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PROTECTING THE RIGHTS OF CONSCIENCE OF HEALTH CARE PROVIDERS AND A PARENT'S RIGHT TO KNOW

THURSDAY, JULY 11, 2002

HOUSE OF REPRESENTATIVES,
COMMITTEE ON ENERGY AND COMMERCE,

SUBCOMMITTEE ON HEALTH,

Washington, DC. The subcommittee met, pursuant to notice, at 3 p.m., in room 2322, Rayburn House Office Building, Hon. Michael Bilirakis (chairman) presiding.

Members present: Representatives Bilirakis, Burr, Norwood, Pitts, Tauzin (ex officio), Brown, Strickland, Capps, Towns, Deutsch, and Wynn.

Staff present: Patrick Morrisey, deputy staff director; Cheryl Jaeger, majority professional staff; Steven Tilton, health policy coordinator; Eugenia Edwards, legislative clerk; John Ford, minority counsel; and Jessica McNiece, minority staff assistant.

Mr. BILIRAKIS. I call this hearing to order and first would like to thank our witnesses for appearing before the subcommittee today. This subcommittee certainly values your expertise, and we are very grateful for your cooperation and attendance. And as you good people fall in, please, let us try to be orderly.

Today's hearing will touch on two subjects that I know many members of the subcommittee, myself included, feel very strongly about. Because of the vastly divergent views and strong feelings invoked by the issues we will be discussing today, I believe it is important to have a hearing which will afford us the opportunity to listen to different viewpoints. And I think this open dialog and expert testimony will aid all members in making an informed decision about how best to legislate in this area.

Our first panel will discuss an issue that we commonly refer to as the conscience clause. In 1996, the Congress passed, and President Clinton signed into law, provisions that provide protections to health care professionals and a, “health care entity” from being forced to perform abortions if they have moral or religious objections to the procedure. However, court interpretations have called into question whether these sections of law apply to hospitals that object to offering elective abortions.

In 1998, a number of senators attempted to clarify the record by stating that a health care entity was defined to include physicians and other which does not mean that it excludes hospitals. However, this clarification has not been sufficient and it has come to my at

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tention that we need to amend the current statute to ensure that hospitals are covered by the conscience clause. Consequently, I have introduced H.R. 4691, the Abortion Non-Discrimination Act, to guarantee that all health care entities are afforded the important protections provided by the original law, as I believe was intended.

Our second panel will discuss the issue of whether parents have the right to know if their children receive contraceptive devices or drugs from title X family planning clinics. And, again, this is an issue where most of us have had some experience in the raising of our children. And I think it is safe to say that most parents have strong feelings about wanting to know what is going on with their children's health, and as a parent, I certainly can identify with this notion.

Title X regulations specifically prohibit health care providers from informing parents of their child's actions to seek contraceptives. I am interested to hear from our witnesses today whether title X rules allow for appropriate flexibility and deference to the health care professionals that provide care in these clinics. Can a doctor use his or her best judgment about notifying a child's parents about health concerns when providing care to a minor? Question.

Again, I know these are difficult issues, and I look forward to hearing from our witnesses so we can make informed decisions about how best to proceed, and I now recognize my good friend from Ohio, Mr. Brown, for his opening statement. Mr. Brown.

Mr. BROWN. Thank you, Mr. Chairman. This afternoon we will discuss the merits of a proposal to permit health care entities to refuse to comply with Federal, State and local laws pertaining to abortion services. We will discuss parental consent requirement for access to reproductive health services. I want to thank Ms. Weiss for joining us, Dr. Jenkins and the other distinguished panelists.

The majority has labeled the first issue for debate a clarification of existing law. They will argue the legislation clarifies a provision of law known as the Coats Amendment, adopted, as the chairman said, in 1996 omnibus appropriations bill. The Coats Amendment allowed post-graduate physician training programs that chose not to provide or refer for training and abortion procedures to still qualify for Federal funding. This so-called clarification bill would dramatically, dramatically expand this narrow law.

Let me be clear, this is not simply a technical amendment. It is a sweeping expansion to the law that would override Federal and State and local laws. This bill expands this scope of the law beyond graduate medical programs and permits any health care entity, including insurance companies and hospitals and HMOs to refuse to perform, to refuse to provide coverage of, to pay for or refer for abortions.

In the interest of time, I want to mention just one example of how this bill is egregious and irresponsible, putting a political agenda, in my mind, above access to critical and human health care. The Federal Hyde Amendment ensures Medicaid patients access to abortion services in cases of rape, incest or where the pregnancy endangers the woman's life. The chairman's bill would override these standards of care. The bill would give the HMOs the

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