CQ HealthBeat Examines Debate Over Potential Federal Rule That Could Limit Birth Control Access

Main Category: Women's Health / Gynecology
Also Included In: Sexual Health / STDs
Article Date: 22 Jul 2008 - 5:00 PDT

email to a friend   printer friendly   view / write opinions   rate article

CQ HealthBeat on Friday examined the debate over a proposed regulation being developed by the Bush administration that allegedly seeks to allow medical providers to refuse patients access to commonly used contraceptive methods as a matter of conscience on the grounds that they are a form of abortion (Reichard, CQ HealthBeat, 7/18).

Under the proposal, to receive funding under any program administered by HHS, researchers, clinics, medical schools and hospitals would have to sign "written certifications" that they will not discriminate against people who object to abortion -- however it might be defined. The certification also would be required of state and local governments when allocating grants to hospitals and other institutions that have policies against providing abortions (Daily Women's Health Policy Report, 7/17). According to CQ HealthBeat, the proposal would require the 504,000 recipients of funds from HHS to certify compliance with requirements that they do not discriminate against medical providers who refuse to perform services related to abortion as a matter of conscience.

Some critics argue that the proposal's definition of abortion is defined so broadly that it would lead to a "cutoff" of federal funding for oral contraceptives, intrauterine devices and emergency contraception that are provided to "millions of women" in the U.S. through federally funded public health programs including Medicaid. The proposal defines abortion as "any of the various procedures -- including the prescription and administration of any drug in the performance of any procedure or any other action -- that results in the termination of the life of a human being in utero between conception and natural birth, whether before or after implantation" on the uterine wall, CQ HealthBeat reports.

Comments

Mary Jane Gallagher, president of the National Family Planning and Reproductive Health Association, said the group is "going to look at every avenue that's possible" to stop the proposal, including legislation or litigation. House Speaker Nancy Pelosi (D-Calif.) in a statement issued Wednesday said the proposal "will launch a dangerous assault on women's health." She also urged the Bush administration to "reject this policy and join with Democrats to focus on preventing unintended pregnancies and reducing the need for abortion through increasing access to family planning services and access to affordable birth control."

Sens. Hillary Rodham Clinton (D-N.Y.) and Patty Murray (D-Wash.) in a letter to HHS Secretary Mike Leavitt also declared their opposition to the proposed rule, CQ HealthBeat reports (CQ HealthBeat, 7/18). Clinton and Rep. Nita Lowey (D-N.Y.) on Friday at a news conference condemned the proposal. Clinton said the draft rule is a "gratuitous, unnecessary insult" to women, adding that women "would watch their contraceptive coverage disappear overnight" if it were enacted. Lowey said, "We will not put up with this radical, ideological agenda to turn the clock back on women's rights." Clinton urged people to sign a petition on her Web site, hillpac.com, against the changes. "Our first effort is to get the Bush administration to rescind the regulation, not issue in its current form," Clinton said. She added, "If that doesn't succeed, we're going to be looking for legislative steps that we can take to prevent this regulation from ever going into effect" (Nichols, Reuters, 7/18).

According to CQ HealthBeat, some lawmakers also are "beginning to feel pressure" from supporters of the proposal. Cardinal Justin Rigali, writing on behalf of the United States Conference of Catholic Bishops in a letter to Congress, said, "The critics' surprise that conscience protection may apply beyond the specific issue of abortion seems based on a lack of knowledge of existing federal law," adding, "If the administration is preparing regulations along these lines, it would simply be performing its proper task in an area of law where that is long overdue." Rigali wrote that "this should be a matter of agreement among members who call themselves 'pro-life' and 'pro-choice': the freedom of health care providers to serve the public without violating their most deeply held moral and religious convictions on the sanctity of human life." He said that Congress should defend "efforts to reaffirm and implement laws on conscience protection."

The Christian Medical and Dental Association in a letter to Leavitt on Wednesday said that "anecdotal accounts suggest that few persecuted health care professionals actually know their conscience rights and that they typically simply submit to pressure by resigning. Unless pro-life professionals are equipped to know and apply their conscience rights, they actually stand at risk of being weeded out from the profession altogether."

Christina Pearson, a spokesperson for HHS, said she was "unable" to comment on whether HHS is considering the regulation, but added that "[o]ver the past three decades, Congress has passed several anti-discrimination laws to protect institutional and individual health care providers participating in federal programs." She noted that "HHS has an obligation to enforce these laws and is exploring a number of options" (CQ HealthBeat, 7/18).

Opinion Pieces

~ Charlotte Observer: The proposed rule "would likely make it harder" for women to obtain legal contraceptives and "should be scrapped," an Observer editorial says. The editorial adds that the "problem" of the proposal would be "most acute for women in small towns or rural areas, where the number of doctors and pharmacies is limited." If women do not have a "legally protected right to birth control, those women may be denied a perfectly legal medical product if the only doctor or pharmacist in town doesn't believe in birth control or believes [EC] to be a form of abortion," according to the Observer. "We suspect President Bush's antiabortion appointees at HHS hoped to sneak this ridiculous measure into place before they depart Washington in a few months," the editorial says, concluding, "They should be ashamed," and the "proposed regulation should die a swift death" (Charlotte Observer, 7/21).

~ Joan Malin, New York Times: The Bush administration is "days away from an attack on women's health care" if this proposal "moves forward," Malin, president and CEO of Planned Parenthood of New York City, writes in a Times letter to the editor. She adds that if this "wrong-headed" proposal is passed, it "will sacrifice women's ability to manage their own health care on the altar of a political ideology" (Malin, New York Times, 7/19).

Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

© 2008 The Advisory Board Company. All rights reserved.