HHS Provider Conscience Rule: You Better Shop Around

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.

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.