaid expansion. But that misses the moral point: no matter how much good a program does, it is wrong to support it when it includes payment for an intrinsic wrong.
In 2010, the USCCB, opposed the final version of the Affordable Care Act (“Obamacare”) for three major reasons, one of which was because it would provide government funding for aborting babies that were not protected by the Hyde Amendment. That remains a sound principle in 2020.
2. It’s the wrong time to expand Medicaid when the Hyde Amendment is under attack. If Amendment 2 is approved and the Hyde Amendment falls after that, Amendment 2 may double the number of surgical abortions that Medicaid would pay for in Missouri.
Critics of MRL’s position, from other pro-life organizations, admit that the Hyde Amendment is under attack and will remain under attack after this coming election. The attack on Hyde comes from adversaries who are quite determined.
Placing Medicaid permanently in the Missouri Constitution creates a permanent threat to unborn children. Why not seek other methods through the legislative process to provide health care to those not currently covered that would allow consideration for changing dynamics from year to year?
Critics say we should trust in our Lord and not operate out of fear. With all due respect, the Lord expects us to work for the moral right. We cannot presume that the Lord will save us from the consequences of our own recklessness. People who try to cross the railroad tracks when the gates are down and the lights are flashing will not usually be saved from the oncoming locomotive.
3. Since the target population includes adults without children, expanding Medicaid will greatly expand existing Medicaid payments for abortions that are caused by “morning after” pills.
Critics of MRL's position make MRL’s point about the “morning after” pills by writing that 200,000-250,000 people may enroll in Medicaid if it is expanded. Merely stating that the number is "nearly" impossible to quantify seems to concede that such "morning after pill" abortions will increase.
Critics of MRL cannot say that it will be fewer or none, in view of the tens of thousands of women of childbearing age who will be newly eligible for Medicaid payments of “morning after” pills. So, one has to ask, how does exact computation make a difference? How many new abortions are the critics of MRL willing to tolerate until it says “Enough! No more expansion!” Missouri Right to Life holds that the number should be zero.
See Romans 3:8 And why not say—as we are accused and as some claim we say—that we should do evil that good may come of it? Their penalty is what they deserve.
(From the USCCB Website)
4. Medicaid is a program for the state and federal governments to pay health care providers. It is not a federal subsidy to the State Treasury. Nor is it “free money” – every taxpayer pays taxes to the federal government for the federal share as well as taxes to the state government for the State’s share. And every payment of federal dollars toward Medicaid expenses must be matched by the State’s percentage share of these expenses.
Critics of MRL’s position agree that expansion of Medicaid will mean another 10% of every new Medicaid expense must be paid by the State of Missouri. The Federal dollars are a “pass-through” at best for the State government, and the extra costs to the State will have to be made up from new taxes or other new sources of revenue.
A Forbes Magazine article indicated that in 2017, Missouri was one of the six states that paid the highest percentage of state government income for the Medicaid program, 22% of Missouri state tax receipts, four years before an expansion under Amendment 2.
Critics do not say how the state government can pay its share. Cutting more budget items, including current pro-life appropriations for women's centers and alternatives to abortion, would seem to be a likely source.
Critics of MRL’s position also indicate that funds come from “state and federal general revenue funds.” This is not some source other than our tax dollars. General Revenue – and all government revenue – comes from taxpayers.
5. Amendment 2 requires the state to maximize the federal share of Medicaid dollars that are paid to Missouri healthcare providers. That means the state government cannot replace federal Medicaid programs with its own Missouri-funded programs that will not pay abortionists for non-abortion services (PP) or that are simply better than the federal programs.
Apparently, critics of MRL admit all of the things that MRL said in this item. Waivers for Missouri-funded programs will not be allowed under Amendment 2 if it means forgoing federal dollars.
Critics acknowledge that Medicaid funds cannot be withheld from Planned Parenthood. So these critics, in essence, are OK supporting giving more money to Planned Parenthood.
We need to fight ANY taxpayer funds from going to Planned Parenthood. Giving them our money for “non-abortion” services is just a dodge. The money goes in the same pants, just a different pocket.
Aborting our babies by means of publicly-funded "morning after" abortifacients, and possibly later by surgical abortions, is too high a price to pay for Medicaid expansion.
6. The provision for maximizing federal dollars will also prevent the State from paying for lawyers (including the Attorney General’s staff) to attempt to obtain protection for the unborn if the Hyde Amendment is ended. The Missouri legal cavalry would not save the day; they could not even saddle up to make the attempt.
Pro-life critics of MRL’s position on Medicaid expansion may have fond hopes that states will not be forced into paying for abortions, but national public opinion is not nearly as powerful as MRL’s critics would wish. Otherwise, in 2018-2019, when Congress was under the control of “conservatives,” it would have enacted a permanent Hyde Amendment into law. That did not happen because a few U. S. Senators stood in the way.
The Democrats don’t care about public opinion. With the help of the media, they will just cram the legislation down the throats of the public. Getting rid of the Hyde Amendment is in their platform and touted by EVERY leader in the party, including Joe Biden. The 40-year history of Hyde carries no weight with the Democrats.
The critics of MRL do not even address the point that if the Amendment passes, Missouri’s own constitution would forbid state officials from attempting to do anything toward reinstating a ban on public funding of abortions. The state constitution would tie the hands of the Legislature and all Executive officials. This makes relying on the Hyde Amendment even more dangerous to the unborn.
7. It is not surprising that Planned Parenthood and other pro-abortion organizations are among Amendment 2’s most active supporters. The Supreme Court of Missouri has recently ruled that the State cannot exclude Planned Parenthood from participating in Medicaid. Expanding Medicaid would shovel more money into Planned Parenthood’s coffers just when Missouri has put the surgical abortion business on the ropes.
The critics of MRL’s position in their answer to point 7 admit what MRL has said in this item, except that it still ignores "morning after pill" abortions. Their answer also suggests that they are ok with funds going to Planned Parenthood for PP services other than abortion. This is another naïve acceptance that more money to PP wouldn’t increase abortions. If Planned Parenthood receives public money for non-abortion services, that's still a subsidy that only bolsters its financial condition. Are these pro-life critics comfortable with additional state Medicaid money going toward the largest destroyer of unborn human lives in this country?
8. Amendment 2 proposes a state Constitutional Amendment that, if adopted, cannot be amended by the legislature, but only by another vote of the people. If the state’s budget were unable to keep up with the new costs of Medicaid, the State Legislature could not change the program to reduce Medicaid expenses.
The critics of MRL’s position does not correctly describe the Cady ruling. The case was not about the implications of Amendment 2, but only whether the Amendment violated any of the procedural requirements for voting on a ballot issue. As the Court noted early in its discussion, “[A] pre-election challenge must . . . involve a 'threshold issue[ ] that affect[s] the integrity of the election itself, and [be] so clear as to constitute a matter of form.'" Cady v. Mo. Sec'y of State, slip op. at 8 (Mo. App. 2020)(quoting previous case law). The Court did not rule that if Amendment 2 is adopted, the General Assembly will be free to ignore federal or other law in regard to Medicaid appropriations. The line quoted by the MRL critics relates to the lack of any direction concerning appropriations in the precise wording of the Amendment, not with the consequences of adopting it.
Those consequences are exactly the problem. Federal Medicaid laws provide that the State cannot refuse to pay legitimate medical fees incurred when people use Missouri Medicaid plan services. The load on the State’s budget is irrelevant under the federal laws. And under Amendment 2, the State could not even use the limited discretion it now possesses to obtain “waivers” of certain Medicaid requirements in order to contain costs, because containing the State’s share of costs inherently requires reducing the federal share as well. Amendment 2 would forbid it in the section that compels maximizing the federal contributions to Medicaid. The Amendment would thus tie State Legislature’s hands on containing costs just when adjustments would be needed most. The fond hopes of the critics of MRL that “there would be a way for the State Legislature to fund the program going forward” would not pay the bills.
9. The Missouri Department of Social Services, the agency that manages Medicaid in Missouri, has estimated that the cost for the first year of expanded Medicaid services under Amendment 2 would be over $2 billion dollars, of which the share owed by the State of Missouri would be over $200 million. Where is the State going to get this money – especially since over $400 million has had to be cut from this fiscal year’s budget because of COVID-19?
In response to the question of how the State could fund Medicaid expansion, the critics of MRL simply refers to its answer in no. 8. That answer ends by again calling attention to the good that is intended by Amendment 2, but it passes over an important moral principle.
In the health care debates of ten years ago, the USCCB always supported the goal of the ACA to provide health coverage for many persons who lacked it. This is the same goal that the MCC seeks for Missourians in 2020. But as the USCCB wrote in its analysis of the ACA,
- Catholic teaching calls for opposition to a law that, on a fundamental issue such as the direct taking of innocent human life, would make governmental policy worse than before. We may support (or allow the passage of) legislation that improves the order of justice, even if the new law does so imperfectly or incompletely; we may not do so when the law will create new fundamental evils or substantially expand the scope of a present evil.
The same principle should be applied to the issue of Medicaid expansion in Missouri in 2020. The critics of MRL’s position should not be supporting an expansion of the horrible wrong of public payments for abortion as the price to pay to obtain better health care for working-class adults.