Presbyterians Pro-Life
March 1996*
*Contact PPL for a 2002 updated booklet about the Medical Plan and Abortion

Freedom of Conscience:
The Presbyterian Church (USA) Medical Plan and Abortion

Is freedom of conscience an issue in our Church's Medical Plan?

Yes, because...

...Our denomination's Medical Plan pays for any abortion done for any reason, at any time during pregnancy, for Plan members and their dependents. This fact is not disputed by Plan administrators.
...The Plan is mandatory as part of the Terms of Call for all pastors installed in churches.
...Based on the teachings of the Scripture and the Confessions of the Church, many Presbyterians have moral objections to their tithes and offerings being used to pay for abortions. They seek a solution that would enable them to support their pastors and churches financially without having their contributions used to pay for abortions.
...Other Presbyterians, who may not object personally to paying for abortions, nonetheless respect the consciences of those who do have moral objections, and would like to see an alternative implemented that would provide relief of conscience.

This document provides more complete information and requests your help in appealing for a morally acceptable solution.


1. How does the denomination's Medical Plan work?
The Medical Benefits Plan of the Presbyterian Church (USA) is designed by the Board of Pensions with the approval of the General Assembly. The Board of Pensions of the Presbyterian Church (USA) is the insurance carrier. Members send their medical claims to the Board of Pensions and they are paid by the Board of Pensions.

The current Medical Benefits Plan was a result of merging the plans of the northern and southern streams of the Church, and was adopted by the General Assembly in 1986. Although the plan covers any abortion done for any reason at any time during pregnancy, no General Assembly ordered or recommended abortion coverage. Initially the plan description made no mention of the abortion coverage. It was only as a result of letters of inquiry from pastors that the abortion coverage came to light. Subsequent revisions of the plan description included reference to abortion coverage under "Pregnancy and Childbirth Services."

The Board of Pensions is a non-profit corporation located in Philadelphia. The Medical Plan booklet explains that "...the plan shall be construed and administered in accordance with the laws of the Commonwealth of Pennsylvania."(1) However, Pennsylvania law (18Pa C.S.A. Sect. 3215 (e)) states:

Insurance Policies. All insurers who make available health care and disability insurance policies in this Commonwealth shall make available such policies which contain an express exclusion of coverage for abortion services not necessary to avert the death of the woman or to terminate pregnancies caused by rape or incest.

The church plan does not comply with this provision of Pennsylvania law.

2. Who is covered by the Plan? Who pays for it?
The Plan is mandatory and church members' contributions pay the dues. While the denomination's medical plan is optional for a great number of church employees, it is mandatory for pastors installed in churches.(2) Pastors and their dependents are covered by the Plan.

A congregation must provide membership in the Church's pension and medical benefits plan as a mandatory component of its terms of call for a pastor. The tithes and offerings of church members pay the dues which fund the plan.(3) The dues the congregation must pay to cover the pension and health plan is an amount equal to a percentage of the pastors annual income.(4) This percentage may change from year to year. Since 1993, it has been 28%: 12% of the dues has gone into the pension fund and 16% has gone toward the medical plan. If a pastor's income is $40,000, for example, the church will pay a total of $11,200 in dues to the Board of Pensions--$4,800 to the pension fund and $6,400 to the medical plan.

3. What abortions does the plan pay for?
The plan pays for any abortion, for any reason, at any time during pregnancy. Abortion is covered by the Church medical benefits plan without limitation even though the plan itself says that "All medical treatment, services, and supplies must be necessary..." (5) in order to be covered.

4. Didn't the new abortion policy adopted in 1992 modify abortion coverage by our medical plan?
The 1992 abortion policy of the General Assembly states that "We affirm that abortion should not be used as a method of birth control," and that "abortion is not morally acceptable for gender selection only or solely to obtain fetal parts for transplantation," and that "it is preferable for [abortion] to happen earlier rather than later," and "abortion ought to be an option of last resort."

In 1988 the General Assembly instructed the Board of Pensions to state in its material that abortions should not be elected only as a convenience or to ease embarrassment and that abortions should not be used as a method of birth control. However, the General Assembly added that in no way is the Board of Pensions expected to police the use of this policy. (6)

The Board of Pensions has updated its statement to quote from the 1992 abortion policy. However, officials admit that they make no attempt to determine the reason for an abortion when a claim is submitted. Moreover, neither the "Exclusions and Limitations" section of the description of Major Medical Benefits (3-94) nor "The Terms of the Benefit Plan of the Presbyterian Church (USA) (1994)" make reference to any limitations on abortions: all abortions are covered. Abortion coverage has not been modified by the new abortion policy adopted in 1992.

5. Does current denomination policy consider any abortion sinful?
Although the 1992 abortion policy does not call any abortion a sin, it does say that "Abortion is not morally acceptable for gender selection only or solely to obtain fetal parts for transplantation." (page 11.) And it says that Presbyterians have "agreement that taking human life is sin." While the policy says that Presbyterians hold "varying points of view about when human life begins," it is notable that all but one of those points of view apply to the child in the womb. Presbyterian Research Services found in a survey they did in 1990 that two-thirds of Presbyterians identify the beginning of a human life at some point before birth, and that approximately one-third of the Presbyterian respondents to their survey believe that human life begins at conception. The clear conclusion from the abortion policy's statement is that for those who hold that human life begins before birth, the Board of Pensions is causing them to sin by the requirement that they pay the dues that cover the unrestricted abortions provided by the medical benefits plan.

6. Why is mandatory participation in a medical plan that covers abortion a problem for individuals and churches?
For those who are persuaded that a human life begins at conception, abortion is the intentional killing of an innocent human being, a practice forbidden by Scripture and the Confessions of the Church. Therefore, the required payment for abortion creates a crisis of conscience both for pastors required to participate in the medical plan and for church members whose contributions to their local church are used to fund the plan. Efforts to appeal to the Board of Pensions and to the General Assembly have not yet been successful either in eliminating or limiting the coverage of abortion. Requests from pastors to be allowed to seek alternative medical insurance coverage for reasons of conscience have been rejected.

7. Have church courts ever considered whether mandatory abortion coverage is consistent with Scripture and the constitution of the PC(USA)?
In 1991, as a matter of conscience, the session of Latta Memorial Presbyterian Church in Christiana, Pennsylvania withdrew from the medical portion of the benefits plan and obtained alternative coverage for their pastor and his family from an insurance company that does not cover abortion. As a result, the presbytery found the church to have failed to meet the minimum terms of call.

The church originated an overture (91-72) which was sent by the presbytery to the General Assembly requesting "...some method of providing relief for congregations who object, as a matter of conscience, to participation in the denominational medical plan to the extent that it funds abortions...."

But Latta Memorial also asked the church courts to consider whether Scripture and the Church's Constitution supported the presbytery's decision that payment for abortion was necessary to meet the minimum terms of call for a minister of the Word and Sacrament in the Presbyterian Church (USA). The Synod Court found that "...the complainant has a reasonable basis in Scripture and the Confessions to believe that abortion is the taking of human life. This is a theological position consistent with the Reformed tradition. The Confessions and Scriptures forbid us to participate in the willful taking of human life...." and that "...Presbyteries and the General Assembly ...must allow for relief from mandatory participation in the Board of Pensions medical plan for those who...believe that abortion is the taking of human life."(7)

8. Did the General Assembly recognize the need for relief of conscience?
The 1991 General Assembly acted on the Latta Memorial overture by establishing a "Committee on Conscience" which was composed of members of the Board of Pensions and members of the Special Committee on Problem Pregnancies and Abortion. The Special Committee was preparing the study paper on problem pregnancies and abortion and drafting policy recommendations for the 1992 General Assembly. None of the Special Committee members who signed the (pro-life) minority report were selected for the "Committee on Conscience." The chairman of the "Committee on Conscience" was a member of the Board of Pensions. The conscience committee considered and rejected these six methods proposed to provide relief of conscience:

1. Provide separate plans: one with abortion coverage, the other with no abortion coverage.
2. Provide an optional rider to the plan.(8)
3. Require those submitting claims for payment for abortion to file a statement concerning the medical necessity of the abortion.
4. Drop abortion coverage.
5. Allow churches to opt out of the medical plan.
6. Use outside fund source to pay for abortions (probably voluntary donations from church members).

Instead the committee recommended, and the 1992 General Assembly adopted, a method called "Capturing Dues for Alternative Use."(9)

9. What is "Capture of Dues"?
Following the General Assembly action in 1992, the Board of Pensions set up an administrative procedure for capturing dues. Under the "capture of dues" provision, a session which decides that paying for abortions violates their conscience may apply to the presbytery for "dues capture." From 1992 until January of 1996, that meant that a small percentage of their dues would be set aside for an alternative use.(10) The remainder of their dues went into the fund from which all claims were paid including abortion claims.

10. Did Presbyterians find the "Capture of Dues" process satisfactory for relief of conscience?
Those Presbyterians who had been protesting that a mandatory medical benefits plan that covers unrestricted abortions is a violation of their consciences before God found the "Capture of Dues" process completely ineffectual in providing relief of conscience for the following reasons:

Many churches applied for "capture of dues" as a way of registering their protest of the Church's abortion coverage. They stated their conviction that the "capture" did not provide relief of conscience.

11. What has happened since adoption of the "Capture of Dues" in 1992?
Just one year after the adoption of the Capture of Dues, the 1993 General Assembly Pensions Committee received another overture requesting that abortion coverage be dropped from the medical benefits plan. While the majority of the committee voted against the request, approximately one third were persuaded that "Capture of Dues" was insufficient to provide relief of conscience. These members submitted a minority report asking the General Assembly to direct the Board of Pensions to eliminate abortion coverage except in cases of threat to the physical life of the mother.

The 1994 General Assembly heard another overture from the presbytery of Western Reserve asking for relief of conscience. That year, nearly half the members of the Pensions Committee, lacking one, voted for the overture. Though the assembly did not adopt the minority report which asked for study of options that would offer true relief, it was clear that "Capture of Dues" was not laying the matter of conscience to rest.

In January of 1995, the Board of Pensions invited representatives of Presbyterians Pro-Life and of presbyteries that had sent up overtures on this subject in recent years to meet with them at their Philadelphia offices. At that meeting PPL set forth two minimum criteria necessary to provide relief of conscience:

As a result of that meeting, a Board of Pensions task force presented a new proposal for relief of conscience at the March 1995 meeting of the Board of Pensions. This proposal appeared to incorporate some of the requests of those seeking relief of conscience. The executive committee adopted the proposal with a single dissenting vote. The proposal was then scheduled to be presented as the executive committee's recommendation to the full board during its meeting two days later.

On the intervening day, three abortion-rights advocacy groups in the denomination--the office of Women's Ministries, the Women's Advocacy Committee, and the Presbyterian Health, Education, and Welfare Association (PHEWA) network called Presbyterians Affirming Reproductive Options (PARO) sent faxes to the Board of Pensions objecting to the proposal. As a result, the executive committee of the Board changed its recommendation and the Board decided to study the matter some more.

In October 1995, PPL received from the Board of Pensions a very different proposal for "improving" the Capture of Dues process and was asked to comment on it. PPL responded by restating the criteria put forth at the previous January meeting, and showed how the new proposal, drawn up without consultation with those whose consciences are violated, failed to meet those minimum criteria. PPL also suggested what changes could be made to meet the criteria.

Over the objections of those whose consciences are violated, the Board of Pensions adopted a Revised Capture of Dues process in October 1995, effective in January 1996. William A. Brafford, Presbyterian elder, federal court attorney, and member of the PPL team at the January 1995 meeting with the Board of Pensions, commented on the new proposal:...

This is the second time the Board of Pensions has adopted a "relief of conscience" measure which is acceptable mainly to those who do not have conscientious objections to abortion.

12. How does the revised "Capture of Dues" process work? Where do things stand now?
Under the revised "capture of dues" process, effective January 1, 1996, all dues from churches that have not applied for relief of conscience will go into a General account. All dues from churches that apply, or have applied, for relief of conscience, will be put into a separate account. From that separate account all claims from relief of conscience churches will be paid, including abortion claims, according to Board President Detterick.

Further, funds will flow from the "separate" account into the "General" account and from the "General" account to the "separate" account to ensure that all claims are paid and that no excess funds sit idle in the "separate" account. Any excess amount in the "separate" account will be used for administrative expenses of the "General" account, thus freeing up more "General Account" money for use to pay claims, including abortion claims.

Under the revised procedure, no church member's contributions are protected from paying for abortions for any reason at any time during pregnancy. The extent of the Board of Pensions' coverage exceeds what even the liberal 1992 abortion policy considers moral. Ours is the only denomination that both requires membership in the plan for all installed pastors and covers all abortions. Ours is the only denomination that offers its members no choice about paying for all abortions.

13. What can a local church do?
Churches that do not oppose coverage of abortion nevertheless may oppose mandatory payment for abortion, especially as a requirement for church membership and pastors' terms of call, because of the crisis of conscience it creates for other Presbyterians.

Many of those who oppose payment for abortion by the church on moral grounds feel they have a spiritual responsibility to see that some action is taken. Presbyterian Church government and policies currently provide for the following actions.

A sample overture is included at the end of this document. Overtures to the General Assembly originate in church sessions, but they must be passed by presbyteries in order to be sent to the General Assembly.

The overture process and deadlines for submitting overtures are in the Manual of the General Assembly, available from the Office of the General Assembly, 100 Witherspoon St., Louisville, KY 40202. Overtures must be postmarked no later than 45 days prior to the convening of General Assembly (120 days for a constitutional change).

An increasing number of churches are surprised to discover how church member contributions are being spent, particularly at synod and General Assembly levels. Finding denomination leaders unresponsive to their concerns about moral and spiritual faithfulness, some local churches have begun not only to designate their mission giving, but also to withhold and redirect some or all of their per capita giving. The General Assembly Permanent Judicial Commission, in 1992, noted the legitimate refusal to pay per capita "for reasons of conscience." Referring to per capita, it ruled that, "A church may neither be compelled to pay nor punished for failure to pay any amounts pursuant to such plan."(12)

14. What can an individual church member do?
Every church member is responsible to be a good steward of the resources God has provided, and each has a responsibility to speak out and act on matters where the rules of human beings or institutions are in conflict with the law of God. (13)

Church members should seek their sessions' help in appealing for change of the church's requirement that their tithes and offerings be used to pay for abortion, so that they can give their contributions with a clear conscience before God. They should make their convictions known to the Board of Pensions.

Some members who for reasons of conscience are unable to fund abortion through their tithes and offerings, and whose appeals to their own sessions have gone unheard, have designated their giving specifically to ministries of the church that do not pay for abortion. This is not a good long-term solution because it requires withholding contributions from support of pastors' salaries, and from medical and pension benefits necessary to the well-being of those who serve the church.

Church members ought to honor the body and those in governance over them. Only when those in governance over us compel us to violate Scripture are we called to resist in order to preserve a clear conscience before God.


Endnotes:

1. "The Terms of the Benefits Plan of the Presbyterian Church (USA)," Article I, section 1.4.

2. The Pension Board explains that the mandatory nature of the plan is necessary to the plan's integrity. Nevertheless, for more than 50% of denomination employees, including some categories of ordained clergy, the plan is optional. The list of those for whom coverage is available but not mandatory includes missionaries, licensed and commissioned church workers, directors of Christian education, directors of music, business managers, lay employees of local churches and governing bodies, agencies or other organizations in the church. Supply pastors, institutional pastors, chaplains, ministers at large, and PC(USA) executives are exempted from mandatory coverage. (Information taken from The Terms of the Benefit Plan, Article III, Section 3.1, 1993, and from Comparative Statistics, 1991, Office of Research Services, Presbyterian Church (USA), Louisville.)

3. Though all members' contributions, are used to pay the dues of the Plan, regardless of their moral convictions, the most recent Presbyterian Panel on abortion showed that at least three quarters of church members are morally opposed to abortion except in cases of rape, incest, serious fetal defect, or endangerment to the mother (Presbyterian Panel Report, Research Services, Presbyterian Church (USA), Louisville, June 1990, p. 25).

4. Total income equals salary plus housing allowance and any deferred compensation.

5. "Major Medical Benefits, Benefits Plan of the Presbyterian Church (USA)," 1989, p. 11.

6. Minutes of the 200th General Assembly, 1988, P.98.

7. Decision of the Permanent Judicial Commission of the Synod of the Trinity of the Presbyterian Church (USA) in the Remedial Case 274-1, George L. Wilson, et al., Complainant v. Presbytery of Donegal, Respondent, September 29, 1992. Donegal Presbytery appealed the decision to the General Assembly Permanent Judicial Commission. Without commenting on the synod decision, the General Assembly Permanent Judicial Commission ruled that the medical benefits plan is mandatory and no exceptions will be made.

A copy of the synod trial transcript is available from PPL.

8. The Presbyterian Church (USA) benefits plan has optional benefits provisions which include a dental plan (Article 15), death benefits (Article 16), and an optional retirement savings plan (Article 17).

9. The methods of relief which the committee considered, and the "Capture of Dues," are explained in the Minutes of the 204th General Assembly, Part I, 1992, pages 808-812.

10. Under the 1992 provision for captured dues, when their request was granted by the presbytery, an actuarially determined percentage of their dues was captured and set aside for an alternative use. The amount set aside was an approximation of the percentage of dollars spent in the preceding year on abortions relative to the total number of dollars spent on all medical claims. For example, if in 1993 a pastor's income was $40,000, the local church was required to pay $6,400 (16% of the total income) in dues to cover the medical plan. To determine how much would be captured, the $6,400 was multiplied by 0.024% (a percentage based on the cost of abortions paid for in the previous year). The resulting amount of $1.53 was then set aside into a special fund. The special fund was not earmarked for any specified purpose but could be used only for already-covered benefits of the medical plan.

11. Book of Order, G-1.0301, and the Book of Confessions, 6.109 (The Westminster Confession of Faith), The Constitution of the Presbyterian Church (USA).

12. Minutes of the 204th General Assembly, Presbyterian Church (USA), Part I, 1992, Remedial Case 204-5, Session of Central Presbyterian Church v. Presbytery of Long Island, p. 179-80.

13. See the Scots Confession, 3.20, "So far then as the council confirms its decrees by the plain Word of God, so far do we reverence and embrace them...," etc; the Second Helvetic Confession, 5.011-5.013, "Wherefore we do not permit ourselves, in controversies about religion or matters of faith, to urge our case with only the opinions of the fathers or decrees of councils; much less by received customs, or by the large number of those who share the same opinion, or by the prescription of a long time. WHO IS THE JUDGE? Therefore, we do not admit any other judge than God himself, who proclaims by the Holy Scriptures what is true, what is false, what is to be followed, or what to be avoided...," etc; See also "The Constitution of the Presbyterian Church (USA) and the Matter of Conscience" at the end of this document.


Suggested Overture

Protect Presbyterians from the sin of complicity in the taking of human life through abortion

Whereas, the Presbyterian Panel of 1990 found that between 58% and 65% of Presbyterians, polled separately as members, elders, pastors and specialized clergy, hold that human life begins at some point before birth (Presbyterian Panel, June 1990, results from Question 15, page A-6); and

Whereas, the current PC(USA) abortion policy says that "Presbyterians hold varying points of view about when human life begins," and lists "The five most common viewpoints," four of which hold that human life begins before birth (from the Report of the Special Committee on Problem Pregnancies and Abortion, adopted as policy by the General Assembly, 1992, section E.1.n., p. 11); and

Whereas, the current abortion policy of our denomination also says that taking human life is sin (E.1.n., p. 11); and

Whereas, for those who hold that a human life has already begun before birth, abortion would be the taking of that human life; and

Whereas, the medical benefits plan will pay for any abortion for which a medical claims form is submitted; and

Whereas, all church members are required to pay for abortions because their offerings are used to pay dues for the Board of Pensions medical benefits plan, which is a mandatory part of the terms of call for all installed pastors; and

Whereas, the Board of Pensions' policy of reimbursement for abortion therefore results in requiring a significant number of Presbyterians to pay for what they believe is the taking of a human life and therefore, in the words of the denominations abortion policy, "to sin"; and

Whereas, Scripture teaches our responsibility to help brothers and sisters avoid sin (Matt. 18:6; Rom. 1:32); and

Whereas, current denomination abortion policy, which makes void all previous actions and policies (General Assembly Council Mission Policy Checklist (1973-1995), p. 54), makes no provision for abortion coverage by the church's medical benefits plan; Therefore, be it

Resolved, that the Presbytery of __________ overtures the ___ General Assembly (199_) to protect Presbyterians who believe abortion is sin, from the sin of complicity in the taking of human life by directing the Board of Pensions to provide a medical benefits plan which will not pay for abortions, except that any procedure necessary to save the physical life of the woman will be covered.


The Constitution of the Presbyterian Church (USA) and the Matter of Conscience

"God alone is Lord of the conscience, and hath left it free from the doctrines and commandments of men which are in anything contrary to his Word, or beside it in matters of faith or worship". and, ".... All synods or councils since the apostles' times, whether general or particular, may err, and many have erred; therefore they are not to be made the rule of faith or practice, but to be used as a help in both"
The Westminster Confession of Faith, 6.109, 6.175

".... no opinion can be either more pernicious or more absurd than that which brings truth and falsehood upon a level, and represents it as of no consequence what a man's opinions are. On the contrary, we are persuaded that there is an inseparable connection between faith and practice, truth and duty. Otherwise, it would be of no consequence either to discover truth or to embrace it."
Book of Order, G-1.0304

".... all church power, whether exercised by the body in general or in the way of representation by delegated authority is only ministerial and declarative; that is to say, that the Holy Scriptures are the only rule of faith and manners; that no Church governing body ought to pretend to make laws to bind the conscience in virtue of their own authority; and that all their decisions should be founded upon the revealed will of God. "
Book of Order, G-1.0307

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