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On Aug. 20, the U.S. Health and Human Services Department announced it is moving forward with a proposed regulation that, if enacted, will jeopardize our nation’s access to comprehensive and unbiased health care. Known as a “conscience clause,” this regulation allows individual employees to deliberately withhold both services and information from patients based on their own personal beliefs. The proposed regulation affects any hospital, clinic, doctor’s office or pharmacy that receives federal funding, directly or indirectly, from HHS.

As a recipient of federal family planning funding and a federal Medicaid/Medicare provider, Planned Parenthood of Montana is concerned that this proposed federal rule will put women’s access to birth control and the information they need to make health care decisions further at risk. We have already seen instances in Montana where women can no longer access birth control because a pharmacist doesn’t “believe” in contraception.

This federal regulation, if implemented, will prohibit employers in rural hospitals, clinics and pharmacies from replacing employees who are no longer willing to save patients’ lives (i.e. hemorrhage due to impending miscarriage) or dispense critical medication (i.e. birth control to preserve fertility in the cases of severe endometriosis). This type of regulation directly targets women’s health and puts the individual interests of a provider over the healthcare needs of a patient.

Montana’s health care system is tenuous at best. As a rural state, we rely on providers who can treat us free of prejudice and, if unable to provide the service, are willing to go out of their way to find the closest provider in a timely fashion. This proposed regulation not only protects those employees who don’t want to serve us, but also protects those employees who won’t even talk to us because our medical decisions differ from their personal beliefs.

Finally, from our state law perspective, the HHS regulation treads on democratically enacted state policies aimed at ensuring equal access to health care for the state’s citizens, such as Montana’s contraceptive equity provision, while protecting religious freedoms as evidenced by our own state statute, MCA 50-20-111. Montanans enjoy contraceptive equity so that all insurance companies providing coverage in the state must cover contraceptives as part of their prescription plans. Under the proposed HHS rule change, enforcement of this law could be in jeopardy.

Also, Montana currently has a state statute that allows individuals, hospitals and others to deny participating in abortion. MCA 50-20-111 states that “All persons shall have the right to refuse to advise concerning, perform, assist, or participate in abortion because of religious beliefs or moral convictions.” While Planned Parenthood of Montana has concerns regarding MCA 50-20-111, it is the law of our state and we are in full compliance.

The proposed HHS regulation goes far beyond our state statute and includes virtually every health-care provider in the state and is not limited to abortion refusals. For those patients who rely on publicly-supported clinics and/or Medicaid/Medicare reimbursement for health care, this HHS rule does not provide them an alternative.

The HHS proposed regulation is now posted in the federal register. A 30-day public comment period is under way and will end on Sept. 25. It is crucial that Montanans who value the right to privacy and access to medical care weigh in and tell the Bush administration to keep politics out of the exam room. You may submit electronic comments on this regulation to www.Regulations.gov or via e-mail to consciencecomment@hhs.gov.

Stacy James is the CEO of Planned Parenthood of Montana, and writes from Billings.

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