Introduction
Soon after taking office, President Obama made it a top priority to reverse a regulation that allows health care providers the right to refuse to perform services to which they object. The regulation, issued by executive order by the Bush Administration and finalized on December 19, 2008,[1] broadens the application of conscience protections initially offered under the Church Amendment, a 30-year-old law establishing protections for health care providers who object to providing abortions or other family planning services. The Bush regulation applied broadly to all workers in a health care setting and included the right to refuse to provide services, information, or advice to patients about subjects to which the provider has moral objections. The Obama Administration began the administrative process to reverse the Bush Administration’s regulation with a proposed rule change in the Federal Register March 10, 2009. However, despite his actions to rescind the regulatory conscience clause protection for health care providers, President Obama stated in his September 9, 2009 address to Congress on health care reform legislation that “federal conscience laws would remain in place.”
How Existing Conscience Protections Impact Health Care Reform
The Bush regulation was a compilation of three underlying amendments. First, the Church Amendments provide fairly comprehensive statutory (strongest) conscience protection; however, they apply only to programs that receive funding through the Public Health Service Act (and two other unrelated acts). None of the funding in the current health care reform bills goes through this funding stream, meaning that the Church amendments would NOT apply.
The Coats Amendments, like the Church Amendments, are statutory protections; however, they apply to graduate medical education funding and focus on restrictions on training health care providers to perform abortions. This is not directly on point with the provisions in the health care reform bills, and thus does not provide sufficient protection.
The protections offered by the Weldon Amendment are included in the Bush regulation. The Weldon Amendment is fairly comprehensive in its scope of protection for conscience rights; however, like the Hyde Amendment restriction on abortion funding, the Weldon Amendment is attached to the yearly Labor Health and Human Services (LHHS) appropriations bill, and thus it is NOT permanent law. Like Hyde, the Weldon Amendment’s protection could fail if Congress refuses to add it to the LHHS bill. Furthermore, the Weldon Amendment only applies to programs appropriated through LHHS Appropriations. There are many provisions in the health care reform bills that bypass the LHHS appropriations altogether and self-appropriate. This means that even if the Weldon Amendment remains, it would offer no protection on those provisions, such as the public plan. For more information, see Health Care Bills in Congress.
Therefore, a broad conscience clause, much like the Weldon Amendment, must be statutorily included in the final health care reform bill before Congress. Without it, the only comprehensive conscience protection that would apply to all of health care reform would be the current Bush regulation, which President Obama is in the process of rescinding.
Conscience Protection in the Healthcare Reform Proposals before Congress
There are presently four different conscience clauses in the health care reform proposals before Congress: two competing clauses were added to the health care reform bill in the House (H.R. 3200) during the Energy and Commerce Committee mark-up, the Capps Amendment and the Stupak/Pitts Amendment; the Kennedy conscience amendment was added during mark-up to the Senate Health, Education, Labor, and Pensions (HELP) Committee bill; and the Senate Finance Committee (Baucus) bill includes language similar to the Capps Amendment.
1. H.R. 3200
H.R. 3200 currently contains two conscience clauses. Reps. Pitts, Stupak, and Lee Terry (R-Neb.) drafted a conscience clause which the Energy and Commerce Committee passed by voice vote, and Rep. Capps also included a conscience clause in the amendment she successfully offered on July 30.
The Stuapak-Pitts Amendment mirrors existing law, i.e., the clear protections for those who oppose abortion which are provided annually through the Weldon conscience amendment (that must be added to an appropriations bill annually). It prohibits federal, state, or local governments that receive funds under H.R. 3200 from subjecting any health care entity to discrimination “on the basis that the health care entity does not provide, pay for, provide coverage of, or refer for abortions.”
By contrast, the Capps Amendment prohibits health insurance plans participating in the Exchange (not government entities) from discriminating “against any individual health care providers or health care facility because of its willingness or unwillingness to provide, pay for, provide coverage of, or refer for abortions.” In other words, this provision protects the right of conscience for abortion providers, and would therefore require pro-life insurance companies to contract, against their conscience, with abortion providers.
2. Senate HELP Committee Bill
The late Sen. Ted Kennedy (D-MA) offered an amendment on July 13 to the HELP bill (amdt. 205) which would ensure that no health care provider or entity is excluded from contracting with an insurance plan participating in “the Gateway” (the HELP bill’s health care exchange framework) on the basis that the provider or entity refuses to perform abortions if performing abortions would be contrary to the religious or moral beliefs of the individual or entity. This amendment was accepted. The scope of the Kennedy amendment is limited however. It does not cover providers who refuse to pay for or refer patients for abortion services. In addition, the amendment provides an exception for “cases of emergency,” which is undefined and can be stretched to fit almost any situation, effectively stripping providers of any protection the amendment may have offered them. Medical providers need true rights of conscience protection and an ability meaningfully to object to performing abortions.
Sen. Coburn offered an amendment (a codification of the Weldon conscience amendment that must be added to an appropriations bill annually) to ensure that health care providers are not forced to participate in abortions or discriminated against because they choose not to do abortions (amdt. 246). The Coburn amendment was defeated.
3. Senate Finance Committee Bill
The Senate Finance Bill includes a conscience provision that mirrors the Capps Amendment in H.R. 3200. Like the Capps Amendment, the Senate Finance Bill would also protect abortionists from discrimination, thereby forcing pro-life insurance companies to contract with the abortionists.
Senator Orrin Hatch offered an amendment (#C13) that would have mirrored the Weldon conscience amendment (that must be added to an appropriations bill annually). However, it was defeated 13-10, with Senator Snowe (R-ME) crossing party lines to vote against the amendment, and Senator Conrad (D-ND) crossing party lines to support the amendment.
Conclusion
Health care providers should be free to deliver care in ethical ways without fear of government reprisal. Any health care reform legislation should protect rights of conscience to the fullest extent possible, and members of Congress must hold President Obama to his word to preserve the current conscience protections.
[1] “The Department of Health and Human Services proposes to promulgate regulations to ensure that Department funds do not support morally coercive or discriminatory practices or policies in violation of federal law, pursuant to the Church Amendments (42 U.S.C. § 300a-7), Public Health Service (PHS) Act §245 (42 U.S.C. § 238n), and the Weldon Amendment (Consolidated Appropriations Act, 2008, Pub. L. No. 110-161, § 508(d), 121 Stat. 1844, 2209).”
{ 5 comments… read them below or add one }
Health Care Providers are Life Keepers.
Health Care Providers dedicate their Lives to Care for Life. Health Care Providers Protect Life. This is what Health Care Providers have chosen to do in Life. This is what they were selected for, through tests and exams. This is what Health Care Providers went to school for. This is what Health Care Providers were trained for: the Care of Life. This is what society expects Health Care Providers to do: take Care of People’s Health and Save Lives.
In history they used to train a completely different set of people to be executioners: individuals who had chosen to do just that: kill humans for a pay, and still be protected by law to do it. Smart guys. But would you trust them to Care for your Life?
Now we all see there is some confusion here, about putting Health Care Providers under compulsion to do a job they have no vocation for.
Would anyone send the animal rights organization’s clerks to slaughter cattle? I assume everybody is smart enough to realize that there would be no meat on the table tonight, in America.
Then where does the confusion come from, about abortions? That a few people, who got trained in health care, perform such? It is their choice. There is a demand and makes them money. They are a minority and they have freedom of choice.
The great majority of Health Care Providers in the United States of America are just that: Health Care Providers. Synonymous with Protectors and Keepers of Life. Fortunately. Because this way they provide for a great need of the American People: good Care of the American People’s Health. Then why do some individuals want to encroach of the Health Care Providers’ Freedom of Choice to perform their work, which is the Care of Life?? This ability just happens to be in high demand nowadays!
Where does the good Care of the American People’s Health come from, if not from the good Conscience with which it is provided? How can a professional whose Conscience is dedicated to Keeping Life, be compelled to destroy it? Common sense says it’s against Human Rights to even attempt to put a Health Care Provider under such compulsion. It would be against the rights of the Health Care Providers, yes. And moreso: against the Human Rights of the Patients who trust them: all of a sudden the American Patients would have no choice but seek Health Care from people who may have used their hands to kill. Would you want to be that patient??
There will be patients’ rights organizations which will ask that the names of health workers who practice abortions or any other kinds of harm to Human Life be listed and posted, exactly like pedophiles’ and child-abusers’ are today.
Will some make a law that to forbid Health Care Providers to make public statements that they Do Not do abortions or euthanasia?
They’ll need a system in place, to make hired killers out of Health Care Providers. Like make them state under oath and sign official papers on graduation day that they willingly submit to becoming hired killers.
Anything wrong with this picture? Or am I the only one confused?
Or … are we head-ed to mayhem … head first?!
Let’s just sit and think together for a moment:
We The American People Do Defend
Our Healthcare Providers’ Right to
Conscious Choice of Life.
Our Life.
Our Children’s Life, Unborn and Born alike.
Our Parents’ Life.
For Life is Our Light.
So Help Us God.
Hey….. Its hurting people without enough money….. my BEST friend…. shes hurting with money issues… so am i… my family almost have a 3 year old die! and I almost died of Swin flue! I DONT THINK THIS HELPS ANYONE BUT THE PEOPLE WHO ARE RICH!
I agree with anne…… shes right! lets just think about the homeless people and hunger…. its all back…. my family is being a good help! we give canned foods to a place and they give them to the hunger! Re-think about this!
If they are not socialist for the bill, then why has a clause been provided and passed to Never revoke this bill. What if it turns out to hurt the country. Well, why would any one out such a clause in the bill unless they had an agenda that was way past this?