Critics say the regulation is a back-door effort by the Bush administration, as it winds down its tenure, to restrict access to birth control. Nancy Keenan, president of NARAL Pro-Choice America, put it this way:
This Bush proposal has the potential to undermine state laws that guarantee rape survivors' access to contraception in the emergency room or require insurance companies to cover prescription birth control in the same way they pay for Viagra...This is yet another example of just how out of touch Bush is with the country's priorities -- and we will not give up in our fight to keep him from doing more damage as he prepares to leave the White House.
Supporters counter that the new regulation would simply enforce an old federal "conscience" provision that allows healthcare professionals to opt out of doing abortions or providing contraceptives if that violates their own beliefs.
This proposed regulation is about the legal right of a healthcare professional to practice according to their conscience. Doctors and other healthcare providers should not be forced to choose between good professional standing and violating their conscience. Freedom of expression and action should not be surrendered upon the issuance of a healthcare degree.
Either way, the deadline for public comments is at midnight today, and department spokesman Kevin Schweers reports a "higher than average" volume of comments. He said the comments mirror those posted on Leavitt's blog.
This week Leavitt met with two of the regulation's biggest critics -- Sens. Hillary Rodham Clinton of New York and Patty Murray of Washington -- and if body language is any indication, the reg will probably be finalized soon.
Murray, saying she appreciated Leavitt's time, noted that the two senators "received no guarantee that women's access to contraceptives will be protected if these rules move forward."
Clinton said they had a "very frank conversation about how this rule could create a slippery slope leading to patients being denied access to contraception." While she urged Leavitt to "take these concerns into consideration," she did not sound optimistic, saying:
With the public comment period coming to a close, everyone who cares about women having access to the health care they need must make their voices heard.
The Bush administration proposed new rules today that critics say would make it more difficult for women to obtain abortions, and for men and women to obtain contraceptives.
After more than a month of internal -- and eventually public -- debate, the administration unveiled regulations that, if enacted, would provide stronger protections for doctors and other healthcare providers to refuse to perform medical procedures -- or, possibly, sell contraceptives -- if such steps violate their religious beliefs.
Jill Morrison, the senior counsel of the National Women's Law Center, told Countdown to Crawford when we reported on the draft regulation in July that it was "essentially a hit list against anything that protects a patient's rights to get access to legal and needed health services" in the area of reproduction.
Publication of the rule in the Federal Register triggered a 30-day public comment period, after which the Bush administration could implement a final rule.
Announcing the proposed regulation today, Mike Leavitt, the secretary of the Department of Health and Human Services, said it was "about the legal right of a healthcare professional to practice according to their conscience."
He said:
Doctors and other healthcare providers should not be forced to choose between good professional standing and violating their conscience. Freedom of expression and action should not be surrendered upon the issuance of a health care degree.
The department said the rule would make it clear that protections against discrimination "apply to institutional healthcare providers as well as to individual employees" whose offices receive certain federal funds.
The department argued that the regulation "would in no way restrict healthcare providers from performing any legal service or procedure" and that patients would be able to obtain the procedure -- an abortion, for example -- from someone who did not assert "a conflict of conscience."
The proposal is certain to face challenge from abortion rights supporters.
Cecile Richards, president of the Planned Parenthood Federation of America, said: “Women’s ability to manage their own healthcare is at risk of being compromised by politics and ideology."
She said, the Associated Press reported, that the organization was concerned that the regulation posed "a serious threat to women’s healthcare by limiting the rights of patients to receive complete and accurate health information and services."
-- James Gerstenzang
Photo of Mike Leavitt in 2006: Kevin Wolf / Associated Press
Mike Leavitt, secretary of Health and Human Services, said he never meant to create a stir over birth control. In proposing a new HHS regulation last month, he said, he only meant to protect the "right of conscience" of federally funded healthcare providers whom he wants spared dismissal because of their objections to birth control or abortion. In a new post on his blog, the secretary said:
An early draft of the regulations found its way into public circulation before it had reached my review. It contained words that lead some to conclude my intent is to deal with the subject of contraceptives, somehow defining them as abortion. Not true.
The Bush administration has consistently supported the unborn. However the issue I asked to be addressed in this regulation is not abortion or contraceptives but the legal right medical practitioners have to practice according to their conscience and patients should be able to choose a doctor who has beliefs like his or hers."
Leavitt added that if the department does now issue a regulation, "it will be focused on the protection of practitioner conscience."
Pro-choice groups weren't buying it.
"Secretary Leavitt's vague comments on the draft HHS rule do nothing to reassure Americans that the administration is not considering redefining abortion to include forms of contraception, thereby jeopardizing women's access to basic healthcare," said Cecile Richards, president of Planned Parenthood Federation of America. "The administration needs to stop playing word games with women's health and state clearly they will reject any regulations that will undermine women's access to basic healthcare."
"Bush and his political appointees have a long, long record of attacks on contraception," agreed NARAL Pro-Choice America President Nancy Keenan. "So Secretary Leavitt's claim that the department never intended to target birth control isn't believable."
As Countdown to Crawford and others reported, the proposed regulation stirred up a furious debate, with more than 20,000 letters sent to Congress in opposition. And Keenan promised more to come.
"We will continue to engage our activists and work with leaders in Congress to stop this administration from pushing a last-ditch attack on birth control as Bush prepares to leave the White House," she said, adding, "In the face of growing public outrage over
this attack on birth control, the Bush administration is trying to backtrack."
The furor kicked off by the Bush administration's draft of a new regulation that could restrict access to abortion and birth control is growing into a bitter debate pitting religious freedom against patients' rights.
That is the finding of the Washington Post in a look at what has occurred in the two weeks since Countdown to Crawford and others reported that the administration was considering a regulation that would allow any healthcare provider to refuse to deliver medical services that violate the worker's moral beliefs.
Critics say the move is intended to further tighten restrictions on abortion.
The Department of Health and Human Services prepared the 39-page draft spelling out a regulation that could have an effect on pharmacies, clinics, individual doctors' offices, hospitals and other workers and facilities in the broad healthcare network that receive federal money.
The rule would be intended, the document says, to make sure that federal funds "do not support morally coercive or discriminatory practices or policies in violation of federal law."
But Jill Morrison, the senior counsel of the National Women's Law Center, said when the draft was disclosed that the measure was "essentially a hit list against anything that protects a patient's rights to get access to legal and needed health services" in the area of reproduction.
When House Speaker Nancy Pelosi, a Democrat, said that if the regulation is enacted, "it will launch a dangerous assault on women's health," the ensuing traffic caused her office website to crash.
Now, says the Post, while conservative groups, abortion opponents and some members of Congress have welcomed the rule as safeguarding medical workers, it has ...
It started as a comment from House Speaker Nancy Pelosi (D-San Francisco), who told reporters yesterday that if the Bush administration goes through with its proposed regulation on abortion, "it will launch a dangerous assault on women's health."
Digg put the comment on its front page, linking to Pelosi's website. Which, as our colleagues at Web Scout reported today, crashed. Big time.
"Our website is being deluged with readers incredulous that the Bush administration may be trying to redefine contraception as abortion," the speaker's press secretary, Brendan Daly, said in an e-mail. "We hope to restore full service to our website soon."
The site was back up within an hour. Daly, noting that Pelosi is a Digg user, added that the speaker "appreciates the attention the site has given to this issue."
The furor began a few days ago when it was reported that the Bush administration is considering a regulation meant to protect doctors and nurses from performing services that violate their moral beliefs.
Abortion advocacy groups criticized the proposal, arguing it would in effect redefine contraception as abortion. On the other side, abortion critics said it will ensure doctors are not discriminated in hiring or employment if they don't want to take part in an abortion.
The Bush administration responded today to reports that it was drafting a regulation that critics fear would further restrict a woman's access to contraceptive materials or abortions.
The 39-page document spells out a regulation that could have an effect on pharmacies, clinics, doctors' offices, hospitals and other workers and facilities in the broad healthcare network receiving federal money.
This afternoon, Kevin Schweers, a deputy assistant secretary of Health and Human Services for public affairs, responded in an e-mail: “Over the past three decades, Congress has passed several anti-discrimination laws to protect institutional and individual health care providers participating in federal programs."
He continued: "HHS has an obligation to enforce these laws, and is exploring a number of options. For example, Secretary [Mike] Leavitt recently sent letters to the American Board of Obstetrics and Gynecology expressing concern over policies that may have forced providers to choose between compromising their personal beliefs and facing economic and professional sanctions."
Asked for a specific response to the draft of the potential new regulation, he said in a follow-up e-mail: "I read through the blog posting and don't think we'll have anything further to add in the immediate future."
In a move that critics say is intended to further tighten restrictions on abortion, the Bush administration is considering a regulation that would allow any healthcare provider to refuse to deliver medical services that violate the worker's moral beliefs, according to a draft of the rule obtained by the Los Angeles Times.
The 39-page document has been prepared by the Department of Health and Human Services. It spells out a regulation that could have an effect on pharmacies, clinics, individual doctors' offices, hospitals and other workers and facilities in the broad healthcare network receiving federal money.
It could be put into effect within two months, although that timetable could be extended. The tentative nature of the plan, still considered for internal discussion, was highlighted by these sentences at the bottom of each page: "This is a confidential, deliberative, pre-decisional document and does not necessarily reflect current policy efforts or plans. For official use only."
The rule would be intended, the document says, to make sure that federal funds "do not support morally coercive or discriminatory practices or polices in violation of federal law."
Summarizing what she presented as the apparent intent of the regulation, Jill Morrison, the senior counsel of the National Women's Law Center, said in a telephone interview that the broad sweep of the measure, from the language of its introduction, "is essentially a hit list against anything that protects a patient's rights to get access to legal and needed health services" in the area of reproduction.
After studying the document, the advocacy group -- seeking to draw attention to the proposal to try to head it off -- said that if put into effect by administrative order, it would restrict a woman's access to reproductive health services and information, including birth control, and allow patients to be denied information "about medically appropriate and necessary services."
Under the rule, clinics, hospitals and other providers of healthcare would be required to certify that they would not fire a worker who has religious objections to providing any particular "health service." These could include multiple forms of contraception, including some birth control pills, IUDs and emergency "morning after" contraception.
Current federal employment law prohibits firing workers because they refused to perform a task that goes against moral or religious beliefs -- protections that have been spelled out in various degrees since the 1970s and now allow health workers to not take part in providing abortions in some circumstances.
But federal law also protects patients' rights to obtain those services and gives employers the right to respect the worker's beliefs -- only to the point that doing so does not impose "undue hardship" on the employer, Morrison said.
She said the purpose of the proposed rule appeared to be to blur the line between abortion and contraception as the Bush administration leaves office -- in effect broadening the definition of abortion and restricting access to procedures fitting the new definition.
"Everywhere in federal law contraception is contraception and abortion is abortion," she said. "What this does is take the extra step of trying to conflate the two. It's an attack on a woman's right to contraception."
James Gerstenzang and Johanna Neuman are reporters in The Times' Washington bureau. Between the two of them, they have covered the White House, diplomacy, military affairs, the environment, international economics, trade and Congress. They have both spent time in Crawford, Texas.
