By:A. G. Simpson
The Women's Health and Wellness Bill has become stalled in the state Legislature because of the controversy surrounding the so-called "conscience clause" included in the Senate version.
The bill would require health plans issued in New York to cover a range of services including mammography and cervical cytology screening, primary and preventive obstetric and gynecological care, bone density measurements, drugs and devices, and contraceptive drugs.
A version of the Bill has passed the Assembly for the last four years, but it had not come up for a vote in the Senate until this year. And when it did, it had something new that has made some of the bill's early supporters angry.
The Senate version, which passed in January, included a conscience clause that allows any group operated by or connected with a religious organization to opt out of providing coverage for any diagnosis or treatment that is contrary to the religious tenets of that insurer.
The conscience clause "is a matter of freedom of religion. I believe that religious freedom is still a very important value," said Sen. Dean Skelos (R-C-Rockville Centre), the deputy majority leader, who helped to introduce the Women's Health and Wellness Bill in the Senate.
Roberta Fortunato, president of the more than 5,000 members of the New York branch of the American Association of University Women, disagrees. Her organization is part of the Women's Health and Wellness Coalition, with more than 80 member groups, whose purpose has been to lobby Albany for passage of the wellness bill.
The conscience clause "would hurt people no matter what particular religion they belong to," Fortunato said. "Religious organizations could - not that they would - but they could hamper a woman's ability to take full advantage of the Women's Wellness Bill."
Right now, a committee made up of both Senate and Assembly members are trying to create a compromise bill but representatives from both branches express reservations as to whether it will be completed this session.
Heated arguments, both for and against the clause, have been presented to the representatives by local organizations.
In a letter to Assemblyman Thomas Alfano (R-Elmont), in which he advocated for inclusion of a conscience clause in the Assembly version of the bill, the Rev. Monsignor John A. Alesandro of the Diocese of Rockville Centre wrote: "No one should be forced to provide insurance coverage that violates their sincerely held moral and religious beliefs."
The Diocese of Rockville Centre, which is responsible for overseeing Mercy Medical Center, is Long Island's second largest non governmental employer, according to information compiled by the Long Island Business News Research Department in June 1999.
According to Joanne Novarro, the public information officer for the diocese, the Catholic Church cannot support procedures and treatments it finds offensive. For instance, in the case of in-vitro fertilization, "The Catholic Church teaches that children should be created through the sexual act of a husband and wife; not a petrie dish," she said.
Barbara Bernstein, executive director of the Nassau chapter of the New York Civil Liberties Union, opposes the conscience clause and expressed fears it would be used by religious organizations to discriminate against employees who don't share such beliefs. The NYCLU is also a member of the Women's Health and Wellness Coalition.
"The Catholic Church should not be reaching so broadly into people's private lives. Our workplace laws do not allow for discrimination on the basis of race, sex and religion," Bernstein said. "The Senate bill would allow religious discrimination."
Novarro countered, saying, "No one is forced to work for the Catholic Church. If it is so important for them to have health insurance that covers these services, they can work for someone else."
Martha Leary, a 53-year old Catholic from Baldwin, agreed. "I think the Church is doing the right thing by fighting this. Many of these services are against what we morally believe in," said Leary. "I don't think people should expect the Church to bend on this."
The Women's Health and Wellness Bill passed the Assembly in March without the conscience clause, despite the personal lobbying efforts of the Archbishop of New York, Edward Egan. Assemblyman Bob Barra (R-Lynbrook), voted for inclusion of a conscience clause in the Assembly bill.
"Catholic hospitals are having this rammed down their throats, and this is anathema to their beliefs," he said.
Thomas Miller of Baldwin sided with the assemblyman. "I'm not a Catholic but I can understand them being against this," said Miller. "It's definitely not any easy question to answer."
Barra said Catholic-run hospitals and other religious groups regarded mandatory contraception coverage as a deal breaker. "They may be forced to go out of business," he said, referring to the notion that religiously affiliated hospitals would rather close down than offer services that violate their beliefs. However, Barra voted for the final draft of the bill without the conscience clause, because it "contains a lot of provisions that are good for women."
He reiterated, though, "I hope there will be a conscience clause included."
The conscience clause is not the only difference between the Assembly and Senate versions of the Women's Health and Wellness Bill. There is also a difference over the age at which annual mammograms for women should be covered by insurance. The Assembly bill lowers that age from 50 to 40. There is no such provision in the Senate bill.
Skelos said he believed the age detail could be worked out by the two houses in the conference committee.
Another difference is the retention of co-payments and deductibles for breast and cervical cancer screenings. Barbara Schwarz of the AAUW believes retention of the co-payments and deductibles will cause low-income women to delay being screened for cancer and that resistance to dropping deductibles and co-pays comes from the insurance industry.
"The insurance companies object because they feel that [the bill] will increase the cost of providing coverage," she said. "Many of the tests that men face are not as expensive as the tests women have to take. But, if an extra mammogram or two would detect cancer earlier, they would save money over providing the more expensive treatment that comes with a later diagnosis."
Skelos dismissed the reasoning that low-income women would be adversely affected by retention of co-payments. "I don't know of any insurance policy that does not have co-pays. And if you qualify for Medicaid, you don't have to pay a co-pay."
The senator also believes this issue will be worked out in the conference talks.
With no easy answers to the conflicts surrounding the bill, it is uncertain whether members of the Senate and Assembly will be able to have the legislation ready for the Governor's signing by June 20, the end of the legislative session.
"Unfortunately, I don't think much is going to be done by the end of the session, because the budget hasn't passed yet," said Assemblywoman Kathleen Murray (R-Levittown), who voted for the Women's Health and Wellness Bill. But there is reason for hope because, she said, "The ironic upside to not having a budget is that there is more time for discussion of controversial legislation like the Women's Health and Wellness Bill."
Larry Maier contributed to this story.
