Washington Post, WSJ Examine Reaction To Draft HHS Rule That Could Limit Birth Control Access

Main Category: Women's Health / Gynecology
Also Included In: Sexual Health / STDs
Article Date: 01 Aug 2008 - 5:00 PDT

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The Wall Street Journal and Washington Post on Thursday examined debate over an HHS rule being developed by the Bush administration. According to the Journal, a draft of the proposed rule has "ignited furor with a proposed definition of pregnancy that has the effect of classifying some of the most widely used methods of contraception as abortion" (Simon, Wall Street Journal, 7/31). The Journal and the Post report that critics of the draft say the regulation would limit access to birth control by defining abortion as "any of the various procedures -- including the prescription and administration of any drug or 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."

According to the draft regulation, which is still being reviewed within HHS and has not yet been released for public comment, 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 a provider or entity chooses to define it. 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. The rule would affect more than 500,000 hospitals, clinics and medical facilities that receive federal funding (Daily Women's Health Policy Report, 7/30). Summaries of the articles appear below.

~ Wall Street Journal: According to the Journal, many medical organizations disagree with the draft's assertion that preventing implantation of a fertilized embryo is terminating the "life of a human being." The groups have stated that pregnancy is not established until after the egg is fertilized and has implanted in the uterus. According to the Journal, dozens of congressional Democrats -- including Democratic presidential candidate Sen. Barack Obama (Ill.) -- have signed letters of protest. Republican presidential candidate Sen. John McCain (Ariz.) declined to comment on the draft rule.

If the rule becomes final, it would not have an immediate effect on the legality of oral contraceptives or intrauterine devices; however, some opponents are concerned it would undermine state laws that promote access to contraception. According to the Journal, some social conservatives are hoping the regulation will create obstacles to contraception. Tom McClusky, a strategist at the Family Research Council, said it would be "fantastic" if the proposed rule prompted insurance companies to drop coverage for prescription birth control. Janet Crepps, an attorney with the Center for Reproductive Rights, said the proposed rule is "pernicious," adding, "A few individuals could mess up the whole system" (Simon, Wall Street Journal, 7/31).

~ Washington Post: FDA officials have not objected to HHS' draft proposal, but several NIH officials have raised "serious concerns," the Post reports. An unidentified NIH official said that the proposal is "causing a lot of distress," adding, "It's a redefinition of abortion that does not match any of the current medical definitions. It's ideologically based and not based on science and could interfere with the development of many new therapies to treat diseases." Susan Wood -- a professor at George Washington University, who resigned from FDA over the agency's handling of emergency contraception -- said that the proposed rule is "another example of this administration's disregard for science and medicine in how agencies make decisions."

The proposal also has "sparked intense criticism" among some members of Congress, medical groups, and family planning and women's health advocates, who are saying it could "create overwhelming obstacles" to obtaining birth control, according to the Post. In addition, critics have said the rule could have "far-reaching, but less obvious, implications" for health care and "raises questions about a broad spectrum of scientific research and care." Robyn Shapiro, a bioethicist and lawyer at the Medical College of Wisconsin, said the "breadth of this is potentially immense," adding, "Is this going to result in a kind of blessed censorship of a whole host of areas of medical care and research?" Critics have said the proposal would cover a broad range of workers at health facilities, including janitors and receptionists. "You could imagine a group of people with less than honorable intentions seeking to get hired at a family planning clinic with a specific objective of obstructing access," Jill Morrison of the National Women's Law Center said, adding that under the proposal, "there is little you could do about it."

Supporters of the proposal have dismissed predictions that it would limit access to contraception. M. Casey Mattox of the Christian Legal Society's Center for Law and Religious Freedom said the proposal "would essentially simply require people to comply with laws that they have been required to comply with for decades." Many conservative groups -- such as the U.S. Conference for Catholic Bishops, Concerned Women for America and the Catholic Medical Association -- have said the regulation is needed to prevent health workers from being forced to provide services to which they have a moral objection (Stein, Washington Post, 7/31).

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