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TREASURY AND GENERAL GOVERNMENT APPROPRIATIONS ACT, 2000 -- (House of Representatives - July 15, 1999)

   If the contraceptive abortifacient mandate in this bill were imposed on all plans, the president of a business who objects or whose employees object to covering abortifacients would not be able to work with an insurance carrier to design a plan that reflects those convictions. The plan would have to cover them, and the business owner and the employees would have to pay for them. No one should be forced to do what he or she believes would cause the death of an innocent human being, particularly in the name of health care.

   Mr. Chairman, this is a rational, common-sense reform. I urge my colleagues on both sides of the aisle to protect the consciences of all those in

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the medical profession and American women.


[Time: 19:45]


   Mrs. LOWEY. Mr. Chairman, I offer an amendment to the amendment.

   The Clerk read as follows:

   Amendment offered by Mrs. LOWEY to the amendment offered by Mr. SMITH of New Jersey:

   In the text of the matter proposed to be inserted, on line 3, strike the words ``or moral convictions''.

   Mrs. LOWEY. Mr. Chairman, I would like to explain the amendment.

   Mr. Chairman, I have no objection to the part C of my good friend, which talks about implementing the section, ``Any plan that enters or renews a contract under this section may not subject any individual to discrimination on the basis that the individual refuses to prescribe or otherwise provide for contraceptives because such activities would be contrary to the individual's religious beliefs and moral convictions.''

   If an individual, be it another provider or a nurse, chooses not to provide this service, as long as the plan will continue to provide this service, we think this would be a perfecting provision. My objection, Mr. Chairman, is to to the first part, that a plan should develop a moral conscience.

   We were very careful last year in crafting this to respect every plan's religious conviction. We included five religious plans: Providence Health Plan, Personal Care's HMO, Personal Choices, OSF Health Plans, Yellowstone Community Health Plan, and any existing or future plan, if the plan objects to such coverage on the basis of religious belief.

   However, Mr. Chairman, in the year that this has been implemented there were no objections. There were no additional plans that appealed to be included in this opt out provision.

   I have real concerns, Mr. Chairman, that we should suddenly give Blue Cross-Blue Shield or any other plans a conscience. I would expect that a plan that wanted to opt out because of their deeply held convictions would have done so in the last year.

   This year, the religious exemption that is in effect today and is contained in the bill continues to specifically exempt the five plans, and again, beneficiaries who want contraceptive services but whose provider choose not to offer them can be referred to other providers by their health plan.

   I want to also remind my colleagues, because this is a very important point, that providing coverage of contraception does not compel provision of services contrary to moral or religious convictions by any individual or health care provider. It merely requires the Federal Employees Health Benefit Plan to provide the coverage, write the check, in other words, for the contraceptives.

   Again, OPM has reported that no other Federal employee health plan has requested a religious-based exemption, and no other plan has complained that the exemption is inadequate. No provider, no beneficiary, has complained.

   So in conclusion, Mr. Chairman, many of us on both sides of the aisle worked very hard to be sure that the religious exemption was well thought out. It was extensively negotiated between the House leadership, the White House, and myself, and most importantly, it is working. It strikes the appropriate balance between the legitimate religious concerns of individuals and plans participating in FEHBP with an equally compelling public policy goal facilitating access to the broad range of contraceptive methods in order to reduce unintended pregnancies.

   Again, I respect the personal views of my colleagues, on whichever side of the issue they fall. We should have respect for each other. But let us not impose our beliefs on any other individual. This provision is working. Let it continue to work. Please reject the motion and please accept this second degree, which we believe is a perfecting motion.

   Mr. SMITH of New Jersey. Mr. Chairman, I move to strike the last word.

   Mr. Chairman, first of all, it is Orwellian double speak--a gross distortion of reality to somehow suggest that pro-lifers are imposing our view in proffering this amendment when we are carving out a conscience clause so women and men, or by extension, groups of people, collections of people, who make up plans and administrators of plans don't have a contraceptive/abortion chemical mandate imposed upon them against their moral convictions. The imposition by force of law is by the pro-abortion side.

   I happen to believe that people who object to abortion chemicals on a basis other than religious beliefs should not have their deeply held moral convictions overruled.

   Not all moral convictions are based on religions. Many of my deeply held beliefs on human rights, including for the unborn, were first arrived at that belief that the unborn child should be protected as a matter of human rights and moral convictions, not religion. Religion inspires a belief in the value of persons but others can value life absent religion.

   Dr. Nathanson, I mentioned him earlier in the debate, was an atheist who came to his view concerning the value of an unborn child not based on religious beliefs. He did not believe in God. He had no religious beliefs. He came to that as a matter of moral conviction buttressed by science and logic.

   This is an imposition of the contraceptive, but more importantly, from my point of view, the abortifacient, chemicals used early in pregnancies or early after fertilization to destroy the growing embryo. That is a terrible, terrible precedent to be set.

   It is outrageous, I say to my colleagues. Where is the choice of those people who say no, I do not want to be involved with this? I think this is outrageous. To strike moral convictions, Mr. Chairman, would set us back in terms of conscience clauses.

   Let me also point out to my colleagues that among the more recent conscience clauses enacted into law is legislation passed by Congress in 1996 to protect medical education programs from being required to provide abortion training. The exemption was provided regardless of whether their opposition was religiously or morally based. We recognize that abortion, the killing of an innocent human being, is simply not the kind of practice that should be forced on anyone.

   Let me also point out that some of our friends on the other side of the issue, including Senator SNOWE, pointed out that institutions and individuals could be and should be protected.

   Let me also point out to my colleagues that in addition to abortion training conscience protection that I just described, Congress has provided conscience clauses for plans under Medicare Plus Choice, if the sponsoring organization offering the plan objects on, and I quote, ``Moral or religious grounds; not just religious ground, moral or religious grounds.

   Another section protects Medicaid managed care organizations from being required to provide reimbursement or provide for coverage of counseling and referral services if the organization objects to the provision of such service on moral and religious grounds. Moral and religious, they go hand-in-hand. But to just have one is to just have half a loaf.

   Also, in yet another section, Congress provided that the Legal Services Corporation fund could not be used to attempt to compel any individual or institution to perform an abortion or assist based on religious beliefs on moral convictions.

   I am amazed, I am shocked, I say to the gentlewoman from New York (Mrs. LOWEY), that she wants to strike moral convictions. Why should she impose her views on those who would otherwise not want to do it?

   Mr. HOYER. Mr. Chairman, I move to strike the requisite number of words.

   Mrs. LOWEY. Mr. Chairman, will the gentleman yield?

   Mr. HOYER. I yield to the gentlewoman from New York.

   Mrs. LOWEY. Mr. Chairman, I would like to respond to the shock of my good friend and colleague, the gentleman from New Jersey (Mr. SMITH).

   I would like to make it very, very clear that what our provision does is allow an individual, a person, a group of people, a provider, to have a religious or moral conviction. I respect that. I want to make that very clear, that be it a doctor or a nurse or a provider, that person, in our provision, certainly may have a religious or a moral conviction.

   But I would like to remind my colleague what my provision does not do

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is allow a plan to have a moral conviction. A Blue Cross-Blue Shield, or another plan, in our judgment, in my judgment, it cannot have a moral conviction. If it has a religious objection, if it is religiously-affiliated, there were five plans that were included. Again, I would like to repeat, any existing or future plan, if the plan objects to such coverage on the basis of religious beliefs, that plan can opt out. No one, not one plan in the past year, requested to opt out.

   So Mr. Chairman, I would like to explain again, we are willing to accept their provision which perfects the one from last year, which gives any provider the right on religious or moral convictions to opt out. That is just fine. But a plan does not have a conscience, and there is no plan that requested to be included in this opt out provision.

   Mr. HOYER. Reclaiming my time, Mr. Chairman, I want to ask my friend, the gentleman from New Jersey (Mr. SMITH), a question, because I know of his very sincere beliefs, and do not question them at all. I agree that we should not question moral convictions, either.

   Is there a problem? Have we had some plan, an insurance company that deals with the FEHBP, i.e., a plan, come to us and say that they were being compelled to do something that they did not want to do?

   Mr. SMITH of New Jersey. Mr. Chairman, will the gentleman yield?

   Mr. HOYER. I yield to the gentleman from New Jersey.

   Mr. SMITH of New Jersey. Mr. Chairman, the language in the amendment says ``Any existing or future plan.'' I think it wise and provided the future to anticipate.

   I know of no plan at the moment to carried a plan may spent nor have I surveyed every plan but that does not mean it has not happened. That does not mean that sitting in the boardrooms around the nation men and women who offer specific plans haven't grappled with this and said, we have to provide this no matter what conditions it violates.

   We have to provide maximum freedom in regard to a moral conviction for people who manifest opposition and dissent, and to opt out. And again, let me also point out that I did say with regard to the future plan. There could be plans that would love to participate in the Federal Employees Health Benefit Plan program but conclude wait a minute, there is a mandate there that violates our moral convictions.

   And that is why I would hope and believe this should be a totally noncontroversial amendment, unless its opponents have designs on using the coercive power of the state to force compliance not withstanding moral convictions.

   Mr. HOYER. Reclaiming my time, Mr. Chairman, I probably do not have much left, but I would say that the gentlewoman I think has tried to reach a resolution within the framework of what we know exists now.

   I asked the gentleman if there was a plan, because if there is a problem and we are compelling them to do something that they have a moral conviction against, we ought to look at that. I agree with the gentleman from New Jersey. He is absolutely right.

   On the other hand, apparently we do not at least now have a problem with respect to this. However, we may, as the gentlewoman from New York has pointed out, have a problem, and we want to make sure that not only do individuals not have to prescribe, but they do not have to involve themselves in providing.

   The gentlewoman's amendment deals with individuals' rights to certainly say, no, I have a moral conviction or religious belief, and I am not going to do that. I really do believe the gentlewoman has tried to reach a middle ground, if any such exists; and I do not know that that is the case, but if any such exists on this particular issue, because I think in the first instance that problem does not exist, but on the second instance, it may exist and she provides a protection against it.

   I would hope that we can adopt the gentlewoman's amendment.

   Mr. HYDE. Mr. Chairman, I move to strike the requisite number of words.

   Mr. Chairman, I certainly will not use the 5 minutes, but it seems to me this really is much ado about nothing; not that the issue is a nothing issue, but the distinctions that should be made.

   Conscience and moral conviction are really facets of the same issue. Religious reasons may motivate a conviction, but ethical reasons, without any religious foundation, are of the same stripe. They are a nuanced way of expressing one's conscience.

   If we want to protect peoples conscience which flows from religious conviction, we want to similarly treat people's moral convictions that do not have a religious foundation but are just as strongly felt.

   Now, does a plan have a conscience? That should not bother anybody. Corporations can act immorally. They can dump toxic wastes in the ground. By continuing to do that, we say that corporation is immoral, is acting immorally.


[Time: 20:00]

   Plans operate through people. It is not some sort of entity out there. It is an intangible. But people make decisions and have consciences and violate their conscience or protect their conscience or act pursuant to it. But there is nothing strange about a plan acting morally.

   We say the profits for this corporation were ``obscene.'' So corporations and these entities can have a conscience, can act pursuant to a conscience because they are run by directors and by people.

   So why do we not protect moral conviction just as strongly as we protect religious conscience? They are two sides of the same coin. And I do not understand why we are doing this.

   Mrs. LOWEY. Mr. Chairman, will the gentleman yield?

   Mr. HYDE. I yield to the gentlewoman from New York not just with pleasure, but with great pleasure.

   Mrs. LOWEY. Mr. Chairman, I thank the gentleman from Illinois (Mr. HYDE) for yielding to me. We have been discussing this issue for many years.

   Mr. Chairman, a plan is a corporate entity, and it is organized often for profit. Its role is to write a check. I do not think that we want a plan to begin to claim a moral conviction, moral objection to writing a check.

   Now this is not about examining a patient, talking about patients, because we have already included in the language that any individual provider, a nurse or other provider, may opt out based on religious or moral conviction. But we are saying if a plan suddenly has 50 people outside protesting, they could develop a moral conscience and say, ``I do not want to write a check.''

   Now, I want to make it clear again that the provision which the gentleman and I negotiated very carefully last year listed all the religiously based plans that wanted to opt out. We gave other plans the option of opting out, but no one took that option.

   Mr. HYDE. Mr. Chairman, before my time lapses if I could recapture it briefly to say we do not suffer from too much moral conviction; perhaps too little. And where we find it, we ought to nurture it and protect it.

   Ms. DeLAURO. Mr. Chairman, I move to strike the requisite number of words.

   Mr. Chairman, earlier today this House voted down an attempt to strike the abortion restriction from this bill. And if Members oppose abortion, there is no better way to try to avoid it than to increase access to contraceptives. My colleagues are offbase with their amendment which is a transparent attempt to cut off access to birth control.

   The amendment offered by the gentlewoman from New York (Mrs. LOWEY) already has a conscience clause that allows religious plans to opt out if they choose to. In fact, five plans have chosen to do just that.

   I also take issue with the contention that a health plan, a nonhuman entity, can have a moral objection to anything. Individual providers do not have to prescribe contraceptives if they do not choose to.

   Mr. Chairman, let us get to the base of this discussion. We know what this is about. We know that those offering this amendment do not believe in birth control. They have said this outright, that they believe that oral contraceptives used by tens of millions of American women every day are a form of abortion. And to imply that those women are abortionists is an affront to every American woman and shows how out of touch some of my colleagues on the other side of the aisle really are.

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   I ask again and again and again that they do not impose their personal agenda on others. If my colleagues want to reduce abortions in this country, and we all want to do that, there is no better way than to support contraceptives and to support birth control.

   Mr. Chairman, I urge my colleagues to support the Lowey amendment and to oppose the Smith amendment.

   Mr. KOLBE. Mr. Chairman, I ask unanimous consent that all debate on the amendment offered by the gentleman from New Jersey (Mr. SMITH), and all amendments thereto, close in 20 minutes, and that the time be equally divided and controlled by the gentleman from New Jersey (Mr. SMITH) and the gentlewoman from New York (Mrs. Lowey).

   The CHAIRMAN. Is there objection to the request of the gentleman from Arizona?

   There was no objection.

   The CHAIRMAN. The Chair recognizes the gentleman from New Jersey (Mr. SMITH) for 10 minutes.

   Mr. SMITH of New Jersey. Mr. Chairman, I yield such time as he may consume to the gentleman from Alabama (Mr. ADERHOLT).

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