The Republican-led House of Representatives Wednesday approved a controversial bill that would hold abortion clinics to the same requirements as surgical ambulatory facilities. And while supporters of the bill say its measures will protect women seeking the surgical procedure, women's health advocates say it will be a "public health catastrophe."
After two days of quarreling and debating about various amendments, the House approved HB 574, from Tioga-county Republican Matt Baker. As we noted this week, the bill would reclassify "abortion facility" to include any location that provides surgical abortions. It would also, among other things, require them to have the same "fire, safety, personnel and equipment" requirements as ambulatory surgical facilities. About 22 freestanding abortion clinics in the state would be affected.
"This is about patient safety," Baker told City Paper in an interview last week. "This isn't about shutting [abortion facilities] down."
Shortly after the House passed the bill Wednesday in a vote of 148 to 43, the Women's Law Project sent out a news release, contending the bill was just a tactic by anti-abortion supporters to shut down legitimate providers.
Some text from the release, from Sue Frietsche, senior attorney at the Project:
"HB 574 would force safe abortion providers to do hundreds of thousands of dollars, possibly millions of dollars, of construction upgrades and staffing upgrades for no legitimate medical reason and with no safety benefit for women. These changes would include hiring fulltime nurses to supervise recovery rooms even on days when no abortions are being performed and increasing the size of procedure rooms to two or three times their current size for no medical reason."
The bill has sparked debate, as our friends at Philadelphia City Paper have well documented, between Democrats and Republicans, pro-lifers and women's health advocates.
On the House floor Wednesday, Mercer County Republican Michele Brooks stood by Baker.
"These facilities should be regulated just like any other ambulatory surgical facility," she said on the floor before the vote. "Nail salons have more regulations on these facilities ... How can anyone say there is not a need for greater restrictions and greater oversight?"
Democrats fiercely disagreed. Philadelphia-area Rep. Mark Cohen contended the bill was unconstitutional. "I believe forcing abortion clinics to shut down to some degree and nearly quadrupling the price of abortion among those clinics that manage to stay open constitutes an undue burden on women seeking an abortion," he said. [A house majority ruled that the bill was in fact constitutional.]
"House Bill 574 is not a magic wand," argued Rep. Dan Frankel, D-Squirrel Hill. It does not ensure better quality of care. It does not address the very real threat of anti-choice extremists and it's not going to keep illegal abortions from happening."
Frankel further criticized the bill's process, saying it moved like a "freight train" through committee, without "thoughtful, deliberate consideration" without appropriate hearings. He moved to have the bill recommitted to the health committee.
House majority leader Mike Turzai contended the bill had already been vetted "significantly" and passed the committee with bi-partisan support. Frankel's motion to recommit the bill to committee failed.
Frankel warned Wednesday, "Clinics that have the women's best interest at heart will be forced to go out of business. House Bill 574 should make us hang our heads in shame."
Baker's bill came in the wake of authorities shutting down an abortion clinic operated by Dr. Kermit Gosnell in January. Gosnell is accused him of killing seven live infants by cutting their spines, and one woman with an overdose of anesthesia.
Baker says he based components of his legislation upon recommendations of a report by the Philadelphia grand jury that indicted Gosnell and his unlicensed employees and called out the health department for negligence for allowing him to operate unchecked.
In a press release, Baker invoked the Gosnell tragedy and sad his bill was something he hoped would prevent another from occurring.
"We have 212 ambulatory surgery centers in the Commonwealth that are regulated and abortion clinics that perform surgical abortions have strangely been exempt. Why? Abortion centers are performing serious surgical procedures and should be regulated in state law to prevent the horrors that transpired in the Philadelphia abortion clinic."
UPDATE: The folks at Planned Parenthood have released a statement on the House action. It's reprinted in full below:
Today the Pennsylvania House of Representatives ignored the needs of thousands of Pennsylvania women and voted to pass H.B. 574, a dangerous bill that would regulate free standing abortion providers as ambulatory surgical facilities (ASF) and subject them to the ambulatory surgical facility regulations. Abortion is the only medical procedure with its own set of burdensome state regulations in existence today, but H.B. 574 would heap on additional unnecessary and costly requirements such as the tripling of procedure rooms from their current size.
"We are disheartened to see that so many house members are content to see ANY bill, rather then a good bill, pass" says Sari Stevens, Executive Director for Planned Parenthood Pennsylvania Advocates. "We had an opportunity to ensure that the tragedy of Kermit Gosnell would not be repeated in our state. Instead, we may see reputable, safe providers shutting their doors and more substandard clinics operating under the radar to fill that gap."
Currently, Pennsylvania abortion providers operate under several forms of regulation including Ambulatory Gynecological Surgery in Hospitals and Clinics, the Abortion Control Act, the MCARE Act, Clinical Laboratory Improvement Amendments, and Occupational Safety and Health Administration regulations.
Neither the Secretary of Health, Dr. Eli Avila, nor the Chairwoman of the Senate Public Health and Welfare Committee, Senator Pat Vance, believe including abortion providers under the ambulatory surgical facility regulation is necessary. "It's surprising that a male attorney has become the expert on abortion regulation with no testimony or even so much as a public hearing on the matter, when the licensed doctor heading the Department of Health and the former nurse heading the Senate Public Health and Welfare Committee both support a different legislative response to this situation" said Stevens.
Proponents of the bill point to the Grand Jury indictment of Kermit Gosnell, which initially recommended applying Ambulatory Surgical Facility regulations to independent abortion providers. Yet they fail to mention that the District Attorney himself clarified that position in a letter to House leadership last week, saying the following: "HB 574 goes beyond the scope of the Grand Jury report and would bring under the scope of both the Health Care Facilities Act and the ASF regulations facilities that are presently not included in either."
Furthermore, the Grand Jury report and indictment of Kermit Gosnell actually praised the independent abortion facilities that would be forced to cease operations under the proposed legislation: "Many organizations that perform safe abortion procedures do their own monitoring and adhere to strict, self-imposed standards of quality. But the excellent safety records and the quality care that these independently monitored clinics deliver to patients are no thanks to the Pennsylvania Department of Health."
"The purpose of abortion regulations should be to protect women's health, not shut down safe providers" remarked Stevens. "Providers who conform to the regulations currently in place are providing a high level of care. What we saw with the events at the Gosnell clinic was someone who willfully disregarded these standards and regulations. Women need accessible care and better enforcement of existing regulations, not additional, unnecessary regulations and politically motivated attacks."
The sponsor of H.B. 574 and its proponents continue to claim that this bill will not decrease access to safe medical care. Yet when anti-abortion organizations urged a previous victim of Kermit Gosnell to testify before the Senate Public Health and Welfare Committee she made it clear that she had sought out his clinic because he was "the doctor she could afford." By pushing H.B. 574, these hard-line anti-abortion organizations will severely increase the cost of an abortion by over 400% and decrease access to high quality providers. Despite their claims, H.B. 574 has one purpose -- to close the safe, affordable abortion providers that Pennsylvania women trust. It has nothing to do with keeping women safe.