Bush Abortion Rule Finalized Despite Opposition

by Christina Jewett, ProPublica

A contentious midnight regulation we've been following has been finalized today, significantly strengthening the government's power to inflict financial pain on any health provider deemed to discriminate against health workers who refuse to perform tasks they find morally objectionable.

Although about 200,000 letters of opposition rolled in, the administration made only technical changes to the rule (PDF). When it becomes law in 30 days, any worker, trainee or volunteer from health insurance companies to podiatry schools will be emboldened to refuse to participate in tasks that offend their conscience.

The regulation singles out abortion and dismisses the notion that health-care workers would be empowered to deny care to immigrants, AIDS patients or sex-change seekers.

The rule adds teeth to existing laws by giving the federal Health and Human Services Department power to withhold money or demand refunds from federally funded health providers that penalize conscience-stricken non-performers.

The rule is expected to affect more than 570,000 health providers -- including about 5,000 hospitals and 230,000 doctors' offices -- that have to sign "certifications" that they will abide by the rule. The rule's financial analysis concludes that the time taken by thousands of employees to sign the certifications will cost the health-care system about $40 million.

What’s more significant, according to the director of the Planned Parenthood Federation of America, is that the rule may cut off patients' access to needed information and care.

"This is a last sort of parting shot at women's health that I think will create chaos among providers across the country," said Cecile Richards, PPFA president.

A 127-page response (PDF) to the rule's opposition basically says that if fewer women get abortion counseling or contraception, then it only goes to show that "health care providers...had previously been compelled to deliver the service over their conscience objections."

Roger Evans, Planned Parenthood's litigation director, says the new federal rule creates confusion around a number of state laws.

One law mandates that female rape victims who go to the emergency room have a right to be informed of all their options -- including abortion. It also throws into question state laws that mandate equal insurance coverage of contraception.

Finally, the rule throws off the legal balance between an employee's right to refuse morally repugnant tasks with an employer's ability to carry out its business (say, fill prescriptions for birth control). In response to other Bush administration officials' objections to the rule's skewing of the balance, the new rule only "threw out a cloud of verbiage," Evans said.

"Final," however, is a relative term in the world of rulemaking. Congress will have 75 working days to overturn the regulation when it returns in 2009. The Obama administration is likely to take steps to reverse it.

Christina Jewett is a reporter for ProPublica, America's largest investigative newsroom.

Comments

[tas11]

As a health care provider I am appalled. We are supposed to put aside out personal feelings to care for, and do what is best for our patients. We are ethically obligated to provide medically accurate information and refer patients to providers if we are unable to help them ourselves. If you are unable to do this, don't go into health care.

[lisakaz2]

Seems to me the goal here is for stealth applicants to get medically-related jobs then refuse to do them and sue to keep their jobs, thus derailing the ability for providers to actually offer healthcare of any kind.

[larmarch5]

I can't wait till the first case of a pharmacist refusing to fill a prescription for Viagra for a single man reaches the Supreme Court.

[lisakaz2]

It seems to me that this prospect was never considered. I'd like to see something like this compel some greater thought.

[messy]

What does the Christian Science Monitor have to say about this? They're against all forms of medicine.

[mredder4]

Can the Obama Administration, taking the reins of the HHS Department, simply instruct their personnel not to enforce this rule? While I may not understand the full functioning of this department, this sounds as though it requires enforcement, which Obama and the HHS Secretary could opt not to require from their workers. Since this rule appears to be set to go into effect for at least one year until the Department revises those rules under Obama, that would seem like the least controversial way, after a correction by Congress (don't hold your breath on that one), to help people that this rule will damage: patients.

People with ethical ojections to certain medicines should not practice any.

[messy]

It's one of the many rules that can be repealed immediately.

[bearhat]

I encourage anyone affected by this rule to sue the care provider. Doctors take a hippocratic oath that says "I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone." It would be, in the presence of a competent court, easy to argue that you have been dealt harm by being refused the proper treatment. All Humans, Men and Women, are entitled to the indefeasible right of bodily integrity. To refuse abortion treatment to a woman is a violation of that inarguable maxim.