On September 26, the House approved, 229-189, a controversial bill (H.R. 4691) that would permit an array of health care facilities, plans, and organizations to refuse to perform, cover, or pay for abortion services or to provide referrals and information if they object to such services on religious or moral grounds.
Current law prohibits federal, state, and local governments from denying funds to health care entities that refuse to undergo abortion training, refuse to provide abortion training, or refuse to provide referrals for abortion training. The provision applies to medical residency training programs, as well as physicians and others participating in those programs. The provision was enacted in 1996 in response to a standard adopted by the Accreditation Council for Graduate Medical Education, which required medical residency training programs to provide abortion training. That standard also allows programs or physicians with a religious or moral objection to opt out of the training.
Sponsored by Rep. Michael Bilirakis (R-FL), the Abortion Non-Discrimination Act (H.R. 4691) would expand current law to health care professionals, hospitals, health maintenance organizations, health insurance plans, and other health care facilities, organizations, and plans. Additionally, the bill would prohibit federal, state, and local governments from denying funds to any entity that refuses to perform, cover, or pay for abortion services or to provide referrals and information.
The bill was heatedly debated under a closed rule, which prohibited amendments. Bill supporters argued that the measure would clarify current law and that it would provide a much needed protection for those individuals and entities who object to such services based on religious or moral beliefs. Opponents countered that the bill would usurp other federal, state, and local laws and regulations and would have the effect of imposing a domestic gag rule and limiting women’s access to information and services.
“H.R. 4691 strengthens existing law by saying that health care entities should not be forced by the government to provide abortions,” argued Rep. Sue Myrick (R-NC) adding, “It is a very small but very important step in the right direction. It simply protects conscience rights of those organizations who do not want to be involved in abortion.”
Calling the bill “the most far-reaching assault on women that I have ever seen in this House,” Rep. Jim McDermott (D-WA) said that it was “simply a step back into the dark ages.”
Saying that the bill “does not expand or change any rights of women,” Rep. Melissa Hart (R-PA) added, “What it does is it allows for the free exercise of a conscientious objection of a health care provider.”
“Nobody should be forced to learn how to do an abortion if they do not want to do it, and, importantly, no health care entity should be forced to perform abortions,” stated Rep. Dave Weldon (R-FL).
“I think it is very important to acknowledge that no federal law requires any health care entity to provide abortion services. Furthermore, there is no requirement that any individual participate in the provision of reproductive health services,” stated Rep. Connie Morella (R-MD), adding that the bill “would be a sweeping new federal exemption from current laws and regulations that assure women access to health care services.”
Rep. Nancy Johnson (R-CT) agreed, “We have never stood on this House floor and allowed individuals to say in conscience, when it might well be not in conscience but in cost, the right to make such decisions in opposition to state law. Are we going to allow the conscience clause now to be polluted as an economic instrument?”
“Whatever happened to legislative intent for crying out loud….,” argued Rep. Bilirakis. “The original law was intended to apply to the broadest definition of health care entities. Transcripts from the debates in 1996 and in extensions of remarks in 1998 show that the original authors of the conscience protection intended a broad definition, a broad definition of health care entity,” he said, adding, “This bill is really a very simple technical correction. It is not a massive expansion or a policy to limit access to health care for women.”
“It does indeed change women’s rights,” stated Rep. Louise Slaughter (D-NY). “It puts a gag rule on women….What this does is drive women back to back alleys.”
A motion to recommit the bill with instructions failed, 191-230. Offered by Rep. Sherrod Brown (D-OH), the motion to recommit would have added language to the bill stating that health care institutions should not be permitted to restrict the information that doctors can provide to their patients, that women should not be denied medically appropriate information or services, and that Congress should not override a state’s right to enforce its own laws.
