Dear HHS: How about you consult YOUR conscience?

September 25th is the last day to submit public comment on the proposed HHS regulations which are not only superfluous, but more importantly, would further limit access to reproductive healthcare (and other healthcare) services in the U.S., particularly for those who already have the greatest limitations to care, which certainly includes teens.

It's so important to have public comment on this, so if you have not done so yet, take a few minutes tonight and be sure to get something in.

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I am writing to urge you to stop efforts to block women's access to basic reproductive health services.

I understand that the proposed regulations that the Department of Health and Human Services released on August 21, 2008 expand existing law to allow more health care providers and institutions to refuse to provide needed care.

As written, the regulations could allow institutions and individuals -- based on religious beliefs -- to deny women access to birth control⁠ and permit individuals to refuse to provide information and counseling about basic heath care services. Moreover, they expand existing laws by permitting a wider range of health care professionals to refuse to provide even referrals for abortion⁠ services.

For those of us working in healthcare, the onus is on us to choose a clinic or an area of practice where we know we want to provide the healthcare services offered to clients, and which we feel is in alignment with our personal values or religious beliefs. It should not be on those seeking needed health services. It is our responsibility -- and we have the greater agency as as workers -- to seek out⁠ the work we want, and leave the work we do not want, or do not feel we can live with, to those who are supportive and can honor any given job description. It is also our responsibility to take a job earnestly, not disingenuously. In healthcare, we have an extra responsibility, which is to put our clients needs and their physical health -- not our ideas about their spiritual health -- ahead of our own, and to care for them in the way which is best for them, objectively, rather than in the ways we feel would be best for us, or feel our religion would mandate.

Since this proposal has come to light, I have looked for any evidence that it is in response to a mass of healthcare workers voicing complaint and finding they are incapable of doing the very jobs they have agreed to do. I have found no such thing. I have also found Mike Leavitt's responses to the concerns of many with this proposal to be disturbingly dismissive, belittling and out-of-touch. The notion that low-income people can (or should have to) simply and easily choose a healthcare provider⁠ whose religious beliefs match their own, as Leavitt has flippantly suggested, is a stunning display of ignorance about the realities of public healthcare and those in need. The Department of Health and Human Services is the principal agency we have for "protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves." That does not mean those who work in healthcare: it means those seeking and receiving healthcare. The head of the HHS blithely stating he is privileging providers over patients seems effectively to be saying that he has no real interest in doing his job or serving the population he has sworn to through his appointment.

That given, I simply can only reasonably deduce that this proposal is one last gasp from the Bush administration to try and limit or remove more of our reproductive rights⁠ . This appears to be nothing more than one more back door through which those who want to control women -- rather than to provide healthcare, which is not to be confused with morality lessons -- and put our health at risk can creep in under the false pretense of self-protection.

I work for two different reproductive health organizations, with populations who would be the most impacted by this policy, should it be approved: with teen and young adult women, with women of color, with low-income women. At both, I see daily how -- already, without these new regulations -- lack of access to reliable contraception⁠ and reproductive health services and accurate information has a negative impact. I see it with the clients who come to the clinic I work at, where we provide abortions and other reproductive healthcare services: a great deal of our clients arrived there because their access to contraception and sound information on contraception was limited or absent. For a nation who endlessly states it wants nothing more than to limit abortions, policies like this have a funny way of showing it. I see it with the young people I counsel every day who often go without reliable contraception or sexual⁠ healthcare because of discrimination they face from healthcare providers, ignorance about contraception due to the limitation of their providers, or valid worries that they will be refused care or service, or given morality lectures rather than healthcare. For a nation which states it wants its citizens to be as healthy as possible, and who want its youth to thrive, proposals like this appear to stand in a strange conflict with that aim.

I do not need to work for either of these organizations: I have far more choice and agency in where I work and what job I do than I -- or others -- do when it comes to healthcare, particularly as an uninsured person in the United States who relies on sound public healthcare. Should I ever forget that, I think it would be sound to suggest it was time I found another profession and that I consulted my conscience. It is a cruel irony to have this proposal state to be about provider conscience, when, in fact, it appears to be about suspending conscience altogether.

My clients cannot exempt themselves from their healthcare needs: I can exempt myself from a job I do not wish to do, or set aside my own personal beliefs to honor those of someone in need of care who has every right to receive it. If I am in earnest about wanting to support reproductive health in my work, should I find myself unable to do the work or put needed care first, exempting myself from it would be the only sound recourse. I should say the same about the federal government and this proposal if it truly supports our health. At a time when more and more Americans are either uninsured or struggling with the soaring costs of health care, the federal government should be expanding access to important health services, not undermining existing protections or interfering in programs that have successfully provided services for years.

For certain, freedom of religion is an essential part of the foundation of this nation: however, separation of religion from public law and policy is the other vital half of that equation, and required for that very freedom. For all of our citizens to have the liberty our constitution assures, it is necessary that no one set of beliefs or values be privileged, nor exercised at the cost of another person's health.

For years, federal law has carefully balanced protections for individual religious liberty and patients' access to reproductive health care. The proposed regulations appear to take patients' health needs out of the equation. I urge you to restore this important balance and protect access to basic care for the millions of Americans who depend on federally funded health care services.

Thank you for your consideration,

Heather Corinna Founder and Director,
CONNECT Program Director, Cedar River Clinics/FWHC