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Fast Facts
Refusal to Provide Medical Services
Are health-care providers really allowed to refuse to provide medically necessary services? |
YES. A number of state and federal laws include provisions known as "refusal clauses," which permit a broad range of individuals and institutions—including hospitals, hospital employees, health-care providers, pharmacists, employers, and insurance companies—to refuse to provide, pay for, counsel for, or even refer patients for medical treatment that they oppose. Although carefully crafted refusal clauses may be acceptable in some circumstances to protect individuals who oppose certain treatments, broad refusal clauses deny women medically necessary information, referrals, and services. In addition, even if individual medical providers are protected, health-care corporations should not be allowed broadly to deny women access to necessary medical services and information. |
CURRENT STATE LAWS47 states and the District of Columbia allow certain individuals or entities to refuse to provide women specific reproductive health services, information, or referrals: AK, AZ, AR, CA, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, WA, WV, WI, WY. |
CURRENT FEDERAL LAWSSeveral federal laws allow health-care employees and companies to refuse to provide, pay for, counsel for, or even refer for abortion services—and in some cases contraceptives. Most recently, Congress passed the Federal Refusal Clause, which eliminates federal, state, and local governments' ability to ensure that abortion care and referrals are available. Under this law, a federal, state, or local government may not require any health-care company to provide, pay for, or refer for abortion services. Any law or regulation that does so can be considered "discrimination" against the entity and a violation of the law.
In addition, in 2009 a Department of Health and Human Services regulation pertaining to refusal rights, proposed by the Bush administration, went into effect. The regulation expands the ability of health-care entities and providers to refuse to provide, cover, or refer for medical services. The Obama administration took the first step toward rescinding the regulation in March 2009, but as of this publication's printing it remains in effect. |
2009 ENACTED STATE LEGISLATION2 states enacted 2 measures modifying existing laws that allow certain individuals or entities to refuse to provide women specific reproductive-health services, information, or referrals: AZ, LA. Arizona's new law expands on state abortion refusal rights and adds provisions to allow hospitals, pharmacies, and individuals to refuse to provide birth control. Louisiana's new law limits the state's abortion refusal rights by including provisions that account for patients' access to health-care services and information. |
2009 FEDERAL ACTIONDuring the health-care reform debate, anti-choice lawmakers attempted to insert several broad refusal clauses into the legislation. Lawmakers in the House passed a bill that codifies the refusal laws already in place for the new health-care system; as of this publication's printing, the Senate had not yet finalized its version of the bill. Anti-choice senators have threatened, however, to offer measures that would grant broad license to health-care providers and entities (including hospitals, HMOs, and insurance companies) to refuse to provide or cover any medical services – including birth control. Such measures even would allow providers to refuse to offer basic information about patients' health-care options.
In addition, in April the Senate voted down an amendment to the budget resolution that would have enshrined the principles of a broad refusal law in the context of health reform. |
2009 NOTABLE CASES
In September 2009, in Planned Parenthood Arizona, Inc. v. Goddard, a state superior court blocked the refusal provisions newly enacted in Arizona. The decision blocks the state's addition of a refusal clause allowing providers to opt out of providing contraception and the state's expansion of its abortion refusal clause.
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2009 NOTABLE DEVELOPMENTS
Despite several laws at the federal level and in 47 states protecting provider rights to refuse services, anti-choice lawmakers continue to push for even broader refusal clauses. Legislators in several states introduced bills that would jeopardize women's access to birth control and allow entire health-care corporations to deny basic services. In addition to the law that passed in Arizona this year, states such as Rhode Island and Hawaii introduced wide-sweeping measures that would allow insurance companies to refuse to cover even birth control.
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| For a map of all states with Refusal to Provide Medical Services - click here. | |
