FACT SHEET
Access Denied: How Refusal Clauses Hurt
Women’s Health
FEBRUARY 2012
Refusal laws allow doctors, hospitals and insurance companies to legally deny women
access to health care services they need. Existing federal refusal laws allow health care
providers and institutions to refuse to provide training, referrals or services related to
abortion or sterilization, putting women’s lives, health and rights at risk every day. Yet
Congress is currently considering legislation that would significantly expand current
refusal laws, further jeopardizing women’s access to
vital health care, including access to contraception.
Oppose New Attacks on Women’s
Health Care
One in 20 women has been denied
access to health care because of
the religious, moral, or personal
objection of a health care
provider.
The Obama Administration has worked diligently to
— Health Care Refusals: Undermining Quality
provide an accommodation for religiously affiliated
Care for Women. National Health Law
entities in the implementation of the Affordable Care
Program, 2010
Act’s (ACA’s) preventive services provision, but still
ensure that most women – regardless of where they
work or who provides their insurance – have access to preventive services like
contraception without copays. Yet some members of Congress still want to undermine this
provision and derail implementation of the ACA.
The National Partnership urges members of Congress to oppose the following bills, which
would allow any employer, health care provider, hospital or insurance company to deny
women the health care they deserve, undermining the ACA and legalizing discrimination.
 The Respect for Rights of Conscience Act (HR1179/S1467) would allow all employers
and health insurance companies to assert religious or moral convictions to refuse to
provide coverage for any health care service. This dismantles essential consumer
protections in the ACA meant to ensure that everyone has core essential benefits and
access to preventive services without copays. That would mean that employers and
insurance companies could not only deny access to contraception, they also could deny
access to any essential or preventive health care service including maternity care,
HIV/AIDS treatment, mammograms or cancer screenings.
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202.986.2600 | www.NationalPartnership.org
 The Religious Freedom Protection Act (S2092) would allow any employer or health
insurance company to refuse to provide coverage of contraception based on the employer
or health insurer’s religious or moral
beliefs, regardless of whether the employer
or insurance company is affiliated with a
Neither the Women’s Health
religious entity. This would create an
Amendment, nor any other
unprecedented refusal clause that singles
portion of the ACA, contemplates
out contraception, eliminating the ACA’s
guarantee that all FDA-approved forms of
allowing certain employers to
contraception be available to women
discriminate against women in the
without copays or other cost-sharing. This
provision of contraceptive
bill unfairly targets women by impeding
services.
their access to the health care services they
need to keep themselves and their families
— Testimony to the House of Representatives
Energy and Commerce Committee. Debra
healthy. The Religious Freedom Protection
Ness, President, National Partnership for
Act expands on similar legislation, the
Women & Families, 2011
Religious Freedom Restoration Act
(HR3897/S2043), by also creating a private
right of action for any person or entity who feels that its rights have been violated or
threatened by the preventive services coverage requirement in the ACA.
Dismantling the Affordable Care Act
The ACA ends many of the health insurance policies that have long discriminated against
women. Insurance companies will no longer be able to charge women higher premiums just
because they are women or have had a cesarean, and insurers will be required to cover the
health care services that women need to stay healthy, such as maternity care and
preventive health services like cancer screenings and contraception. While the ACA puts us
closer to the day when prevention is a priority and essential women’s health services are
covered by all health insurance plans, the Respect for Rights of Conscience Act, the
Religious Freedom Protection Act, and similar proposals would undermine the law and
dismantle its core protections.
Legalizing Discrimination
Allowing certain employers to refuse to provide contraceptive coverage violates Title VII of
the Civil Rights Act of 1964, as amended by the Pregnancy Discrimination Act (PDA),
which prohibits sex discrimination in employment. In addition, Section 1557 of the ACA
prohibits discrimination in health care on the basis of – among other things – sex. Since
the burdens of pregnancy fall entirely on women and most contraceptive methods are
available only to women, failure to provide equal access to contraception constitutes
discrimination on the basis of sex. In keeping with this, the Equal Employment
Opportunity Commission ruled in 2000 that the Pregnancy Discrimination Act prohibits
employers from treating contraceptive coverage differently than other preventive services
or prescription drugs.
The National Partnership for Women & Families is a nonprofit, nonpartisan advocacy group dedicated to promoting fairness in the workplace, access to quality health care and
policies that help women and men meet the dual demands of work and family. More information is available at www.NationalPartnership.org.
© 2012 National Partnership for Women & Families, All rights reserved.
NATIONAL PARTNERSHIP FOR WOMEN & FAMILIES | FACT SHEET | ACCESS DENIED: HOW REFUSAL CLAUSES HURT WOMEN’S HEALTH
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