Medical Groups, AHA, 13 Attorneys General Voice Opposition To HHS Regulation

Main Category: Women's Health / Gynecology
Also Included In: Abortion;  Sexual Health / STDs;  Public Health
Article Date: 26 Sep 2008 - 5:00 PDT

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In advance of Thursday's end to a public comment period on an HHS draft regulation that would allow health care providers who receive federal grants to "opt out" of care they object to based on moral or religious grounds, six medical associations and 13 state attorneys general on Wednesday wrote to HHS to protest the rule, the AP/Google.com reports. In separate letters, the groups and attorneys general urged HHS to withdraw the regulation (Freking, AP/Google.com, 9/24). According to the BNA Health Care Daily, the American Hospital Association on Tuesday also wrote to the agency calling for the rule to be pulled (Kessler, BNA Health Care Daily, 9/25).

The six medical groups -- which include the American Academy of Pediatrics; American Nurses Association; American Psychiatric Association, Association of Women's Health, Obstetric and Neonatal Nurses; Physicians for Reproductive Choice and Health; and the Society for Adolescent Medicine -- said the regulation would not clarify existing laws but instead would broaden them by giving health care providers the authority to deny access to contraception and "withhold medical information based on their religious or moral beliefs" (Semnani, CQ Today, 9/24). According to the letter, although health care providers currently are allowed to refuse to perform abortion or sterilization procedures they object to, they are "ethically bound" to refer patients in a timely manner to another provider who can. The medical groups wrote, "Implementation of this regulation would effectively allow health care providers' personal beliefs to override patients' right to full disclosure of accurate information and available health care resources"(Medical groups' letter, 9/24).

AHA's letter states that the proposed rule contains "several issues that cannot be properly addressed in a 30-day comment period," adding that it does not "speak to the many state and federal laws that require hospitals to provide certain services," such as state laws requiring emergency departments to provide rape survivors with emergency contraception. The letter also asks how the new regulations on written certification would affect hospitals' efforts to comply with federal Medicaid requirements on provision of prescription contraceptives. "Because these issues are of such significance to the hospital field and the patients we serve, we request that the proposed rule be withdrawn to allow for a longer, deliberative process," the letter says (BNA Health Care Daily, 9/25).

The 13 attorneys general -- representing Arizona, Connecticut, Illinois, Iowa, Maine, Maryland, Massachusetts, Montana, New Jersey, Oregon, Rhode Island, Utah and Vermont -- in a separate letter commenting on the rule said it is too vague; undermines current law's balancing of the interests of patients and health care providers by failing to ensure protection of patient rights; and restricts the ability of states and institutions to ensure patient access to health care services. "Vagueness and broad application, together with the penalty of withdrawal of critical federal health care funding to a health care entity that violates -- even inadvertently -- the proposed regulation may have substantial and significant consequences for the provision of health care to many Americans," the letter says. The letter adds, "The proposed regulation completely obliterates the rights of patients to legal and medically necessary health care services in favor of a single-minded focus on protecting a health care provider's right to claim a personal or moral religious belief." According to the attorneys general, the rule would "unconscionably favor one set of interests, upsetting the carefully crafted balance that many states have sought to achieve" (Attorneys general letter, 8/24).

Connecticut Attorney General Richard Blumenthal (D) said that the proposed rule "threatens to drastically discourage and even deter a woman's right to choose," adding that it also "unconscionably puts personal agendas before patient care ... failing even to acknowledge the rights of rape victims and others to access birth control and related vital health services" (Sanders, AP/San Francisco Chronicle, 9/25).

According to HHS, if the regulation becomes law, it would cost more than $44 million annually to enforce and would require 584,294 federally funded medical entities and their staff to certify compliance or face disciplinary and/or punitive penalties (CQ Today, 9/24). HHS spokesperson Christina Pearson said she would not "speculate" on the department's course of action, adding, "We have an open comment period, so I'm unable to comment on what will happen beyond here" (AP/Google.com, 9/24).

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