In the wake of the November excommunication and demotion of Arizona hospital administrator Sister Margaret McBride, for approving an emergency termination of a pregnancy to save a woman’s life, the ACLU has sent a letter to the Centers for Medicare and Medicaid Services (CMS), a division of Kathleen Sebelius’ Department of Health and Human Services.  The letter requests that two laws, not subject to provider refusal clauses — so-called “conscience clauses” — be enforced at denominational health facilities or that non-compliant facilities should lose their Medicare and Medicaid funding.

Since passage of the first provider refusal law in 1973, organizations have worked to balance provider’s rights with patients’ rights, often with the latter succumbing to the collusion of professional associations and religious organizations.  Because the Catholic Church manages 1/5th of all U.S. hospitals — which are 50% funded by public monies — provider refusal laws allow these facilities to deny women (and elder and LGBT patients) those medically sound, legal services which the church opposes.

The Catholic Church has long claimed that health care is a primary part of their mission; for decades regulatory bodies have failed to understand “mission.”  So long as abortion continues to be legal (and certain fertility services, (emergency) contraceptives, sterilization services, STD and AIDS prevention counseling, condoms and patient removal from artificial nutrition and hydration at the end of life) at the federal and state level, Catholic efforts to eliminate access at the local level will continue.

If you can’t make God’s subjects abide Him willfully, you must exercise authority.  At least that’s the position of many “pro-life” activists.  Like popular blogger Jill Stanek, who writes regarding the incident that got McBride excommunicated:  she authorized “the abortion of an 11-week-old baby whose mother was deemed to be gravely ill.”  The fetus was eleven weeks old but the rhetoric, however sincere, pits compliance with God’s laws against compliance with the constitution.  We’ve seen a trend toward the loss of women’s rights at the state level and other indicators prove that the climate for individual rights is not so good: look for instance at the conversation during Kagan’s hearings about the “unfortunate” distinction between God-given rights and constitutional rights, and the GOP/Tea Party penchant for characterizing anything during this presidency as nation-destroyingly radical.

Cover for this practice of discrimination at health facilities has long been the prioritization of individual conscience:  doctors can’t be forced to do things they don’t believe in, like abortion.  Fair enough.  And yet, provider refusal laws also allow institutions to claim conscience protections — which permits the Catholic Church to continue hospital operation while prohibiting performance of accepted services (for both doctors and patients).  These laws even allow institutions or individuals to deny a patient informed consent (knowledge of all available services) and meaningful referrals to facilities where they are performed.

Organizations like The Merger Watch Project, which monitors secular and denominational hospital mergers, and Catholics for Choice have long worked to raise awareness.  As the ACLU letter  — and Obama’s recent effort to protect hospital visitation rights for same-sex couples — shows, public acknowledgement of denominational discrimination is finally dawning.  Whether any laws, like those stated in the letter and not subject to provider refusal clauses, are enforced is another matter.