The debate on Medicaid Faith leaders weigh in on impact of expansion

Father Alexander McDonald, pastor of St. John Neumann Church, speaks about Medicaid expansion with the S.C. Christian Action Council at the Statehouse in Columbia last month.

Christina Lee Knauss/The Catholic Miscellany

“I needed clothes and you clothed me, I was sick and you looked after me, I was in prison and you came to visit me.”

— Matthew 25:36

By Jennifer Berry Hawes

During Lent, Catholic Diocese of Charleston Bishop Robert E. Guglielmone penned a letter to his brothers and sisters in Christ.

Jesus made healing the sick central to his ministry, the bishop wrote, and the Catholic Church has remained faithful to that, creating hospitals and clinics and defining health care as a basic human right.

In closing his letter, the leader of South Carolina’s 200,000 Catholics urged followers to consider supporting a Medicaid expansion under the Affordable Care Act, other portions of which the church strongly opposes.

Yes, expanding the state-federal health insurance for low-income and disabled residents would cost everyone more, the bishop wrote, but that cost would be worth it.

“Bearing a cost for the sake of something greater is the heart of our faith,” he wrote. “It brought us salvation.”

Guglielmone is among a growing number of local and state clergy throwing support behind the controversial expansion of Medicaid, which is part of the Affordable Care Act.

Charleston’s hospital systems, numerous medical advocacy groups and the Charleston Metro Chamber of Commerce have joined advocates for the mentally ill and disabled in supporting the expansion.

And last month, the S.C. Christian Action Council, which represents 1 million state churchgoers, sponsored an “advocacy day” to urge Gov. Nikki Haley to expand Medicaid as a way to fulfill Jesus’ call to serve the suffering. The event also drew Jews, Muslims and others.

Haley and many Republican state lawmakers are leading opposition to the expansion, contending it would leave the state with an enormous bill it could ill afford. They contend that Medicaid, which already covers 1 million low-income South Carolinians, is expensive and ineffective.

It all leaves many faithful asking: If they follow Jesus’ call to help those in need, who should pay the bill?

Not all pastors are convinced that expanding Medicaid is the best way to help those who lack access to care. Yet even more conservative clergy find themselves hard-pressed to advocate against providing government health care to more poor and disabled folks.

The Rev. Kevin Baird, senior pastor of Legacy Church in West Ashley, opposes the Affordable Care Act in its current form due to what he deems religious liberty violations related to abortion.

But he considers Medicaid expansion a separate issue because it deals with providing basic medical care to those in need. He has not formed his final stance.

“Like most clergy, I want to extend compassion in areas like this, but my conservative nature is challenged as well,” Baird said. “The issues of debt that may be created by expansion makes it even more difficult.”

The Rt. Rev. Steve Wood, bishop of the Diocese of the Carolinas, also struggles with the issue.

“The poor need to be cared for — must be cared for — that is a Gospel imperative,” says Wood, also rector of St. Andrew’s in Mount Pleasant. “I honestly have to say that I don’t know the best way for the state to do that. But what we are doing is inadequate.”

Some agree with Tony Keck, director of the state agency that implements Medicaid, who has opposed the expansion. Keck has argued that the program is ineffective and dumping more money into it will create more waste and not improve health.

The Rev. Ron Dillon, senior pastor of First Baptist Church Mount Pleasant, also is debating the balance.

“On the one hand, I think we should do what is right to help the poor to get medical care. On the other hand, I agree with Mr. Keck that our system is very wasteful and needs to be thoroughly restructured,” Dillon said.

That begs a question: Should South Carolina wait for reform, which could take a long time or never happen, or “pour money into a system that does not give very good results?” Dillon asked.

The Rev. Don Flowers, pastor of Providence Baptist on Daniel Island, sees the real challenge as figuring out how to pay for lower-income folks’ care, not whether they should have it in the first place. Houses of worship simply cannot foot the multimillion-dollar bill.

“I’m not willing to go to the mat and say Medicaid is how we have to do it,” Flowers said.

But he’s not aware of a workable alternative.

Flowers, who serves as a pool chaplain at the Medical University of South Carolina, sees patients suffer from serious illnesses because they lack access to preventive care.

He also has relatives who lack health insurance. They pray their children don’t get sick or injured because they cannot afford the bills.

“If we are going to continue with this delusion that we are a faith-based, compassionate society, we have a responsibility to care for these people,” he said.

When the Rev. Jeremy Rutledge served as a hospital chaplain in Houston, he saw children with asthma come in so sick they landed in the ICU on ventilators — they and their parents terrified and the child’s health weakened. Early care could have avoided that.

Rutledge, senior pastor of Circular Congregational Church in Charleston, pointed to the Bible verse:

“Truly I tell you, whatever you did for one of the least of these brothers and sisters of mine, you did for me.” — Matthew 25:40

“Who are ‘the least of these’ more than a person who needs Medicaid?” Rutledge asked.

To him, cost isn’t the critical issue in supporting a Medicaid expansion.

“It is very clear in Jesus’ teachings that money was not very important,” Rutledge added. “He was constantly teaching us not to place our emphasis on things that are not really sacred. When we see that sick kid, all of us know what is sacred.”

The Rev. Leonard O. Griffin, pastor of Morris Street Baptist in Charleston, also pointed to numerous Bible passages that reference healing and caring for the poor. He considers doing so, as much as financially possible, to be “a spiritual and moral obligation.”

“Many people find themselves in impoverished situations or ill health through no fault of their own,” Griffin said. “Some are living in dysfunctional or abusive situations lacking the courage or means to escape without a compassionate and caring helping hand.”

The Rev. Joseph Darby contends Medicaid can provide that helping hand. The Charleston resident is presiding elder of the AME Church’s Beaufort District and was active in its passing of a resolution in March supporting the expansion.

“It is a moral issue,” Darby said. “The Scriptures urge us to see to the well-being of others, and doesn’t say that our doing so is only a matter of individual initiative.”

The S.C. General Assembly breaks for the year June 6, but the discussion is unlikely to end there.

The state’s United Methodists will tackle Medicaid expansion at their annual gathering June 9. They will consider a resolution supporting the expansion given that church founder John Wesley sought to provide free medical services to the poor and that Methodist social principles state that health care is a basic human right.

Guglielmone echoed those sentiments in his Lenten letter. Catholic bishops and popes, he noted, long have considered access to health care a basic human right.

It’s a belief in that right that Sister Mary Joseph Ritter upheld during her 20 years as executive director of the Our Lady of Mercy Community Outreach on Johns Island, where she oversaw its growth from a small facility to a campus that offers everything from prenatal and dental care to clothing and GED prep.

Ritter now serves as general superior of the James Island convent, whose nuns in 1882 founded what today is Roper St. Francis Hospital.

“The church’s social mission is characterized by a preferential love for the poor and vulnerable, ensuring that all people have the opportunity for the basic human necessities for life,” Ritter said.

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