Blogs Comment On HHS Provider 'Conscience' Rule, 'Mexico City' Policy, Incoming Obama Administration

Main Category: Sexual Health / STDs
Article Date: 24 Dec 2008 - 3:00 PDT

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The following summarizes selected women's health-related blog entries.

~ "HHS Publishes Provider Conscience Expansion Rule," Emily Douglas, Huffington Post blogs: The broad scope of the HHS "conscience" rule provides protections for providers who would like to "conflate" contraception and abortion, Douglas writes in a blog post. She adds that one of the rule's "more disturbing provisions is the announcement that Title X family planning funding will now be open to grantees who refuse to counsel women on the availability of abortion." In addition, the rule "fails to make clear whether health care centers who do intend to provide unbiased options counseling can even ask potential employees whether they are comfortable participating in an abortion procedure or counseling a woman about her options," according to Roger Evans of Planned Parenthood, Douglas writes. She adds that if using the Congressional Review Act to invalidate the rule "fails, Congress could refuse to appropriate funds for the implementation of the rule, or Congress could pass the legislation introduced by" Sens. Hillary Rodham Clinton (D-N.Y.) and Patty Murray (D-Wash.) "that would prohibit HHS from implementing the regulation. Finally, the new administration could begin a new round of rule-making, perhaps the most time-consuming option" (Douglas, Huffington Post blogs, 12/19).

~ "Health Care Conscience Rule Could Stir Legal Backlash," Deborah Kotz, "On Women," U.S. News & World Report blogs: "Women's groups, state governments and a host of others have reacted harshly to the new" rule, Kotz writes in a blog post. She adds that newspaper "editorial writers have gotten in on the act, too," including those at the Albany Times Union, which recently called on Clinton to "fight the rule before she leaves office to become secretary of state. Of course, bloggers have been sounding off about this regulation since it was first proposed last summer." According to Kotz, the "[m]ost fascinating" reaction has been from Connecticut Attorney General Richard Blumenthal (D), who said he plans to "challenge the regulation by filing a lawsuit or petition in federal court arguing that the rule tramples on states' and patients' rights." She adds that one "dozen other states with similar laws for rape victims -- including Maryland, Illinois and Arizona -- could join him in the legal battle" (Kotz, "On Women," U.S. News & World Report blogs, 12/22).

~ "Bush's Parting Shot Undermines Health Care," Cecile Richards, Huffington Post blogs: Richards, president of the Planned Parenthood Federation of America, writes that she was "completely disheartened" when "despite the written opposition from more than 200,000 Americans, 150 members of Congress, a bipartisan coalition of governors and attorneys general, the American Medical Association and women's health organizations like Planned Parenthood," HHS issued the provider "conscience" rule. According to Richards, the rule "will undermine health care access at nearly 600,000 pharmacies, clinics and hospitals across the country." President Bush's "'take the drapes on your way out' approach is the final chapter of an administration that has prized political ideology over health care for [its] entire eight years," she says. She continues that the regulations are "likely to create total chaos in an already stressed health care system" and that the rule "may spell the end of the few available health care options" for low-income women and families. As a result of the new rule, anyone attending a medical facility that receives federal funding could "be subject to the luck of the draw in terms of what kinds of reproductive health care they are offered," Richards writes. Although this "might seem far-fetched," certain groups such as Pharmacists for Life already "have campaigned nationally to have pharmacies refuse to provide women birth control prescribed by their physician," according to Richards. She continues, "If you had any doubt that this rule is about politics, not health care, just watch the high-fives among the far right," such as a statement by Tony Perkins of the Family Research Council contending that the regulations are "'a huge victory for religious freedom and the First Amendment.'" According to Richards, the "bottom line in health care has always been that patients' health comes first," but "this regulation turns that basic tenet on its head." She concludes that "in the days and weeks to come," PPFA "will work with the new administration and Congress to overturn this disastrous rule" (Richards, Huffington Post blogs, 12/19).

~ "The Time To Lift the Global Gag Rule is Now," Isaiah Ndong, RH Reality Check: Over the past eight years, the impact of the "Mexico City" policy, also known as the "global gag rule," has "been harshest in parts of the world most in need of better health services," Ndong -- a physician who worked with EngenderHealth in Ghana at the time the rule was implemented -- writes. According to Ndong, after the implementation of the policy, EngenderHealth "felt the effect almost immediately," as the rule restricted which local partners the organization could work with. It also reduced contraceptive supplies in Ghana by half and "forced" clinics to "shut down or drastically reduce their family planning, maternal and child health and HIV services," Ndong writes. He adds that although the policy supposedly "was designed to reduce abortion, ... there is no evidence" that abortion rates have declined, and "unsafe abortion remains among the leading causes of maternal deaths." Furthermore, "the policy's domino effect has had negative effects on people's lives that have nothing to do with abortion," Ndong writes. He continues that "[b]ecause health clinics often offered integrated care, the loss in funding due to the global gag rule has had dramatic consequences for services like immunizations for children, voluntary counseling and testing for HIV and treatment for malaria." As a result of the policy, "entire communities" in Africa, Asia and Latin America "have seen their health care options compromised," Ndong writes. President-elect Barack Obama's administration "has the opportunity to repeal the global gag rule, and we must pressure him to do so," Ndong says, adding that repealing the rule would be "a symbolic move saying that the United States cares about women's rights and about the rural poor." He concludes that although "there is much more to be done to ensure that every woman has access to high-quality reproductive and maternal health care," eliminating the Mexico City policy would affirm that the U.S. "is committed to women's health and rights, to global health and development and to the principles of informed choice" (Ndong, RH Reality Check, 12/23).

~ "On Abortion, Pro-Choice is the Compromise Position," Sam Sedaei, Huffington Post blogs: President-elect Barack Obama and the "mainstream media ... have presented abortion as an issue on which the country is evenly divided between two camps -- pro-life and pro-choice -- and the only way to deal with the issue is to come up with a grand compromise," according to Sedaei. However, he says, the stance supporting abortion rights "is the compromise position, and the next administration must not negotiate away abortion rights." Sedaei provides what he describes as a "specific list of choice-related issues that the Obama administration will face, and why he must support the pro-choice stance on them." The issues include whether to reverse the new HHS "conscience" rule issued last week; whether to overturn regulations "such as the one that makes fetuses eligible for health care coverage" under SCHIP; whether to decrease funding for abstinence-only education and increase funding for comprehensive sex education; and whether to allow federal health plans to cover the cost of abortion procedures. Sedaei offers suggestions for how Obama can address each of the issues "in the context of the existing national debate on abortion." As Obama "proceeds through the first few months of his presidency, he cannot treat abortion as another issue on which to negotiate," Sedaei says. He concludes, "Instead, he has a unique opportunity to use his political capital to fundamentally reframe the debate and permanently establish one important fact: abortion is as legal and legitimate of a medical operation as any, and the government needs to do what it can to help women get educated about it and have easy and safe access to it" (Sedaei, Huffington Post blogs, 12/22).

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.

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