Advocates move to rescind 'conscience' rule
Reproductive health advocates are throwing their support behind the Obama administration's move to rescind a controversial "conscience" rule that would expand the right of health care personnel and institutions to refuse to provide or assist in the provision of services on moral or religious grounds.
The Bush regulation, enacted in December 2008, cuts off federal funding for thousands of state and local governments, hospitals, health plans, clinics, and other entities if they do not accommodate doctors, nurses, pharmacists, or other employees who refuse to participate in care they feel violates their personal, moral, or religious beliefs.1 The Department of Health and Human Services (HHS) finalized the rule despite receiving more than 200,000 letters in opposition from several medical professional associations, state officials, members of Congress, and the general public.2
Current law already protects physicians and health care providers who refuse to provide abortions and sterilizations based on religious or moral beliefs, notes the American College of Obstetricians and Gynecologists, which joined other health care organizations in asking the Obama administration to rescind the rule. In proposing to rescind the rule in its entirety, the Obama administration is requesting comments from the public and advocacy groups to provide information about several issues, including specific examples to support or refute allegations that the final rule reduces access to information and health care services, particularly by low-income women. (Editor's note: April 9, 2009, was the cut-off date for public comment on the rule rescission. To enter a comment online, go to the web site, www.regulations.gov and in "Search Documents," enter "HHS_FRDOC_0001." Under "Rescission of the Regulation titled 'Ensuring That Department of Health and Human Services Funds Do Not Support Coercive or Discriminatory Policies or Practices in Violation of Federal Law,'" click on "Send a Comment or Submission.")
Reg said to be 'hopelessly flawed'
The regulation is "hopelessly flawed" and should be rejected outright, said Nancy Northup, president of the Center for Reproductive Rights. The center has joined such groups as the National Asian Pacific American Women's Forum and the National Latina Institute for Reproductive Health in entering comments about the regulation's impact on low-income women. While the ruling suffers from numerous failings, its most glaring defect is that it does not address the rights and medical needs of patients, said Northrup in a press statement.
"Specifically, the more-than-17 million women across the country who rely most heavily on public health programs are bearing the burden of this rule — a disproportionate number of them low-income and women of color," she said. "As it is, these groups already face tremendous barriers getting health care, including inadequate funding of medical assistance programs, cultural barriers, logistical obstacles such as inflexible work schedules, and insufficient child care."
Legal battle launched
In January 2009, the National Family Planning & Reproductive Health Association (NFPRHA), represented by the American Civil Liberties Union, filed a lawsuit in federal court challenging the conscience rule. The case was filed along with two other legal challenges: one brought by the state of Connecticut, joined by California, Illinois, Massachusetts, New Jersey, New York, Oregon, and Rhode Island; and the other, by Planned Parenthood Federation of America and Planned Parenthood of Connecticut.
States that are involved in the legal battle note why the regulation impedes care. For example, in New York, the rule conflicts with state laws that require hospitals treating rape victims to provide information on all legal options, including emergency contraception. The provider conscience regulations would likely make it impossible for the state to enforce such laws and adequately protect the rights of sexual assault victims, according to a statement from Attorney General Andrew Cuomo's office.3 Advocates involved in Connecticut's lawsuit say the conscience regulation could undermine the $1.3 billion in Medicaid stimulus money targeted for Connecticut over the next three years.4
The regulations limit access to essential health care for millions of low-income women, says Mary Jane Gallagher, NFPRHA president and CEO. "Patients deserve — and in this time of economic crisis, sorely need — the ability to access necessary, widely used medical services," she asserts. "NFPRHA plans to continue our lawsuit and fight the proposed rule in every way possible until it is reversed."
References
- Stein R. Health workers' 'conscience' rule set to be voided. The Washington Post, Feb. 28, 2009:A01.
- 73 Fed Reg 78,071 (Dec. 19, 2008).
- State of New York Office of the Attorney General. Attorney General Cuomo sues Bush over 11th-hour regulations that threaten vital health services for sexual assault victims, NY women. Press release. Accessed at www.oag.state.ny.us.
- State of Connecticut Office of the Attorney General. Attorney General hails move to rescind rule endangering women's health rights, including birth control access. Press release. Accessed at ct.gov/ag/cwp.
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