Commentary Law and Policy

“Protect Life Act” Wins Approval From House Committee

Amie Newman

HR 358, the bill which does anything but protect life, is on its way to a full vote in the House of Representatives where legislators can vote on whether a pregnant woman has more of a right to life than a provider has to his or her religious belief.

Does a pregnant woman’s right to life supercede a provider’s religious belief? Legislation which makes it lawful to allow a pregnant woman to die instead of providing legal abortion care – if the hospital in which the woman is a patient is religiously-affiliated or the provider is opposed to legal abortion – passed out of the House Committee on Energy and Commerce today by a vote of 33 – 19 and is on its way to the full House now.

HR 358, also known as The Protect Life Act (noted without a hint of irony), introduced by Rep. Joe Pitts (R-PA) of health care reform fame, has been barraged by women’s health advocates and picked apart by media outlets for its extreme take on what are called refusal or conscience laws. Federal law allows for health care providers who work at hospitals which receive federal funds (via Medicaid or Medicare, for example) to refuse to provide abortion care if the provider holds a religious or moral objection, and most states have also enacted conscience or refusal laws. However, federal law also currently mandates that hospitals must ensure public access to emergency services. This law, the Emergency Medical Treatment and Labor Act (EMTALA) also says that hospitals are “required to provide stabilizing treatment for patients with EMCs [Emergency Medical Conditions]. If a hospital is unable to stabilize a patient within its capability, or if the patient requests, an appropriate transfer should be implemented.”

Yet the Protect Life Act is attempting to widen that loophole as big as the audacity its based upon and allow for providers to simply opt-out of saving pregnant women’s lives if it means providing abortion care.

Jodi wrote about the bill on Friday, February 11, as fellow House members objected to its lack of proper citation of constitutional authority,

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Today Rep. Henry A. Waxman (D-CA), Ranking Member of the Energy and Commerce Committee, and Rep. Frank Pallone, Jr., (D-NJ) Ranking Member of the Health Subcommittee, sent a letter (full text below) to Congressman Fred Upton (R-MI), Chairman of the House Energy and Commerce Subcomittee, urging him to withdraw consideration of H.R. 358, a bill which among other things would permit hospitals to deny life-saving treatment to pregnant women. The bill passed in subcommittee yesterday. Waxman and Pallone have called on Upton and Congressman Joe Pitts (R-PA) not to bring the bill to full committee unless and until it is re-introduced with a proper citation of constitutional authority, in accordance with a rule passed by the House GOP leadership on the first day of the new session.

The bill blatantly permits health care providers to opt-out of providing abortions – even if said abortion will save the woman’s life (which of course makes very little sense given that saving the woman’s life will save the life of the fetus growing inside as well; but who said logic was a part of this process, anyway?). As Marcia D. Greenberger, Co-President of the National Women’s Law Center said of the legislation,

“Plain and simple, the Pitts bill jeopardizes women’s health. It threatens women’s ability to use their own money to purchase private health insurance that includes abortion coverage and broadly expands the ability of health care providers to refuse women essential health care services. Under this bill, hospitals could just refuse to perform an emergency abortion—even when a woman’s life is at risk.”

If you think this is hyperbole, it’s not. The experience of one young mother of four at a Catholic hospital in Phoenix illustrates the danger perfectly. When her pregnancy also threatened her life, and she was rushed to the hospital with pulmonary hypertension, the Catholic hospital administrators struggled with whether or not to perform the life-saving procedure. Ultimately, it was in large part thanks to a nun who worked with the hospital, on its Ethics Committee, that the abortion was performed, allowing this mother to return to her four children and her husband alive and well. The hospital, however, was stripped of its affiliation with the Roman Catholic Diocese by the Archbishop who saw the life-saving, emergency care as superfluous, and not in line with Church tenets.

The bill would also bar a woman from purchasing abortion care coverage with her own money if she also took part in a state health exchange (soon to be created under health reform) and prohibit insurance plans from offering coverage of abortion care if they served even one person who also took part in a state health exchange.

News Health Systems

Complaint: Citing Catholic Rules, Doctor Turns Away Bleeding Woman With Dislodged IUD

Amy Littlefield

“It felt heartbreaking,” said Melanie Jones. “It felt like they were telling me that I had done something wrong, that I had made a mistake and therefore they were not going to help me; that they stigmatized me, saying that I was doing something wrong, when I’m not doing anything wrong. I’m doing something that’s well within my legal rights.”

Melanie Jones arrived for her doctor’s appointment bleeding and in pain. Jones, 28, who lives in the Chicago area, had slipped in her bathroom, and suspected the fall had dislodged her copper intrauterine device (IUD).

Her doctor confirmed the IUD was dislodged and had to be removed. But the doctor said she would be unable to remove the IUD, citing Catholic restrictions followed by Mercy Hospital and Medical Center and providers within its system.

“I think my first feeling was shock,” Jones told Rewire in an interview. “I thought that eventually they were going to recognize that my health was the top priority.”

The doctor left Jones to confer with colleagues, before returning to confirm that her “hands [were] tied,” according to two complaints filed by the ACLU of Illinois. Not only could she not help her, the doctor said, but no one in Jones’ health insurance network could remove the IUD, because all of them followed similar restrictions. Mercy, like many Catholic providers, follows directives issued by the U.S. Conference of Catholic Bishops that restrict access to an array of services, including abortion care, tubal ligations, and contraception.

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Some Catholic providers may get around the rules by purporting to prescribe hormonal contraception for acne or heavy periods, rather than for birth control, but in the case of copper IUDs, there is no such pretext available.

“She told Ms. Jones that that process [of switching networks] would take her a month, and that she should feel fortunate because sometimes switching networks takes up to six months or even a year,” the ACLU of Illinois wrote in a pair of complaints filed in late June.

Jones hadn’t even realized her health-care network was Catholic.

Mercy has about nine off-site locations in the Chicago area, including the Dearborn Station office Jones visited, said Eric Rhodes, senior vice president of administrative and professional services. It is part of Trinity Health, one of the largest Catholic health systems in the country.

The ACLU and ACLU of Michigan sued Trinity last year for its “repeated and systematic failure to provide women suffering pregnancy complications with appropriate emergency abortions as required by federal law.” The lawsuit was dismissed but the ACLU has asked for reconsideration.

In a written statement to Rewire, Mercy said, “Generally, our protocol in caring for a woman with a dislodged or troublesome IUD is to offer to remove it.”

Rhodes said Mercy was reviewing its education process on Catholic directives for physicians and residents.

“That act [of removing an IUD] in itself does not violate the directives,” Marty Folan, Mercy’s director of mission integration, told Rewire.

The number of acute care hospitals that are Catholic owned or affiliated has grown by 22 percent over the past 15 years, according to MergerWatch, with one in every six acute care hospital beds now in a Catholic owned or affiliated facility. Women in such hospitals have been turned away while miscarrying and denied tubal ligations.

“We think that people should be aware that they may face limitations on the kind of care they can receive when they go to the doctor based on religious restrictions,” said Lorie Chaiten, director of the women’s and reproductive rights project of the ACLU of Illinois, in a phone interview with Rewire. “It’s really important that the public understand that this is going on and it is going on in a widespread fashion so that people can take whatever steps they need to do to protect themselves.”

Jones left her doctor’s office, still in pain and bleeding. Her options were limited. She couldn’t afford a $1,000 trip to the emergency room, and an urgent care facility was out of the question since her Blue Cross Blue Shield of Illinois insurance policy would only cover treatment within her network—and she had just been told that her entire network followed Catholic restrictions.

Jones, on the advice of a friend, contacted the ACLU of Illinois. Attorneys there advised Jones to call her insurance company and demand they expedite her network change. After five hours of phone calls, Jones was able to see a doctor who removed her IUD, five days after her initial appointment and almost two weeks after she fell in the bathroom.

Before the IUD was removed, Jones suffered from cramps she compared to those she felt after the IUD was first placed, severe enough that she medicated herself to cope with the pain.

She experienced another feeling after being turned away: stigma.

“It felt heartbreaking,” Jones told Rewire. “It felt like they were telling me that I had done something wrong, that I had made a mistake and therefore they were not going to help me; that they stigmatized me, saying that I was doing something wrong, when I’m not doing anything wrong. I’m doing something that’s well within my legal rights.”

The ACLU of Illinois has filed two complaints in Jones’ case: one before the Illinois Department of Human Rights and another with the U.S. Department of Health and Human Services Office for Civil Rights under the anti-discrimination provision of the Affordable Care Act. Chaiten said it’s clear Jones was discriminated against because of her gender.

“We don’t know what Mercy’s policies are, but I would find it hard to believe that if there were a man who was suffering complications from a vasectomy and came to the emergency room, that they would turn him away,” Chaiten said. “This the equivalent of that, right, this is a woman who had an IUD, and because they couldn’t pretend the purpose of the IUD was something other than pregnancy prevention, they told her, ‘We can’t help you.’”

News Law and Policy

Anti-Choice Group: End Clinic ‘Bubble Zones’ for Chicago Abortion Patients

Michelle D. Anderson

Chicago officials in October 2009 passed the "bubble zone" ordinance with nearly two-thirds of the city aldermen in support.

An anti-choice group has announced plans to file a lawsuit and launch a public protest over Chicago’s nearly seven-year-old “bubble zone” ordinance for patients seeking care at local abortion clinics.

The Pro-Life Action League, an anti-choice group based in Chicago, announced on its website that its lawyers at the Thomas More Society would file the lawsuit this week.

City officials in October 2009 passed the ordinance with nearly two-thirds of the city aldermen in support. The law makes it illegal to come within eight feet of someone walking toward an abortion clinic once that person is within 50 feet of the entrance, if the person did not give their consent.

Those found violating the ordinance could be fined up to $500.

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Harassment of people seeking abortion care has been well documented. A 2013 survey from the National Abortion Federation found that 92 percent of providers had a patient entering their facility express personal safety concerns.

The ordinance targets people seeking to pass a leaflet or handbill or engaging in “oral protest, education, or counseling with such other person in the public way.” The regulation bans the use of force, threat of force and physical obstruction to intentionally injure, intimidate or interfere any person entering or leaving any hospital, medical clinic or health-care facility.

The Pro-Life Action League lamented on its website that the law makes it difficult for anti-choice sidewalk counselors “to reach abortion-bound mothers.” The group suggested that lawmakers created the ordinance to create confusion and that police have repeatedly violated counselors’ First Amendment rights.

“Chicago police have been misapplying it from Day One, and it’s caused endless problems for our faithful sidewalk counselors,” the group said.

The League said it would protest and hold a press conference outside of the Planned Parenthood clinic in the city’s Old Town neighborhood.

Julie Lynn, a Planned Parenthood of Illinois spokesperson, told Rewire in an email that the health-care provider is preparing for the protest.

“We plan to have volunteer escorts at the health center to make sure all patients have safe access to the entrance,” Lynn said.

The anti-choice group has suggested that its lawsuit would be successful because of a 2014 U.S. Supreme Court decision that ruled a similar law in Massachusetts unconstitutional.

Pam Sutherland, vice president of public policy and education for Planned Parenthood of Illinois, told the Chicago Tribune back then that the health-care provider expected the city’s bubble zone to be challenged following the 2014 decision.

But in an effort to avoid legal challenges, Chicago city officials had based its bubble zone law on a Colorado law that created an eight-foot no-approach zone within 100 feet of all health-care facilities, according to the Tribune. Sidewalk counselor Leila Hill and others challenged that Colorado law, but the U.S. Supreme Court upheld it in 2000.

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