Health Workers' 'Conscience' Rule Set to Be Voided
By Rob Stein
The Obama administration's move to rescind broad new job protections for health workers who refuse to provide care they find objectionable triggered an immediate political storm yesterday, underscoring the difficulties the president faces in his effort to find common ground on anything related to the explosive issue of abortion.
The administration's plans, revealed quietly with a terse posting on a federal Web site, unleashed a flood of heated reaction, with supporters praising the proposal as a crucial victory for women's health and reproductive rights, and opponents condemning it as a devastating setback for freedom of religion.
Perhaps most tellingly, the move drew deep disappointment from some conservatives who have been hopeful about working with the administration to try to defuse the debate on abortion, long one of the most divisive political issues.
"This is going to be a political hit for the administration," said Joel Hunter, senior pastor of the Northland Church in Longwood, Fla., whom Obama recently named to his Advisory Council on Faith-Based and Neighborhood Partnerships. "This will be one of those things that kind of says, 'I knew it. They talk about common ground, but really what they want is their own way.' "
Administration officials stressed that the proposal will be subject to 30 days of public comment, which could result in a compromise. They said they remain committed to seeking a middle ground but acknowledged that will not always be possible.
"We recognize we are not going to be able to agree on every issue," said an administration official, who spoke on the condition of anonymity because the process has just begun. "But there remains a substantive area of common ground, and we continue to believe we can make progress and will make progress."
The announcement capped a week when anger among conservatives was already running high because of the ambitious progressive agenda outlined in the administration's proposed $3.6 trillion budget.
The debate centers on a Bush administration regulation, enacted in December, that cuts off federal funding for thousands of state and local governments, hospitals, health plans, clinics and other entities if they do not accommodate doctors, nurses, pharmacists or other employees who refuse to participate in care they feel violates their personal, moral or religious beliefs.
The rule was sought by conservative groups that argued that workers were increasingly being fired, disciplined or penalized in other ways for trying to exercise their "right of conscience."
Women's health advocates, family-planning proponents, abortion rights activists and others condemned the regulation, saying it created a major obstacle to providing many health services, including family planning and infertility treatment, and possibly a wide range of scientific research. After reviewing the regulation, newly appointed officials at the Health and Human Services Department agreed.
"We've been concerned that the way the Bush rule is written, it could make it harder for women to get the care they need," said an HHS official who spoke on the condition of anonymity for the same reason. "It is worded so vaguely that some have argued it could limit family-planning counseling and even potentially blood transfusions and end-of-life care."
An array of family-planning groups and others praised the move.
"The Obama administration is taking the right step forward to rescind this misguided rule," said Rep. Diana DeGette (D-Colo.), who has introduced legislation to overturn the regulation.
But the Family Research Council, the U.S. Conference of Catholic Bishops and others condemned it.
"It is open season to again discriminate against health-care professionals," said David Stevens, head of the Christian Medical & Dental Associations. "Our Founding Fathers, who bled and died to guarantee our religious freedom, are turning over in their graves."
The announcement -- which follows an administration decision to lift restrictions on federal funding of international family-planning groups that perform abortions or provide abortion information -- was also disappointing to some who have been working more closely with the administration on reducing the number of abortions.
"I think what was in place was as good as one could find in terms of seeking and securing common ground," said the Rev. Frank Page, the immediate past president of the Southern Baptist Convention and another member of Obama's faith council. "It's a matter of respect. I felt like what was in place was that middle ground of common respect."
Administration officials stressed that the president remains committed to protecting the rights of health-care workers who do not want to participate in abortions; such rights have been guaranteed for decades by several federal laws.
"We recognize and understand that some providers have objections to providing abortions. We want to ensure that current law protects them," the HHS official said. "But the Bush rule goes beyond current law and seems to have upset the balance."
The administration is open to a new rule that would be more focused on abortion, the official said, adding, "We believe that this is a complex issue that requires a thoughtful process where all voices are heard."
Some predicted that the administration will produce a narrower regulation that protects workers who object to abortion but ensures access to other types of care.
"If the president kept in place the conscience clause in regard to abortion but reversed it in regard to birth control, most Americans would agree that's common ground," said Rachel Laser of the group Third Way, which is working to find compromise approaches to a number of contentious issues.
But Page noted that some health-care workers consider certain forms of birth control, such as the morning-after emergency contraception pill, to be the moral equivalent of abortion.
"If they choose not to be part of the distribution of that, that should be their conscience and their right," Page said.
While some family-planning groups acknowledged privately that they might consider a compromise, others said they are doubtful that any regulation is needed.
"Our general feeling is this was an area that does not cry out for further clarification," said Marcia D. Greenberger, co-president of the National Women's Law Center. "I would be skeptical."