Obama Administration May Rescind “Conscience” Rule

Cristina Page

The Obama administration takes the first step to rescind Bush's midnight regulations that would allow any health care worker to obstruct a woman's access to contraception.

The Obama
administration will rescind Bush’s midnight regulations that would
allow any health care worker to obstruct a woman’s access to
contraception, the Chicago Tribune reports this morning. In its place they will make another rule that clarifies
"what health-care workers can reasonably refuse for patients."

Rachel Maddow celebrates the reversal of Bush’s HHS “provider conscience” regulation.

The Tribune reports that, in an effort to strike "common ground,"
the administration is seeking perspective from "across the ideological
spectrum before it finalizes the rollback." An unnamed official told the
paper, "We believe that this is a complex issue that requires a
thoughtful process where all voices can be heard."

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It would appear the regulation was already beginning to wreak havoc
in the mere two months it’s been in effect. The Tribune reports,

Seven states, including California, Illinois and Connecticut, as well
as two family planning groups, have filed suits challenging the Bush
rule, arguing it sacrifices the health of patients to religious beliefs
of medical providers.

The American College of Obstetrics and Gynecology has reported
cases such as that of a Virginia mother of two who became pregnant
because she was denied emergency contraception. In Texas, the group
said, a rape victim had her prescription for emergency contraception
rejected by a pharmacist.

We can expect the pro-lie movement to be at
its finest making its case to the public to retain the refusal
regulation. I predict we’ll hear a lot from them about healthcare
providers being forced to take part in abortion services and that
they’ll fail to mention that by "abortion" they mean "contraception."
What often gets reported as a footnote in news stories is that three
separate laws dating back 30 years already protect health care workers
who refuse to take part in the delivery of abortions services.

The refusal regulation Obama is beginning to rescind today is of
course very different and far more expansive than those laws. Even
Bush’s own officials at the EEOC spoke out against his regulation. The
following is an excerpt from my piece, "Bush, Our Ex-Boyfriend,"
published on the day the regs took effect, inauguration day, literally
in the last minutes of the Bush administration:

The
HHS regulations were a last minute, hastily executed,
unconstitutionally vague, attempt by Bush to repay his only loyal
constituency left, the religious right wing. The regulations attempt to
expand health care workers right to "consciously object" to the
broadest array of health care services imaginable, basically anything,
even in medical emergencies. They can, in other words, refuse to
provide you medical care, because it offends them! It opens the door to
many patient abuses, shreds state laws and contradicts federal
discrimination statutes. Healthcare workers would be able to withhold
information from a patient about healthcare options without the patient
even knowing that any information is being withheld. Patients can be
refused referrals if the healthcare worker objects to the care they’re
seeking somewhere else.

And here is one particularly bizarre twist. The regulations specify
that workers don’t have to inform their employers of the service or
services they object to before hand. It’s also unclear the extent to
which employers have the right to ask job applicants about their
willingness to take part in the services they provide. Thus, imagine
the situation in which an anti-choice person applies for a position at
Planned Parenthood. The employer couldn’t ascertain that she’s against
abortion, nor could it fire her when she refused to have anything to do
with it.

But the regulations’ real intent (revealed in a draft version of the
proposal leaked this summer) is perhaps worse: to allow those who want
to obstruct a woman’s access to birth control full license. Keep in
mind, there is already ample protection for those who do not wish to
take part in abortion services, three laws in fact. The right to refuse
to take part in abortion services has existed for over 30 years. Here’s
the thrust of the new regulations (in my own words), "If you’d like to
consider contraception an abortion method and refuse to take part,
please do, but also feel free to object to contraception, or any other
health care service, for any reason you can dream up. The only thing
limiting your right to refuse is your own imagination." Your conscience
is yours. Use it how you want. Even if it infringes on the conscience
of others.

There will be a 30-day comment period about the
rescinding of the regulation. Rewire will post information
about how to comment so please check back soon.

The Obama
Administration promises to listen to all perspectives–one of the
clearest hallmarks of how different an administration this is from the
last. But as a result, we can’t assume administration officials
understand all the problems with the original regulations. That’s why
we must speak up as clearly now as we did before. We know for sure
opponents of birth control will.

Analysis Politics

Paul Ryan Uses Falsehoods Behind Texas HB 2 to Push Yet Another Abortion Restriction

Ally Boguhn

In a CNN town hall Tuesday night, Paul Ryan agreed with an audience member's baseless sentiment that the Supreme Court had struck down “commonsense health and safety standards at abortion clinics" in its Whole Woman's Health v. Hellerstedt ruling.

During a CNN town hall on Tuesday night, House Speaker Paul Ryan (R-WI) pushed falsehoods about the anti-abortion provisions at the center of the recent U.S. Supreme Court decision in Whole Woman’s Health v. Hellerstedt being necessary for patient health and safety. Ryan nonsensically then used the decision as a launch point to promote House Republicans’ Conscience Protection Act, which passed in the House Wednesday evening and supposedly shields those who object to abortion from discrimination. The only things Texas’ provisions and the legislation have in common, however, is that they’re all about blocking access to abortion care.

Town hall audience member and executive director of New Jersey Right to Life Marie Tasy claimed during the event Tuesday that the Supreme Court had struck down “commonsense health and safety standards at abortion clinics,” in its landmark ruling against two provisions—the admitting privileges and surgical center requirements—of Texas’ HB 2.

“Absolutely,” Ryan said in response to Tasy’s remarks. “I agree with that.”

But the provisions of the law in question were not about keeping anybody safe. As Justice Stephen Breyer noted in the opinion declaring them unconstitutional, “When directly asked at oral argument whether Texas knew of a single instance in which the new requirement would have helped even one woman obtain better treatment, Texas admitted that there was no evidence in the record of such a case.”

All the provisions actually did, according to Breyer on behalf of the Court majority, was put “a substantial obstacle in the path of women seeking a previability abortion,” and “constitute an undue burden on abortion access.”

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Despite this, Ryan then used the falsehood at the center of HB 2 as a call to action for yet another anti-choice restriction: the Conscience Protection Act. After fielding the question from Tasy about how anti-choice issues could be advanced in Congress in the wake of the Court’s decision, Ryan pivoted to claim that the government is “forcing people to conduct [abortion] procedures”:

Actually, tomorrow we are bringing a bill that I’ve been working on called the Conscience Protection Act. I’m pro-life. I think you probably know that. And I would like to think we could at least get consensus in this country that taxpayers shouldn’t be funding abortions. That the government shouldn’t be forcing people to conduct procedures, especially health-care workers, against their own conscience.

Our First Amendment is the right of conscience, religious freedom. Yet our own government today, particularly in California, is violating that right and not allowing people to protect their conscience rights, whether they’re Catholic hospitals or doctors or nurses. Tomorrow we’re bringing the Conscience Protection Act to the floor and passing it. It’s Diane Black’s bill. And it is to give those citizens in America who want to protect their conscience rights their ability to defend those rights. That is one thing we’re doing tomorrow to protect the conscience, because I believe we need to cultivate a culture of life. And at the very least, stop the government from violating our conscience rights.

Ryan would go on to make similar remarks the next day while speaking on behalf of the bill on the House floor, though this time he added that the “bill does not ban or restrict abortion in any way …. All it does is protect a person’s conscience.” 

As Rewire‘s Christine Grimaldi previously reported, the Conscience Protection Act would codify and expand on the Weldon Amendment. According to the Department of Health and Human Services (HHS), the amendment prohibits states that receive federal family planning funding from discriminating against any health care entity-including physicians, health-care professionals, hospitals, and insurance plans, “on the basis that the health care entity does not provide, pay for, provide coverage of, or refer for abortions.”

The Weldon Amendment currently must be passed each year as part of annual appropriations bills.

Grimaldi noted that the act “would give health-care providers a private right of action to seek civil damages in court, should they face alleged coercion or discrimination stemming from their refusal to assist in abortion care.”

Ryan proposed similar conscience protections as part of his recently released health-care plan, though, as Grimaldi wrote, “the Conscience Protection Act goes a step further, allowing providers to sue not only for threats, but also for perceived threats.”

But those whom Ryan and his colleagues are claiming to defend already have protections that impede access to abortion care, according to critics of the measure.

Ryan, for example, suggested in both his CNN appearance and his House floor speech the next day that California’s requirement that insurance plans must cover elective abortions under “basic health services” violates “religious freedom.” But a June investigation by the HHS Office for Civil Rights into whether California’s requirement violated the Weldon Amendment rejected similar complaints by anti-choice group Alliance Defending Freedom.

“Let’s be very clear—right now, current law says that hospitals, insurers, and doctors may refuse to perform an abortion or provide coverage for abortion, which already greatly limits women’s access to legal procedures,” said Rep. Jan Schakowsky (D-IL) Wednesday, speaking after Ryan on the House floor during remarks before the Conscience Protection Act passed.

“More importantly, when a woman’s health is in danger, providers would not be required to act to protect the health of that mother. This bill would allow them to refuse to … facilitate or make arrangements for abortion if they have a moral objection to it,” continued Schakowsky. “They could also refuse to provide transportation to another hospital if a woman is in distress if that hospital provides abortions.”

Debra L. Ness, president of the National Partnership for Women & Families, explained in a statement following the passage of the legislation in the House that the measure is about blocking access to abortion. “The Conscience Protection Act is dangerous, discriminatory legislation designed to block women’s access to abortion care,” said Ness.

“For example, a hospital could rely on the Conscience Protection Act to turn away a woman in an emergency situation who needs an abortion or refuse to provide a woman information about her treatment options. This legislation is a license for providers to discriminate against women and undermine their access to essential, constitutionally protected health care,” Ness said.

News Abortion

Anti-Choice Legislator Confirms Vote on House Conscience Protections (Updated)

Christine Grimaldi

The Conscience Protection Act would give health-care providers a private right of action to seek civil damages in court, should they face supposed coercion to provide abortion care or discrimination stemming from their refusal to assist in abortion care. The Act allows providers to sue not only for threats, but also for perceived threats.

UPDATE: July 14, 10 a.m.: The House passed the Conscience Protection Act Wednesday night in a largely party line 245-182 vote. Prior to floor consideration, House Republicans stripped the text of an unrelated Senate-passed bill (S. 304) and replaced it with the Conscience Protection Act. They likely did so to skip the Senate committee referral process, House Democratic aides told Rewire, expediting consideration across the capitol and, in theory, ushering a final bill to the president’s desk. President Barack Obama, however, would veto the Conscience Protection Act, according to a statement of administration policy.

The U.S. House of Representatives will vote next Wednesday on legislation that would allow a broadened swath of health-care providers to sue if they’re supposedly coerced into providing abortion care, or if they face discrimination for refusing to provide such care, according to a prominent anti-choice lawmaker.

Rep. Joe Pitts (R-PA) told Rewire in a Friday morning interview that House leadership confirmed a vote on the Conscience Protection Act (H.R. 4828) for July 13, days before the chamber adjourns for the presidential nominating conventions and the August recess. Pitts said he expects the bill to be brought up as a standalone measure, rather than as an amendment to any of the spending bills that have seen Republican amendments attacking a range of reproductive health care and LGBTQ protections.

The office of U.S. House Speaker Paul Ryan (R-WI) had no immediate comment.

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Pitts’ remarks came during and after he hosted a “Forum on Conscience Protections” in the House Energy and Commerce Committee room to garner support for the bill.

Energy and Commerce Democrats boycotted the forum, a House Democratic aide told Rewire in a subsequent interview.

Legislation Builds on Precedent

Conscience protections are nothing new, the aide said. The latest iteration is a successor to the Health Care Conscience Rights Act (S. 1919/H.R. 940), which remains pending in the House and U.S. Senate. There’s also the Abortion Non-Discrimination Act (S. 50) and similarly named bills in both chambers. The fiscal year 2017 Labor, Health, and Human Services funding bill, which guts Title X and Teen Pregnancy Prevention grants, includes the Health Care Conscience Rights Act.

At the leadership level, Ryan’s recently released health-care plan mimics key provisions in the Conscience Protection Act. Both would give health-care providers a private right of action to seek civil damages in court, should they face alleged coercion or discrimination stemming from their refusal to assist in abortion care. The Conscience Protection Act goes a step further, allowing providers to sue not only for threats, but also for perceived threats.

The proposals would also codify and expand the Weldon Amendment, named for former Rep. Dave Weldon (R-FL), who participated in Pitts’ conscience forum. The Weldon Amendment prohibits states that receive federal family planning funding from discriminating against health-care plans based on whether they cover abortion care. Currently, Congress must pass Weldon every year as an amendment to annual appropriations bills.

Administration Action Provides Impetus

There hadn’t been much public dialogue around conscience protections with the exception of some anti-choice groups that “have really been all over it,” the aide said. The National Right to Life issued an action alert, as did the Susan B. Anthony List, to galvanize support for the Conscience Protection Act.

The relative silence on the issue began to break after the Obama administration took a stand on abortion care in June.

The U.S. Department of Health and Human Services’ Office for Civil Rights rejected anti-choice groups’ “right of conscience” complaint against California’s requirement that insurance plans must cover elective abortions under the definition of “basic health-care services.” Anti-choice groups had argued the California law violates the Weldon Amendment, but the administration found otherwise.

The California decision reinvigorated support for the Conscience Protection Act, the aide said. Ryan’s earlier health-care plan also specifically references the decision.

“We think this is going to be a big issue for us throughout the rest of this Congress,” the aide said.

Aide Outlines Additional Consequences

Beyond creating a private right of action and codifying Weldon, the Conscience Protection Act contains additional consequences for abortion care, the aide said.

The legislation would expand the definition of health-care providers to employers, social service organizations, and any other entity that offers insurance coverage, allowing them to raise objections under Weldon, the aide said. The aide characterized the change as a direct response to the California decision.

The legislation also broadens the list of objectionable services to include facilitating or making arrangements for abortion care, according to the aide.

The Republican-dominated House is likely to pass the Conscience Protection Act. But the aide did not expect it to advance in the Senate, which would all but certainly require a 60-vote threshold for such a controversial measure. More than anything, the aide said, the bill seems to be catering to anti-choice groups and long-time proponents of conscience clauses.

“The House oftentimes will pass these kinds of anti-choice proposals, and then they just go nowhere in the Senate,” the aide said.