Federal Refusal Clause

Speaking of reproductive health education, and making information available to women, here's an interesting article about the refusal-to-treat law (aka federal refusal clause):

A new law making it easier for health professionals to withhold reproductive health information from patients made its way into the courtroom in January amid concerns that it undermines the nation's family planning programs and risks the health and lives of women.

The law, known as the federal refusal clause, was inserted into fiscal year 2005 omnibus appropriations legislation that was signed by President Bush in December 2004. The clause, inserted by Rep. Dave Weldon, R-Fla., allows a federally funded "health care entity" to deny women information on abortion services, even if state laws mandate that such information be given upon request. States that attempt to enforce their laws can be accused of discrimination, and be denied all of their health, education and labor funding as appropriated under the omnibus bill.

"The overarching principle is that this is a backdoor attempt to gag referrals for abortion, to gag health care providers and to basically intimidate states away from having anything to do with abortion," said Judith DeSarno, president of the National Family Planning and Reproductive Health Association, which filed suit to stop enforcement of the refusal clause. "The precedent here is that you can withhold any kind of information and still get federal dollars."

According to the association, the refusal clause is at odds with numerous regulations attached to the Title X program, the nation's only federal program solely dedicated to providing family planning and reproductive health care to low-income and uninsured women. Organizations that receive Title X funding must agree to a number of requirements that range from blood pressure screenings to sexually transmitted disease testing to giving abortion referrals upon request. Those who violate the terms of Title X grants, DeSarno said, can then be sued or have their federal funds withdrawn. But with the Weldon clause, such requirements can be rendered unenforceable.

"There's a bitter constitutional question here: Can Congress mandate state law through the appropriations process?" DeSarno told The Nation's Health.