HHS Rule Change: LAST DAY TO COMMENT
Get your comments in! The comment period for the HHS rule change closes today! Don’t know what to write? Here’s a sample:
Dear Secretary Leavitt,
I am writing to urge you to stop the proposed HHS rule change regarding reproductive health care and “conscience clause” exemptions. The proposed rule change is extremely vague in terms of defining abortion and leaves it up to health care employees to define abortion according to their own whims. This vagueness will lead to many people classifying birth control and emergency contraception as abortion and taking the rule change as license to deny patients medication, treatment, accurate information, and referrals to other health care employees that are willing to do their jobs and help their patients. Denying women access to treatment on the basis of religious feelings is inherently discriminatory and coercive and the rule change privileges the feelings of health care providers over the real, immediate needs of their patients. The rule change speaks of protecting health care providers, but simultaneously leaves patients vulnerable and unprotected.
In many places, women and girls will have more than one option for accessing reproductive health care. However, their insurance might not cover a visit to another doctor if their primary care physician refuses to write a prescription for birth control. They might not be able to take the time off of work for multiple appointments searching for a health care provider who won’t deny them access to contraceptives. Once they have a prescription, they might not be able to find a pharmacist who won’t refuse to fill their prescription. For the women with more limited options, the situation will be even more bleak. Ultimately, whether or not women can eventually find health care providers who are willing to do their jobs and give them the medications they need, this rule change will put more obstacles in the way of exercising their basic right to access health care and decide their reproductive future. It’ll make it more difficult. It’ll make it more time- and labor- intensive and not everyone can afford to waste those commodities. The burden of the rule change would, like so many other policies restricting health care, fall most heavily and harshly on the lower class and poor people in this country.
The rule change also does not take into account the fact that birth control is also used for treating medical conditions unrelatd to conception and pregnancy, such as endometriosis, menstruation-related anemia, dysmenorrhea, polycystic ovary syndrome (PCOS), acne, regulating irregular periods, etc. Under the rule change, health care employees would be free to deny patients birth control treatment for these conditions, should the employees have a blanket objection to birth control.
The rule change will be expensive to implement, costing an estimated $44.5M/year to administer. It would increase health care costs for patients, many of whom already suffer from the onerous cost of health care in this country. It essentially gives health care employees carte blanche to refuse to do the jobs they were hired for and to patients’ health, lives, and futures at risk for the sake of indulging employees’ objections to treating women and girls as equal human beings with the ability and the right to make decisions over their own bodies. The rule change is nothing more than a codification of misogyny and an intrusion of a particular form of Christianity into the public sphere.
Sincerely,
[your name]
[your address]
Online comment form at regulations.gov to send a comment. If that link doesn’t work, you can search for the rule change at regulations.gov with any of the following info:
Docket ID: HHS-OS-2008-0011
Docket Title: Ensuring that Department of Health and Human Services Funds Do Not Support Coercive or Discriminatory Policies or Practices In Violation of Federal Law*
Document ID: HHS-OS-2008-0011-0001
Document Title: Ensuring that Department of Health and Human Services Funds Do Not Support Coercive or Discriminatory Policies or Practices In Violation of Federal Law
You can also email consciencecomment@hhs.gov, putting “Provider Conscience Regulation” as the subject – in fact, do both!
If you’ve already sent a letter, please take a moment to call 1-877-696-6775 and say: “I am calling regarding the proposed regulatory changes released on August 21. I would like to register my strong disagreement with the proposed change.” – Liss
I called them this morning and all the lines were busy. Keep calling until you get through!
ACLU Action Alert to contact the Department of Health and Human Services
Speaker of the House Nancy Pelosi: 202-225-4965 (DC)
Senate Majority Leader Harry Reid: 202-224-3542 (DC)
Democratic presidential candidate Senator Barack Obama: 202-224-2854 (DC)
Democratic vice-presidential candidate Senator Joe Biden: 202-224-5042 (DC)
Senators: Senate.gov
Representatives: House.gov
* Geez, talk about Orwellian nomenclature. The name of the rule change is misleading, since it suggests that it’s coercive and discriminatory to force health care employees to do their jobs. With all due respect, I would like to suggest that it is discriminatory to refuse to provide women treatment on the basis that they don’t deserve the information and health care they need, on the basis of their gender and on the basis that they are inferior human beings without the ability or the right to make decisions about their own bodies. I would also like to suggest that it is coercive to refuse to provide women treatment, information, and referrals and to do one’s best to force them to bear pregnancies they do not want or to suffer without treatment for medical conditions.
Obama on the HHS Rule Change
Last week, I wrote about why Obama and Biden need to fight the HHS rule change. During the course of researching whether or not Obama and Biden had done anything about the rule change, I found a grand total of two things: (1) Obama, but not Biden, signed on to Clinton and Murray’s July 22 letter to HHS Secretary Michael Levitt; (2) one statement that Obama made on the HHS rule change. Actually, that’s not quite correct. The link to Obama’s Senate site will take you to a page showing this text:
Statement of Senator Barack Obama on Proposed HHS Rule Changes
Friday, August 22, 2008For Immediate Release
Contact: Michael OrtizWASHINGTON, D.C. – U.S. Senator Barack Obama (D-IL) today criticized the Department of Health and Human Services’ decision to propose a rule that would limit the rights of patients to receive complete and accurate health information and services, particularly access to contraceptives.
“In the waning days of his administration, President Bush continues to issue policies and proposals that put politics ahead of common sense solutions that help middle class Americans in their daily lives.
“This proposed regulation complicates, rather than clarifies the law. It raises troubling issues about access to basic health care for women, particularly access to contraceptives. We need to restore integrity to our public health programs, not create backdoor efforts to weaken them. I am committed to ensuring that the health and reproductive rights of women are protected.”
What I found on September 19, 2008, was somewhat different:
To further clarify, here’s an image of the same press release that went up at 7thSpace, complete with PhotoShopped editorial. 7thSpace was the only other place I found the press release, by the by.
Statement of Senator Barack Obama on Proposed HHS Rule Changes
Friday, August 22, 2008For Immediate Release
Contact: Michael OrtizWASHINGTON, D.C. – U.S. Senator Barack Obama (D-IL) today criticized the Department of Health and Human Services’ decision to propose a rule that would limit the rights of patients to receive complete and accurate health information and services, particularly access
Notice something missing? A friend of mine called Michael Ortiz, the press contact listed at the 7thSpace site, and Ortiz promptly fixed the Obama.senate.gov version of the web page to display to full press release. We waited with bated breath to see what it would say…
…and got a pathetic, spineless press release. Obama’s press release does not lay out the many substantive problems with the HHS rule change, does not strongly lay out his objections to it, and does not say what he will do to fight the rule change. “Troubling issues about access”? How about “will greatly hamper access to information and care for millions of women and girls across the country”? “Troubling issues about access … to contraceptives”? How about “Will allow pharmacists, doctors, and other health care workers to refuse to provide contraceptives, prescriptions, and referrals to patients”? “policies and proposals that put politics ahead of common sense solutions that help middle class Americans in their daily lives”? What kind of mealy-mouthed, bland, generic statement is that? That could apply to any number of policies being put forth by the Bush government and the McCain-Palin campaign. It’s unspecific and makes the HHS rule change sound like a run of the mill Bush policy rather than something that speaks straight to patients’ rights, womens’ rights, and the right to health care (all of which are items in the Obama-Biden platform). Obama doesn’t clearly explain what the rule change is or go into even the barest of specifics as to what it will do and why it’s bad. Instead, he talks blandly about “[restoring] integrity to our public health programs.” He says that he is “committed to ensuring that the health and reproductive rights of women are protected,” but he lays out no specific plans for how he will ensure that.
It seems to me that the Obama staff couldn’t be arsed to distribute a correct, full-length version of the press release, given that it appeared in a truncated form on Obama’s own Senate site and on a third party site. It’d be ridiculous to hold Obama personally responsible for that failing, since it’s hardly his role to code pages or distribute press releases. However, I do hold him responsible for not making the rule change a big enough issue that his staffers would be on top of it. I do hold him responsible for issuing only one press release, not taking any public or substantive action against the HHS rule change, not calling out HHS Secretary Leavitt, and not bringing publicity to the scope of the rule change. The rule change will definitely affect the lives of millions, further undermine the much-vaunted protections of Roe v. Wade, undermine state laws regulating conscience clauses, and further undermine the separation of church and state.
SHOW. SOME. LEADERSHIP.
This press release is an example of exactly what I mean when I talk about Obama’s empty rhetoric. It’s all platitudes, no specifics, no specifics on why the policy is bad, what it will do, and what he is planning to do to fight it. It’s great to be committed to ensuring access to reproductive health care, but that verbal commitment means nothing if it’s not backed by substantive actions. The comment period for the rule change closes tomorrow, September 25. I’m still waiting for you to act, Senator.
HHS Rule Change: 21 Days
“Alternatively, what kind of advertisement would you develop, considering these factors?
I’d love to see the Dems go full force against HHS’s upcoming policy that equates birth control with abortion. Senators Clinton and Murray have been fighting pretty much alone on this front, and a full court press against it from the entire Democratic Congressional Delegation, including Senators Obama and Biden, would show the Democratic commitment to choice.
I’m talking ads, speeches, some sort of Dem Leadership march on Secretary Leavitt’s office that’s carefully planned, meticulously scripted, thoroughly publicized on every talk show with lots of zingy talking points. Plus the Dem leaders in each state could hold related press events, building the Dem brand for downticket races too. If Senator McCain and Governor Palin are forced to go on record either for OR against birth control, their ticket’s rep as “Mavericks” is going to sustain some serious damage with either evangelicals or moderates. Heads we win, tails they lose.
Most Americans want access to birth control and would be horrified to learn that this policy may put their access in jeopardy. Even many anti-choice voters are pro-contraception. And this could be an easy way to win some points with independents and moderate Repubs, plus reminding Dems what side fights for them, since it doesn’t involve waiting on a court decision or until election day. All we have to do is make Leavitt so uncomfortable that he pulls the policy. We have less than 30 days.
Originally posted as a comment by eleanora on Shakesville using Disqus.
That? Is a fantastic idea. You know the drill: call, email, and write your senators and representatives and call up the Democratic candidates, too.
Speaker of the House Nancy Pelosi: 202-225-4965 (DC)
Senate Majority Leader Harry Reid: 202-224-3542 (DC)
Democratic presidential candidate Senator Barack Obama: 202-224-2854 (DC)
Democratic vice-presidential candidate Senator Joe Biden: 202-224-5042 (DC)
Senators: Senate.gov
Representatives: House.gov
Comment on the rule change at Regulations.gov, providing “Provider Conscience Regulation” as the subject.
I Would Just Like To Reiterate
on the occasion of the first female VP candidate (anti-choice) on the Republican ticket (anti-choice, anti-reproductive health care, full stop), that time for stopping the HHS rule change is marching away. The HHS rule change would create a “conscience clause” exemption allowing “health care providers” at institutions receiving federal funds to refuse to provide “abortions” and “abortion-related services.” The comment period for the rule change closes on September 25th.
Please send an email to the Department of Health and Human Services via the ACLU site (Via Liss).
Please call your representative and senators and ask them their positions on the rule change, if they’re aware of its impacts on the ability of women and girls to get the reproductive health care they need in order to be safe and healthy, and what they plan to do to fight the rule change.
Please call Speaker of the House Nancy Pelosi at 202-225-4965 (DC), Senate Majority Leader Harry Reid at 202-224-3542 (DC), Democratic presidential candidate Senator Barack Obama at 202-224-2854 (DC), and Democratic vice-presidential candidate Senator Joe Biden at 202-224-5042 (DC) and ask them the same questions.
Please submit a comment at the Regulations.gov site, providing “Provider Conscience Regulation” as the subject. Comments submitted through regulations.gov are on the public record at the website and even if HHS passes the rule change, they have to justify the policy against the comments they’ve received. Regulations.gov also has the rule change text in PDF and HTML form.
Melissa has a post on conscience clause exemptions and why they’re crap in the medical professions – the post is written in the context of the recent CA Supreme Court decision that religious objections are not valid grounds for denying GLBTQ individuals health care, but the reasoning applies to conscience clauses more generally.
Reasons for the scare quotes in the first paragraph:
“Conscience clause”: I think it’s nothing more than an abdication of morality and one’s conscience to refuse to provide treatment for people in need of it, and to lie and provide misinformation about contraception and abortion.
“Health care providers”: The rule change redefines health care provider to encompass every employee at a medical institution receiving federal funds – the clerks processing insurance claims (oh, won’t that be fun to sort out, if one of them has an objection to filing claims for birth control), the doctors, the nurses, the pharmacists, the aides that sterilize equipment, etc.
“Abortions” and “abortion-related services”: The definition of abortion is left up to the individual, in the text of the rule change. This means that someone who thinks that birth control, emergency contraception, and any form of contraceptive is abortion, no matter what you’re using it for (e.g. PCOS, regularize periods, anemia, endometriosis), can refuse to provide those medications and services because they’re “abortion.” This includes writing and filling prescriptions and providing referrals to medical professionals who are willing to provide abortions and related services.
More on the HHS Rule Change
Cara provides some more info at Feministe: Bush Officially Proposes Anti-Abortion DHHS Rule
The first is that despite Leavitt and other anti-choice puppet’s proclamations, this will limit women’s access to reproductive health care. The denials reek of classism. You see, barring some unforeseen circumstances, I’ll be fine. Those of us who happen to have insurance and private doctors, this will rarely affect us. But those of us who lack insurance? Many who are low-income? These are the people who generally use services that are government funded, and they are the ones who will be affected. The only people who will have less access to health care as a result of this rule the are people who already have the least access to health care. Despite Leavitt’s disgusting rationalizations, not everyone has the access to transportation, child care, money and time to “go to another provider.” That is, in fact, quite a privilege.The second thing is that many, many, if not most reproductive health centers in the U.S. receive government funding. That includes many organizations which provide abortions, which may be the only abortion provider in a given area, and already work on a strict budget. And under this rule, these organizations would not be able to fire a person for refusing to do their job.
Cara has info on how to comment online and a link to the full text of the proposed rule change.
I called the DC offices of Obama, Reid, and Feinstein this morning. Reid’s (D-NV) and Senate Majority Leader) staffer said that he issued a press release on the rule change today, but I can’t find it on his website. Feinstein’s (D-CA) staffer had no idea what she was planning to do, if anything. Obama’s (D-IL) staffer also had no idea what Obama’s position on this was.
The draft of the rule change was proposed back in July and over a month later, very, very few of my elected officials know what’s going on. Even fewer of them have done anything about it. Senators Boxer, Feinstein, Reid, and Obama oh so bravely and boldly signed onto Senator Clinton’s and Senator Murray’s letter to Secretary of HHS Leavitt, but they haven’t released press statements about their positions, they haven’t brought attention to the issue, they haven’t done anything to actually stand up and fight against the rule change. In the case of Obama, he hasn’t shown any leadership on this issue. Speaker of the House Pelosi didn’t even sign the letter. I can see how much she can be arsed to defend my ability to exercise my reproductive rights.
It is utterly important that we stop this rule change. A federal rule change will supersede state laws, meaning that even in the few states where there are no restrictions on access to abortion, health care providers will be able to deny access to abortion, abortion-related services such as referrals to doctors who do perform abortions, and counseling, birth control (hormonal, IUDs, voluntary sterilization, etc.), emergency contraception, writing prescriptions for all of the above, filling prescriptions for all of the above, and more.
So call your senators and representatives and the House and Senate Majority Leaders – it’s their damned jobs to be leaders and to spearhead party movements, so make them aware that this issue is important. Frau Sally Benz has links to Planned Parenthood’s email campaign and NARAL’s email campaign. Those are form emails, it’s just a few clicks to fill in your name and information and send a message to your senators and representatives.
Something else that might be useful is contacting candidates in local races – present the rule change as a way they can show that they genuinely support a woman’s ability to choose her reproductive future as well as her theoretical right to choose. It could be a means of distinguishing themselves from their opponents and showing leadership. I called Cindy Sheehan’s office this morning because she doesn’t have a statement on reproductive rights on her website, but the staffer wasn’t able to provide any information about Sheehan’s positions on the rule change (barely acceptable; apparently not many people who aren’t obsessed with reproductive rights don’t know about it) or on Proposition 4 (unacceptable; statewide proposition on parental notification that would amend the state constitution). I’m sending an email later and hoping to get more information. Given Representative Pelosi’s complete and utter lack of action on either the rule change or Prop. 4, this could be a way of drawing pro-choice voters fed up with Pelosi over to Sheehan and give her wider appeal on the issues.
ETA: I just got an email from HillPAC about the rule change and the petition they’re running against the rule change. You can sign it here:
Dear Secretary Leavitt,The regulations now published by HHS raise serious concerns about women’s access to family planning services. I strongly urge you to revise this policy that threatens to affect Medicaid and Title X programs that are important to millions of families, and would undermine the health of women across the country. I also call on the Department to issue final regulations that include an assurance that a woman’s access to contraception will not be compromised.
I stand with Hillary Clinton and women and men across America in speaking out against these proposed regulations. We’ve had enough of putting ideology over science and failed policies harming healthy families.
More on the HHS Rule Change
A longer SF Chronicle article:
A proposed Bush administration regulation on contraception and abortion would stop California from enforcing a state law that requires Catholic hospitals and charities to provide birth control coverage for thousands of female employees, state Attorney General Jerry Brown and family-planning advocates said Wednesday.
The U.S. Health and Human Services Department regulation, still in draft form, would define abortion as including certain methods of contraception and would prohibit states and other recipients of federal funds from penalizing health care workers who refused to provide those services because of religious or moral beliefs.
Violators would forfeit federal health care funds, which in California amount to as much as $37 billion a year. …
California’s law was passed in 2000 in response to decisions by many health insurance plans to cover the male potency drug Viagra but continue to deny coverage for birth control pills, forcing women to pay for contraceptives.
The state Supreme Court upheld the law in a 2004 ruling that applied to 1,600 employees of Catholic Charities and 52,000 employees of Catholic hospitals in the state. The law exempts church employees, but the court said affiliated agencies such as Catholic Charities are secular institutions because they employ and serve mostly non-Catholics.
New York’s highest court later issued a similar ruling, and the U.S. Supreme Court denied review of Catholic Charities’ appeals in both cases. Similar laws exist in 25 other states, according to the Guttmacher Institute, a reproductive health research organization.
Such laws would be unenforceable if the proposed regulations take effect, opponents and some supporters of the Bush administration plan agreed.
“By financially punishing noncompliant states with the loss of (federal) funding, the regulation would intrude on the authority of states to enact and enforce laws that ensure women’s access to birth control,” Brown said in an Aug. 4 letter to Michael Leavitt, the administration’s Health and Human Services secretary.
Other opponents include the American Medical Association, the American College of Obstetricians and Gynecologists and 150 members of Congress – mostly Democrats, including California Sens. Dianne Feinstein and Barbara Boxer, prospective presidential nominee Sen. Barack Obama and Sen. Hillary Rodham Clinton. On Wednesday, Planned Parenthood and MoveOn.org submitted 325,000 signatures on petitions to Leavitt urging withdrawal of the regulation.
“This is a giant step down a road that will potentially leave women with a major loss of access to contraceptive methods,” said Kathy Kneer, chief executive of Planned Parenthood Affiliates of California.
She said the administration’s proposal would also allow pharmacists to refuse to supply contraceptives and not refer the customer to another employee or a nearby pharmacy, as California law now requires.
The administration drafted the proposal to implement laws prohibiting recipients of federal funds from penalizing health practitioners who refuse to perform abortions or provide abortion referrals.
The draft proposal covers Catholic Charities and other employers who object to abortion, by defining their insurers as health practitioners. It would define abortion as any procedure or drug that terminates a human life after conception, “whether before or after implantation.”
That language, and other portions of the regulation, cover the most common oral contraceptives and intrauterine devices, said Ellen Golombeck, a national Planned Parenthood spokeswoman.
Although some have interpreted the proposal more narrowly, Deirdre McQuade, the U.S. Conference of Catholic Bishops’ spokeswoman on abortion, said the goal is to protect those who object to any form of artificial contraception.
I called a few offices today.
Senator Boxer’s office: “Senator Boxer has not yet released a statement, but I’ll pass on your message.”
Senator Feinstein’s office: left a message.
Senator Obama’s DC office: “The mailbox for Senator Barack Obama is full. Goodbye. [click]“
Senator Obama’s campaign office: Christ, the phone menu sounds like it’s for a store (options: 1. Donations! 2. Volunteering! 3. Using our website, widgets, and apps! 4. somethingsomething 5. somethingsomething), not a political candidate. To skip the phone menu and talk to a volunteer, press 6.
PD: I’m calling regarding Secretary of HHS Michael Leavitt’s proposed rule change to redefine contraception as abortion and create a conscience clause exemption that would allow health care employees to refuse to provide contraceptives, birth control, abortion services, counseling, and accurate information about abortion based on religious objections. Reproductive rights are an extremely important issue to me and one that I will be weighing heavily when I vote.
Volunteer: Er, what? I have no idea what his position is.
PD: Do you know if he has plans to do something to fight this rule change? I know he signed the letter that Senators Clinton and Murray sent to Secretary Leavitt, but I’d like to see some positive action. It would go a long way toward convincing me that he will protect womens’ reproductive rights and their access to health care services that enable them to plan their reproductive futures.
Volunteer: Well, he solidly supports a woman’s right to choose-
PD: Actually, no, he doesn’t. So far, he’s pandered to the right and made statements about making decisions in consultation with my pastor and husband.
Volunteer: Well, you mentioned that you’re going to be considering this when you vote. So, what you have to do is consider him in comparison to the alternative, Mc-
PD: Actually, no, I don’t owe my vote to Senator Obama, and simply being better than McCain on this issue is not good enough. It’s not enough that he won’t appoint anti-choice justices to the Supreme Court, given that there are already enough judges on the bench to overturn Roe v. Wade and that he almost approved Roberts. He has to be good in his own right and so far, he has no legislative or policy history of defending womens’ access to reproductive services.
Volunteer: Believe me, I understand what you’re saying. But I have no idea what his position is or what he plans to do. Here, why don’t I take down your information and I’ll forward it to someone else who can hopefully get back to you.
I gave the volunteer my name and email. Hopefully it won’t come back to haunt me in the form of donate for Obama spam.
Representative Pelosi’s office:
Volunteer: Er, I have no idea!
PD: Do you know if she plans on issuing a statement or working to defeat this rule change? Reproductive rights are an issue I will be considering when I vote in November.
Volunteer: She hasn’t issued a press release yet. If you’d like to follow her press releases, you can do that at [website]
PD: Yes, I’m aware that she hasn’t issued a press release yet, what I’d like to know is if she plans on doing something in the future or if there’s a way to express that this is a deep concern for me.
Volunteer: I have no idea!
PD: Okay, thank you.
Seriously, the volunteer was perky and bouncy and chipper while declaring that he has no idea what the rule change was about and whether the Speaker of the House planned on doing anything.
Got Senate Majority Leader & Professional Pushover Reid’s voicemail, so I’ll call his office and Feinstein’s office back tomorrow.
