The Bush administration has issued new protections to health care providers who refuse to perform abortions and other procedures because of religious or moral objections.
But critics say the new regulation is vague and cumbersome and would lead to patients being denied needed services and medication, including birth control, HIV testing and treatment, and mental health services.
The new "provider conscience regulations" are designed to strengthen existing federal laws that prohibit institutions from discriminating against individuals who refuse to participate in abortions or provide a referral for one. The administration's rule, issued Thursday, is intended to ensure that federal funds don't flow to providers who violate those laws.
"Doctors and other health care providers should not be forced to choose between good professional standing and violating their conscience," Health and Human Services Secretary Michael O. Leavitt said. "This rule protects the right of medical providers to care for their patients in accord with their conscience."
Violators could face the termination of HHS funding and could be required to return funds already received.
The administration estimates that health care providers will spend about $44 million annually in administrative costs to comply with the regulation.
The new rule takes effect Jan. 18 -- two days prior to President-elect Barack Obama's Jan. 20 inauguration.
Federal protection of provider conscience rights dates back to the 1970s and since have been amended many times.
Critics say the latest update is nothing more than a last-minute effort by the Bush administration to make it more difficult for women to learn of their options regarding pregnancy.
Several medical associations, state attorneys general and members of Congress were among the many thousands who wrote to HHS to protest the rule.
"This midnight regulation, issued in the last days of the Bush administration, undermines this country's fragile health care system, as well as patients' access to health care information and services," said Planned Parenthood Federation of America President Cecile Richards.
Sen. John Kerry, Massachusetts Democrat, criticized the regulations as an "eleventh-hour new edict (that) denies patients end-of-life care and family planning and restricts essential research initiatives."
Obama spokesman Nick Shapiro said the president-elect "will review all (Bush administration) eleventh-hour regulations and will address them once he is president."
Mr. Obama in August had criticized HHS after it announced the proposed rule change, saying they would complicate, rather than clarify current law.
"It raises troubling issues about access to basic health care for women, particularly access to contraceptives," he said then. "We need to restore integrity to our public health programs, not create backdoor efforts to weaken them."
But the administration insists rules will strengthen provider conscience rights without restricting health care providers' abilities from performing any legal service or procedure.
Tony Perkins, president of the conservative Family Research Council, called the administration's action "a huge victory for religious freedom and the First Amendment."
"This is also a victory for the right of patients to choose doctors who decline to engage in morally objectionable practices," he said. "The scope of conscience must be defined by individuals and not the government."