[NOW Action List] Urge Senators to Repeal Dangerous Refusal Clause
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Support NOW's Work  |   April 19, 2005   |  Tell a Friend

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Repeal Dangerous Refusal Clause: Urge Senators to Vote "Yes" on Boxer Bill

Action Needed:

Please call or send a message immediately to your Senators to urge them to vote "Yes" on legislation offered by Sen. Barbara Boxer (D-Calif.) that would repeal a dangerous provision that allows hospitals, clinics, insurance companies and others to deny reproductive health care services to women if it violates their "conscience" or is "morally objectionable." Tell them that buildings and businesses do not have individual consciences and if they are receiving federal funds they must provide services that are safe and legal.

Without the Boxer repeal bill, any state that enforces its own laws requiring provision of health care services through a federally-funded entity risks losing all federal health, labor and education funding assistance if there is a "conscience" objection.

The vote could come as early as Thursday, April 21, so please take a moment right now to use NOW's interactive lobbying website to send our message or write one of your own. Thanks for helping out on such short notice!

Take action NOW.


As early as Thursday, April 21 Senators may be asked to cast a key reproductive health vote on a bill offered by Sen. Barbara Boxer to roll back a stealth attack on a woman's right to receive services and referrals for her reproductive health care needs - even in life-threatening situations. This attack came without debate or a vote in the Senate, and was adopted as part of the massive omnibus spending package adopted in the final moments of the 108th Congress in December of 2004.

Proponents of the original language, authored by Rep. Dave Weldon (R-Fla.), misleadingly call it the Abortion Non-Discrimination Act. Organizations such as the U.S. Conference of Catholic Bishops are lobbying to extend the one-year provision and have consistently, but wrongly, argued that it is needed to protect the conscience of individuals and health care organizations that oppose abortion. The reality is that no federal law forces individuals to provide abortion care. In fact, the 1973 Church amendment explicitly protects individuals who object to providing abortion care based on religious beliefs or moral convictions. No federal law requires hospitals to provide abortions either, except in a medical emergency. Moreover, upwards of 45 states have refusal clauses for either individuals or institutions that object to providing or participating in abortion services.

A more accurate title for the Weldon provision is the Federal Refusal Clause because it allows any federally funded "health care entity" to deny women abortions services or even referrals for abortion services, even if state laws mandate otherwise. In other words, an HMO or hospital that doesn't want to provide reproductive health services or referrals can refuse to do so without fear of punishment - even in medical emergencies. States that attempt to enforce their own laws requiring provision of services can be accused of discrimination - and that state would lose hundreds of millions of dollars in health, education and labor funding as appropriated under the omnibus bill.

Two legal challenges to the law are pending - one by the National Family Planning and Reproductive Health Association (NFPRHA), which represents more than 4,000 clinics that provide family planning services across the country, and the other by the State Attorney General and the Secretary of Education in the State of California. They are challenging its scope, its vagueness, its dubious constitutionality, and the seeming incompatibility with the patient's long-standing entitlement to referrals under the Title X family planning program. There have not been any rulings in either case. Although the true impact of the federal refusal clause is unclear, its proponents want it to be defined broadly. If their view prevails, the provision will present a direct and serious threat to women's reproductive health. The provision should therefore be repealed.

The Federal Refusal Clause Could . . .

  • Give health care corporations license to gag their doctors and other health care providers, preventing them from providing information or referrals regarding abortion, and thus undermining the doctor-patient relationship.
  • Override federal Title X guidelines which ensure that women receive referrals when requesting information about all of their medical options.
  • Restrict low-income women's access to necessary reproductive health care.
  • Jeopardize the lives of women in emergency situations.
  • Impinge upon states' ability to protect women's health.
  • Cost states billions of dollars through the loss of all health, education and labor-related funds if it requires health care entities to provide services, thereby violating the federal refusal clause.

The Public Opposes Refusal Clauses.

Although the intention of the federal refusal clause is to allow health care entities to refuse to provide abortion services or referrals for any reason, not just on the basis of religious objections, recent research shows that the public strongly opposes even religious-based exemptions from the provision of health services.

  • Seventy-six percent of the public oppose exempting hospitals from providing medical services to which they object on religious grounds.
  • Eighty-nine percent oppose allowing insurance companies to refuse to pay for medical services on religious grounds.
  • Seventy-nine percent of women say they oppose legislation granting hospitals the right to refuse to provide medical services or medications based on religious or moral objections.
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