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ROBERT SIEGEL, host:

From NPR News, this is All Things Considered. I'm Robert Siegel.

MELISSA BLOCK, host:

And I'm Melissa Block. The Bush administration issued a new and controversial rule today. It allows health care workers, hospitals, and even insurance companies to decline to provide services that violate their moral or religious beliefs. Opponents say the rule is so broad it could threaten patient care, as NPR's Julie Rovner reports.

JULIE ROVNER: This fight, like so many others in health care, started over abortion. For decades, federal law has protected doctors and other health care workers from being required to perform or participate in abortions if it violates their conscience. But outgoing Health and Human Services Secretary Mike Leavitt says he wanted to add the regulation to clarify those laws. His actions came after a spat last year with the group that represents the nation's obstetricians and gynecologists over a new ethics policy. As Leavitt explained in September...

Secretary MIKE LEAVITT (Department of Health And Human Services): It came about primarily because some professional associations were trying to define as competence a willingness to perform abortion, and I think that's wrong. A person can be perfectly competent and feel it's not morally correct to perform an abortion, and they ought to have the capacity to be protected in that right.

ROVNER: In fact, what the new OB/GYN policy focused on was not the willingness of doctors to perform abortions, or other controversial procedures. Rather, the policy said doctors who were unwilling to do such procedures should tell patients up-front and refer them to someone who will. Under the rules issued today, they don't have to do either. And the rules extend beyond doctors and abortion. For example, pharmacists can refuse to dispense birth control. Religious health insurance plans can refuse to cover in-vitro fertilization or sterilization. Cecile Richards is president of Planned Parenthood.

Ms. CECILE RICHARDS (President, Planned Parenthood Federation of America): In fact, I think the Bush administration has now opened the door to allow individuals, based on their own personal biases, to deny patients access to information and health care services.

ROVNER: One of the things that worries Planned Parenthood most about the new rules is that they supersede state laws, like ones that require rape victims to be offered emergency contraceptive pills. Roger Evans is the group's general counsel.

Mr. ROGER EVANS (National Litigation Director, Planned Parenthood Federation of America): A lot of states around the country where the policy that has been adopted is that victims of rape who show up in an emergency room have a right to be offered emergency contraception, the states are now going to be hamstrung in enforcing the laws.

ROVNER: Bush administration officials, however, say the rules don't change any laws. They simply make health care providers more aware of the laws that already exist. Joxel Garcia is the HHS assistant secretary of health. He's an OB/GYN and former health commissioner in Connecticut. Yet he says he didn't learn about the federal conscience laws until after he started working for the federal government.

Dr. JOXEL GARCIA (Assistant Secretary of Health, Department of Health and Human Services): Sometimes we are so into helping our patients that we don't even know what legal framework we have to protect ourselves.

ROVNER: The rules are said to take effect in 30 days, but they may not be in effect for long. Opponents, including lawmakers like Washington Democratic Senator Patty Murray, say they're already working on ways to rescind the rule.

Senator PATTY MURRAY (Democrat, Washington): We are not going to sit by and just let this occur. It may take us a while to undo something like this. But, you know, for the health care of women in this country, they should not have this slammed on them as this president walks out the door.

ROVNER: Because the rule is coming so late in the president's term, it's subject to something called the Congressional Review Act. That allows it to be cancelled be a simple majority vote of the House and Senate and signed by the new president. Julie Rovner, NPR News, Washington.

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