As if they haven’t done enough,
the Bush Administration is making one last attempt to undermine women’s
reproductive freedom. The Department of Health and Human Services
(HHS) recently proposed a regulation that it claims will protect federally-funded
healthcare providers from discrimination; but in reality, will further
limit a woman’s ability to obtain health services and increase the
number of providers and institutions allowed to refuse her care.
Low-income women and women of color who rely more on public programs
will ultimately be hit the hardest. Significant percentages of Latinas,
Asia Pacific Islanders and African-American women work in low-wage jobs
that don’t offer benefits and therefore, they lack health insurance
of any kind. Public programs such as Medicaid and Title X fill that
void by covering prenatal, pregnancy-related care and contraceptive
services. The deeply flawed regulation fails to serve the needs
of these patients by erecting new barriers to their obtaining reproductive
Under current law, recipients
of federal money, such as Medicaid and Title X, cannot force medical
professionals to provide a woman abortion or sterilization services
if they object for moral or religious reasons. But the proposed
regulations would expand these laws at the expense of patients in several
ways. For one, startlingly, healthcare providers may now be able
to refuse to provide a woman contraception as well as abortion.
The initial draft of the regulations included a definition of abortion
that was so broad that it included some forms of contraception, such
as birth control pills and IUDs. After a huge public outcry, the
HHS removed that definition, but by raising the issue in the first place,
the department left the door open for healthcare providers to use the
sweeping definition to justify the denial of contraception. Before no
institution would have objected to giving a woman birth control pills
and argued that it is the same as performing an abortion.
Two, under the proposed regulation,
HHS would expand the pool of medical professionals who can deny a woman
services. Not only doctors, but virtually anyone involved–like receptionists,
health insurance claim adjustors, and janitors–would be able to refuse
to perform tasks based on religious or moral beliefs. For example,
a receptionist may be allowed to decline to make an appointment for
a woman who needs a prescription for birth control pills or a nurse
may choose not to sterilize equipment used in an abortion. Such
refusals will not only disrupt services in health facilities, but could
possibly result in a woman not receiving reproductive care at all.
Finally, the proposed regulation
would allow healthcare professionals to withhold basic information,
including counseling and referrals. This means that healthcare providers
could not only refuse to give information about abortion and contraception
to a woman, but also to refer her to someone who can explain to her
all of her options.
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Low-income women and women
of color already face significant hurdles in accessing healthcare including
discrimination, inflexible work schedules, and inadequate childcare
and transportation. If they are turned away from healthcare providers,
they may not have the resources to locate another physician or healthcare
facility and make arrangements for a second time.
HHS was required by law to
include a cost-benefit analysis with the proposed regulation, but its
analysis was cursory and inadequate, ignoring the costs to individual
patients and the severe impact the regulation will have on vulnerable
groups. The department did not even point to a single instance
where current laws have failed to protect healthcare providers’ religious
liberty and yet, that is the problem the new rules are purportedly designed
to solve. The supposed benefits, such as diversity in the workforce
and increasing awareness of protections for health care providers, are
not supported by any evidence. There’s no scientific, statistical
or empirical data showing that the supposed benefits are a likely to
occur if the regulation is adopted.
There is already an imbalance
between rights of conscience and a woman’s right to reproductive health
care in this country, and the regulations will purposefully tip the
balance further away from a woman’s rights. Implementation of
these regulations will only exacerbate the difficulties low income women
face in getting healthcare and allow the denial of vital health information
and services to those who need it most.
The Center for Reproductive
Rights, the National Asian Pacific American Women’s Forum, and the
National Latina Institute for Reproductive Health believe that the regulations
should be rejected outright, and are submitting joint comments to the
HHS, focusing primarily on the impact on low-income women and women
of color. You can read these comments here.