permaculture

["Lawrence F. London, Jr." <lflj@intrex.net>]

http://www.madison.com/tct/news/stories/325323

Last minute administrative rule by Bush administration threatens health access

Judith Davidoff  —  12/24/2008 11:50 am

Wisconsin's new law that requires hospitals to provide emergency contraception to rape victims may be unenforceable due 
to an 11th-hour administrative rule released by the Bush administration that allows medical staff to refuse to provide 
services they find morally objectionable.

"It would in essence nullify our compassionate care law," confirmed Rea Holmes, executive assistant of the Wisconsin 
Department of Health Services.

While doctors and nurses can, under federal and state law, opt out of providing abortions, the new rule broadens this 
so-called "conscience clause" to all health workers, who can now also refuse to provide information, including a 
referral, to patients seeking an abortion. Opponents and proponents of the rule also say it additionally allows 
providers to refuse to provide birth control and other health services.

The rule, released late last week, has provoked outrage from the American Civil Liberties Union, family planning 
advocates and health care organizations.

"The new HHS rule is President Bush's parting shot at women's access to basic health care," Caroline Fredrickson, 
director of the ACLU Washington Legislative Office, said in a news release. "This administration has continually put 
politics and ideology before science and patients' health."

U.S. Congresswoman Tammy Baldwin also criticized the rule in a statement, saying that she was "deeply troubled by the 
Bush administration's latest attack on patients' rights and the doctor-patient relationship." Medical care, she added, 
"must be based on science and the patients' best interest, not the providers' religious, political or other 
philosophical views."

Nicole Safar, legal and policy analyst at Planned Parenthood of Wisconsin, said the rule would have far-reaching 
effects. "Any state that has patient protections against health care denials based on ideology won't be able to enforce 
those laws," Safar said.

She said the new rule, for instance, would bar states from enforcing laws that require insurance plans to cover 
contraception. It also threatens state laws that require pharmacies to ensure that women have timely access to birth 
control, according to the National Women's Law Center, based in Washington, D.C.

Opponents are banking on President-elect Barack Obama and Congress, once in office in January, to either block the rule 
or authorize that it be revised. "There is indication on the federal level this is one of the first things they are 
going to be taking up," said Holmes.

News that the U.S. Department of Health and Human Services was working on such regulations leaked out over the summer. 
The news created a firestorm, prompting opponents to try to persuade the Bush administration to change course.

Gov. Jim Doyle expressed his "strong opposition" to the proposal in a letter in late September to Michael Leavitt, 
secretary of the department: "Allowing HHS to impose a federal conscience clause effectively creates a culture of health 
care refusal, whereby patients can be denied access to any number of services, including HIV/AIDS and fertility care." 
Doyle also notified Leavitt that the proposed regulation "effectively nullifies" Wisconsin's compassionate care law.

At the time, Matt Sande, director of Pro-Life Wisconsin, praised the proposed rule because it contained a definition of 
abortion that would likely apply to forms of hormonal contraception, including birth control pills. His group opposes 
all forms of birth control other than natural planning methods. Sande did not return a phone call for comment on the 
final rule.

The published rule actually leaves abortion undefined, which is why state officials say the compassionate care act 
cannot be enforced as long as the rule is in effect.

"By taking out the definition of abortion you have the whole debate of when life begins and so emergency contraception 
could be swept into there," Holmes said. "You could have somebody ready to go into a clinic, ask for E.C. and that 
provider would have the right to deny the victim."

Judith Davidoff  —  12/24/2008 11:50 am