New U.S. Rules on Doctor Rights Met With Opposition, Questions
On Thursday, HHS Secretary Mike Leavitt announced regulations that he says aim to protect health care providers and other workers from disciplinary measures if they refuse to provide abortions or refer patients to other providers for abortions, the Washington Times reports (Duin, Washington Times, 8/22).
Under the proposed regulation, federal officials could withdraw federal funding from more than 584,000 hospitals, clinics, health plans, physicians and other entities if they do not accommodate employees who refuse to participate in a procedure or medical service that they object to on personal, religious or moral grounds (Stein, Washington Post, 8/22).
If it takes effect, employers would have to certify in writing that they are complying with the regulation.
The proposed rule would establish a system for enforcing existing protections in three federal laws (Alonzo-Zaldivar, AP/San Francisco Chronicle, 8/21).
An earlier draft of the proposed regulation included language that defined abortion -- for the first time in a federal law or regulation -- as anything that interferes with a fertilized egg after conception.
That language was eliminated, but supporters and opponents maintain that the proposed regulation remains broad enough to protect health care providers who decline to provide oral contraception, Plan B emergency contraception and other types of contraception. Moreover, the proposed rule permits health care providers to decline to provide patients with information about such treatments or services.
Advocates for women's health, family planning, abortion rights and other causes maintain that the proposal could create obstacles to abortion, family planning services, end-of-life care and a broad range of scientific research (Washington Post, 8/22).
In addition, NPR's "Morning Edition" reports that there is concern that doctors could invoke the rule to deny treatment to gays and lesbians, following the California Supreme Court's ruling this week that physicians could not use religious beliefs as an exemption to the state's anti-discrimination laws (Shapiro, "Morning Edition," NPR, 8/22).
However, Leavitt said, "This regulation is not about contraception." He added, "It's about abortion and conscience. It is very closely focused on abortion and physician's conscience" (AP/San Francisco Chronicle, 8/21).
According to the Los Angeles Times' "Countdown to Crawford" blog, the proposed regulation "is certain to face challenge from abortion rights supporters" (Gerstenzang, "Countdown to Crawford," Los Angeles Times, 8/21).
California Attorney General Jerry Brown (D) has spoken out against the proposed regulation, arguing that it could limit California's ability to enforce a state law requiring employer health plans to cover contraception (California Healthline, 8/21).
Advocates for and against abortion rights maintain that the regulation could be used to challenge such state laws, and the Wall Street Journal reports that the federal government could compel states to change those laws as a pre-condition for federal funding.
Studies indicate that state laws requiring contraceptive coverage have expanded women's access to birth control, but it remains unclear whether health insurers would drop contraception benefits if state mandates were eliminated.
Presumptive Republican nominee Sen. John McCain (Ariz.) has not indicated his position on the proposal.
Presumptive Democratic nominee Barack Obama (Ill.) signed a letter opposing an earlier draft of the regulation, and the Journal reports that Obama would reverse the regulation if he is elected (Simon, Wall Street Journal, 8/22).