HHS Provider Conscience Rule: You Better Shop Around

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HHS Provider Conscience Rule: You Better Shop Around

Marilyn Keefe

Today's provider conscience regulations go so far as to put the onus on patients to divine what information and services might be withheld by any given provider, and then shop around to find alternatives.

Today the Bush Administration put
in place the final piece of its shameful women’s health care legacy
by finalizing ill-conceived provider "conscience" regulations that
could dramatically undermine information and access to reproductive
health care services. Confirming our fears, the final rule spends more
than 70 pages explaining why the Administration is ignoring the avalanche
of comments from the medical, legal, women’s and other communities,
as well as from the EEOC, that urge them, in the interest of public
health, to halt all efforts to move forward on the rule.

Like the proposed rules, today’s
regulations will make it easier for providers to refuse patients vital
health services, and harder for patients to learn more about their health
status and health options – precisely the wrong outcomes for our health
care system. The regulations upend the notion of informed consent and
go so far as to clarify that the onus is on women to somehow divine
what information and services might be withheld by any given provider,
and then shop around to find alternatives.

Moreover, the regulations will
create confusion in crucial situations where the health and well-being
of patients should be the top priority. Current law already allows providers
and institutions to refuse to provide abortion or sterilization services
if doing so clashes with their religious or moral beliefs.  Yet, sticking
to utterly unsubstantiated claims that a climate of religious intolerance
is preventing qualified individuals from entering health care professions,
HHS finalized a rule that dramatically expands the ability of health
care workers and institutions to refuse health care services. 

These final regulations continue
to leave the term "abortion" undefined – thereby inviting providers
to interpret the term to include birth control. Despite claims to the
contrary, this goes far beyond current law, which already accommodates
providers who do not want to offer reproductive health services because
they have religious or moral objections.  It opens the door for
insurance plans, hospitals, doctors, nurses and even administrative
staff to deny women access to contraception. The new rule also claims
that Title VII of the Civil Rights Act, which carefully balances protections
for the religious beliefs of employees with protections that ensure
that patients get access to health care services and information, just
doesn’t apply when it comes to reproductive health.  According
to the final rule, provider objections in these instances should be
held to a "higher standard" – one that allows providers a virtually
unfettered ability to refuse services and information without requiring
any balancing of patient needs at all!  In fact, providers would
be under no obligation to even inform patients of their objections to
providing certain services. That is, quite simply, wrong.

Sex. Abortion. Parenthood. Power.

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The good news, of course, is
that in the 2008 elections, Americans said they want leaders who will
work together to reduce unintended pregnancy and end attacks on reproductive
rights.  Policymakers – in office now and those coming in this January
– have already signaled their intent to work to reverse this rule.
However, we must be vigilant about ensuring that the sincere efforts
to find common ground on reproductive health issues do not result in
any delays in reversing these regulations in service to the "big lie"
at their center:  That the moral beliefs of health care violators
are being violated in any way.

At a time when reproductive
health clinics are woefully under-funded, and women in this country
experience millions of unintended pregnancies each year, the Administration
should have been looking for ways to increase women’s access to the
family planning information and services that can help them avoid unintended
pregnancy.  Instead, it has done just the opposite.

In the weeks ahead, we are
urging Americans to contact the incoming Administration and Congress
to urge them to say ‘no’ to these dangerous regulations. There are
multiple legislative and administrative remedies to avoid the harm –
but immediate action is essential.  At the top of the list is a request
to President-elect Obama to suspend the enforcement of the rule and
then issue a routine request for comments on rescinding the rule permanently.

"You better shop around"
may work for finding bargains in this holiday season, but it’s an
onerous and unacceptable burden to put on low-income women seeking the
reproductive health care they need.