Of course, Democrats may wind up passing a plan with controversial abortion provisions over objections from the bishops and other Catholics. That would have political costs. "Moderate Catholics are big constituencies in states like Pennsylvania and Ohio," says Schneck. But opposing the final healthcare reform plan on abortion grounds could have political consequences for the church, too. As middle-class whites leave Catholicism and are replaced by immigrants, working-class concerns like health insurance are more important than ever to the church's American flock.