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The San Francisco Chronicle

Bush Plan Would Blunt State Birth Control Law

Bob Egelko

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.

The draft regulation describes the problem as laws such as those in
California and New York that require employers to include
contraceptives in any prescription drug coverage they offer to
employees. The federal agency had no comment Wednesday on the proposal.

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.

States would lose authority

Such laws would be unenforceable if the proposed regulations take
effect, opponents and some supporters of the Bush administration plan

"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 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
Knorr, 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

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.

"Pregnancy is not a disease to be treated by abortion, and neither
is fertility," she said. "To be coerced to treat it as if it were a
condition that is pathological is unjust."

The administration's proposal is backed by other religious
organizations that oppose abortion. Dr. David Stevens, chief executive
of the 15,000-member Christian Medical Association, said many of the
group's members have been denied jobs or promotions because they
objected to performing abortions or to providing contraceptives that
they consider the equivalent of abortion.

"There is an organized effort to force health care professionals to do things that violate their conscience," Stevens said.

In an Aug. 7 blog entry, Leavitt said his department was still
deciding whether to issue a regulation, which would then be submitted
for 30 days of public comment before it could take effect.

Its focus, he said, "is not abortion or contraception, but the legal
right medical practitioners have to practice according to their
conscience" and the right of patients to choose like-minded doctors.

Religious beliefs

According to the draft regulation, health practitioners are often
unaware of their rights and are encountering "an environment in the
health care industry that is intolerant of certain religious beliefs,
ethnic and cultural traditions, and moral convictions."

Requiring states and federal fund recipients to honor the refusal of
health care practitioners and others to take part in procedures they
find objectionable would promote "a more inclusive, tolerant
environment," increase diversity in the medical field, and affect
states "only insofar as they engage in illegal discrimination," the
proposal says.

Planned Parenthood's Knorr said opponents will campaign as hard as
they can to stop the regulation, lobbying Congress as well as federal
officials. If they fail, she said, they'll ask the next administration
to repeal it.

Read the proposal

The Bush administration's draft regulations on abortion and contraception can be read at:


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