by Maureen Kramlich
May 10, 2002
When the Accreditation Council for Graduate Medical Education—a medical organization that gives the stamp of approval to physician residency programs—proposed mandating abortion training in all ob/gyn residency programs in 1995, Congress responded with protective legislation. The law, 42 U.S.C. §238n, declares that the federal government and any state or local government that receives federal financial assistance may not discriminate against health care entities that refuse to train, perform, refer for, or make arrangements for abortions.
To specifically protect residents and residency programs, the law states that "health care entity includes an individual physician, a postgraduate physician training program, and a participant in a program of training in the health professions." Of course the word "includes" meant what it said, that is, the definition doesn't provide an exhaustive list. It merely states some examples of what is contained in the definition. Or as Senators Frist, McConnell, Gregg, Hutchinson, Coats and Dewine said in a 1998 Senate Committee Report, "By the word, 'includes' Congress intended to add to, not subtract, from, the range of entities generally seen as 'health care entities' under Federal law."
But leave it to abortion groups, not exactly known for using language that matches reality, to act as if "includes" means something quite the opposite. As if it means "limited to" and as if hospital, clinics, and health systems aren't "health care entities." And they have exploited this seeming ambiguity to persuade government bodies to require health provider to perform abortions.
In Alaska, they persuaded the state supreme court to order a private non-sectarian hospital with a pro-life policy to begin performing abortions. After they learned that an outpatient surgical center proposed by four Connecticut hospitals would not perform abortions and sterilizations, they formed a coalition to defeat the proposed center and intervened in "certificate of need proceedings." In New Hampshire, when they learned that a newly merged hospital would no longer perform elective abortions, they approached the New Hampshire attorney general to challenge the merger. In 1997, after Catholic dioceses in New York created Fidelis Care, a managed care health plan, Family Planning Advocates of New York began pressuring the state health department to force the Catholic health plan to provide abortion counseling and referrals.
Fortunately, there are efforts underway in Congress to put an end to this. A bill introduced in the Senate by Senator Judd Gregg (S. 2008) and in the House by Representative Michael Bilirakis (H.R. 4691) will put hospitals and health clinics back where they belong. . . back into the definition of "health care entity." The bill, the Abortion Non-Discrimination Act (ANDA), clarifies existing law to say that the term "health care entity" includes "a hospital, a provider sponsored organization, a health maintenance organization, a health insurance plan, or any other kind of health care facility, organization or plan." ANDA also strengthens existing law by stating that health care providers may not be required to pay for abortions.
ANDA protects a basic human right, the right to decline to participate in an injustice. We should urge our Senators and Representatives to protect this human right and pass ANDA.
Maureen Kramlich is a public policy analyst with the Pro-Life Secretariat, United States Conference of Catholic Bishops