Federal Refusal Clause

Resolution Adopted by the CCAR


Adopted by the 116th Annual Convention

of the Central Conference of American Rabbis

Houston, TX

March, 2005


On December 8, 2004, President George Bush signed into law the FY 2005 Consolidated Appropriations Act. Included in this omnibus appropriations bill is a provision known as the Federal Refusal Clause. This provision states that any federal, state or local government agency that .discriminates. against any .health care entity. that does not provide, pay for, or refer a patient to abortion services can lose its federal funding for health and human services and labor programs. There are no exceptions to protect the life of the woman. This would override the Title X guidelines that requires health care agencies receiving Title X funding (for family planning services) to make referrals to abortion services. Title X does not provide funding for abortion services, nor is any individual health care worker forced to provide abortion services or referrals, but agencies receiving the funding must provide the referrals. "Conscience clauses" are already in place, protecting the rights of individual health care workers to refuse to provide referrals or services that violate their conscience, as long as comparable service is available through other means. But the Federal Refusal Clause applies, not to individuals, but to any "health care entity", which is broadly defined as, "an individual physician or other health care professional, a hospital, a provider-sponsored organization, a health maintenance organization, a health insurance plan, or any other kind of health care facility, organization, or plan." As the Religious Coalition for Reproductive Choice states,

"We firmly believe that medical personnel who are opposed to participating in an abortion procedure should be allowed to excuse themselves as long as this does not deprive the patient of the care she needs. However, these entities are not individuals and they are not religious.they serve the public, receive public funding, have a diverse workforce, and have an obligation to provide medically necessary services. By treating HMOs, health care insurers, and hospitals as individuals, this provision places their preferences above the religious beliefs, decisions of conscience, and reproductive health decisions and needs of individuals."

By allowing health care entities to refuse to provide referrals for abortion services, this clause places a stumbling block before the blind (Leviticus 19:14). Women go to doctors, hospitals and clinics, in good faith, with every expectation of receiving appropriate care and complete information about the treatment options open to them. It is essential that they be able to receive the care they need.

If not renewed, the Federal Refusal Clause will expire at the end of Fiscal Year 2005. Yet there are efforts to repeal the provision sooner. A vote is expected in Spring 2005 on a measure sponsored by Senator Barbara Boxer (D-CA) to overturn the Federal Refusal Clause. The National Family Planning and Reproductive Health Association (NFPRHA) has filed a motion for a preliminary injunction to prevent enforcement of the law. The California Attorney General has also challenged the law, alleging that it infringes on state sovereignty, exceeds Congress.s spending powers and violates a woman.s Constitutional right to abortion to preserve her life or health. The Religious Coalition for Reproductive Choice began an educational campaign in January, 2005, to raise awareness of the serious repercussions of this bill in its ability to curtail access to needed reproductive health care information.*

Whereas, as Reform Jews and as rabbis, we of the CCAR have a long history of support for reproductive rights and

Whereas we honor women as moral decision makers empowered to make their own decisions regarding when and whether to have children, according to their own consciences and religious beliefs and

Whereas we oppose efforts to restrict access to reproductive health care and to deprive women of their right to complete, accurate, and impartial information about a legal and often necessary health care option and

Whereas, in Jewish tradition, the practice of medicine is a mitzvah, an element of pikuach nefesh, and a health care professional who fails to provide medical care, "is as if he has shed blood" (Shulchan Arukh Yoreh De`ah 336:1),

Therefore, the Central Conference of American Rabbis resolves to:

  • engage in efforts to reverse the Federal Refusal Clause;
  • send a letter of support from the CCAR to Senator Barbara Boxer for her efforts to have this provision repealed;
  • lobby members of Congress to support legislative efforts to overturn the Federal Refusal Clause;
  • educate our congregations and communities about the truth behind the Federal Refusal Clause; and
  • affirm the right of individuals to refuse to provide medical services so long as patients are not harmed and arrangements can be made to meet their needs.