National Partnership for Women & Families

Refusal Provisions | In the News

Many states have or are considering laws that allow health providers to refuse to provide certain medical services that violate their moral or religious beliefs. Although these laws originally focused primarily on abortion and sterilization services, in recent years they have been expanding. States have passed laws to allow pharmacists to refuse to provide emergency contraception to women who need it, and current efforts have focused on allowing medical professionals to deny access to contraception and other medical care with which they disagree. These provisions put women’s health at risk, and are especially dangerous for women in rural areas or small towns where there are few medical providers or pharmacies.

20-Week Abortion Ban, Other Bills on Wis. Anti-Choice Groups' Legislative Agendas
With conservatives retaining control of Wisconsin's Legislature, antiabortion-rights groups intend to push proposals that failed last year, as well as introduce new measures, the AP/HTR News reports.

States Slow Pace of Antiabortion-Rights Legislation, But Restrictions Up Overall, Guttmacher Report Shows
States passed fewer abortion restrictions in the first half of this year compared with the same time period in any of the past three years, but state laws restricting abortion access continue to vastly outnumber those expanding access, according to a new report from the Guttmacher Institute, Vox reports.

Featured Blog: 'AL HB31: Where Saving a Woman's Life Becomes a Question of Conscience'
An Alabama bill "would allow the entire hospital staff, including but not limited to physicians, nurses, pharmacists, counselors, and social workers, to refuse to provide medical care in situations that would 'violate their conscience,'" Feministe reports.

Featured Blogs
"This Law Allows Genetic Counselors To Turn Away Gays and Unwed Parents" (Redden, Mother Jones, 3/25) and "Repro Wrap: If There's a Uterus in the House the GOP Wants To Legislate It and Other News" (Marty, Care2, 3/21).

Featured Blogs
"AL HB31: Where Saving a Woman's Life Becomes a Question of Conscience" (Caperton, Feministe, 1/31) and "Repro Wrap: So Many TRAPs, so few Clinics and Other News" (Marty, Care2, 1/31).

Refusal Bill Advances in Ala. House
The Alabama House Health Committee on Wednesday advanced legislation (HB 31) that would allow most health care providers to refuse to participate in abortion care or other services if they personally object, the AP/Atlanta Journal-Constitution reports.

Wis. Antiabortion-Rights Bills Postponed for This Year
Wisconsin Senate Majority Leader Scott Fitzgerald (R) on Friday delayed floor consideration of two antiabortion-rights bills (AB 216; AB 217) until at least early next year, Wisconsin Public Radio News reports.

Featured Blog
"Wisconsin Senate Prepares To Vote on Abortion and Contraception Restrictions" (Wilson, RH Reality Check, 11/11).

Wis. Senate Committee Advances Two Antiabortion-Rights Bills
The Wisconsin Senate Health Committee on Thursday advanced a pair of antiabortion-rights bills to the floor for a full vote, the AP/Minneapolis Star Tribune reports.

Hiring of Antiabortion Adviser is 'Latest Fiasco' at N.C. Health Dept., Editorial States
The hiring of a "deeply conservative" adviser to the North Carolina Department of Health and Human Services is the "latest fiasco" in a string of controversial personnel decisions by Gov. Pat McCrory (R) and DHHS Secretary Aldona Wos, a Raleigh News & Observer editorial states.

Crisis Pregnancy Center Board Member Advising N.C. Agency That Will Rewrite Abortion Rules
The administration of North Carolina Gov. Pat McCrory (R) has hired an antiabortion-rights conservative organizer to advise the state health department, which is rewriting state rules on abortion, the AP/Atlanta Journal-Constitution reports.

Featured Blogs
"Washington State Won't Let Public Hospitals Refuse To Provide Abortion Care" (Culp-Ressler, "ThinkProgress," Center for American Progress, 8/22) and "Albuquerque 20-Week Abortion Ban Won't Make it on High-Turnout Ballot" (Grimes, RH Reality Check, 8/20).

N.C. Antiabortion Bill Signed Into Law as Protests Continue
North Carolina Gov. Pat McCrory (R) on Monday night signed into law an expansive antiabortion-rights measure (SB 353), while opponents held a 12-hour protest outside the executive mansion denouncing the bill, the Raleigh News & Observer reports.

N.C. Gov. McCrory Confirms That He Will Sign Wide-Ranging Abortion Bill; Abortion-Rights Supporters To Stage Protest
North Carolina Gov. Patrick McCrory (R) at a press conference on Friday announced he would sign a wide-ranging antiabortion-rights measure (SB 353) approved by the state Senate on Thursday, WITN reports.

N.C. Antiabortion Bill Faces Veto Threat
North Carolina Gov. Pat McCrory (R) on Wednesday pledged to veto an antiabortion-rights measure championed by Republicans in the state Legislature, Reuters reports.

Amendment Adds Omnibus Antiabortion Measure to N.C. Bill
The North Carolina Senate on Tuesday gave preliminary approval to several abortion restrictions after a committee attached the provisions to an unrelated bill (HB 695), WRAL's "@NCCapitol" reports.

Mo. Law Allows Pharmacies To Not Stock Emergency Contraception
Missouri Gov. Jay Nixon (R) last week signed a bill (SB 126) that allows pharmacy owners to refuse to carry certain drugs, such as emergency contraception, AP/KSDK reports.

Hawaii Gov. Signs Bill To Ensure Emergency Contraception Access at Hospitals
Hawaii Gov. Neil Abercrombie (D) on Monday signed into law a bill (HB 411) that requires hospitals to provide sexual assault survivors with accurate information about emergency contraception, as well as access to it, the Honolulu Star-Advertiser reports.

Editorial Criticizes Mo. Bill That Could Hinder Emergency Contraception Access
Although a federal judge recently "overturned an Obama administration rule preventing girls younger than 17 from buying emergency contraceptive pills over the counter, ... in Missouri, a bill [SB 126] already had passed the state Senate to prevent pharmacists from having to stock such medication," a St. Louis Post-Dispatch editorial states.

Mo. Attorney General Declines To Appeal Ruling on State Contraceptive Coverage Law
Missouri Attorney General Chris Koster (D) on Thursday said he will not appeal a federal ruling that struck down a state law (SB 749) allowing employers and health plans to refuse to cover contraceptives on moral, ethical or religious grounds, KCUR reports.

Mo. Senate Approves Bill Allowing Pharmacies To Refuse To Carry Emergency Contraception
The Missouri Senate on Thursday voted 24-9 to approve legislation (SB 126) that would allow pharmacies in the state to refuse to stock certain drugs, including emergency contraception, the AP/Atlanta Journal-Constitution reports.

Mo. Attorney General Requests Clarification in Ruling on State Contraceptive Coverage Law
Missouri Attorney General Chris Koster (D) on Thursday asked a federal judge to clarify the scope of a federal ruling that struck down a state law (SB 749) allowing employers to refuse to offer health plans that cover contraception because of moral objections, the AP/KTTS reports.

Ky. Legislature Overrides Veto of 'Religious Freedom' Bill
The Kentucky General Assembly on Tuesday overturned Gov. Steve Beshear's (D) veto of a measure (HB 279) that purports to protect "sincerely held religious beliefs" from infringement unless there is a "compelling governmental interest," the Lexington Herald-Leader reports.

Mich. Senate Bill Would Allow Insurers, Providers To Deny Contraception, Other Services
The Michigan Senate Health Policy Committee on Thursday approved a bill that would allow health care providers and insurers to refuse to cover or provide contraceptives and other services for moral, ethical or religious reasons, Interlochen Public Radio reports.

Mo. House Speaker Urges Appeal in Ruling on State Contraceptive Coverage Law
Missouri House Speaker Tim Jones (R) on Wednesday urged the state's attorney general to appeal a federal ruling that struck down a state law (SB 749) allowing employers and health plans to refuse to cover contraception on moral or religious grounds, the AP/Atlanta Journal-Constitution reports.

Mo. House Approves Refusal Measure
The Missouri House on Monday approved a bill (HB 457) stating that health care providers and facilities may not be discriminated against for refusing to provide or participate in services and research because of ethical, moral or religious objections, the AP/Atlanta Journal-Constitution reports.

Hawaii Senate Approves Emergency Contraception Bill, Rejects Religious Refusal Provision
The Hawaii Senate on Tuesday approved legislation (SB 1109) that would require hospital emergency departments to provide emergency contraception to sexual assault survivors, the AP/Garden Island reports.

Neb. Committee Hesitant on Refusal Bill, Hears Testimony on Abortion Information Bill
Lawmakers on the Nebraska Senate Judiciary Committee on Friday gave a "skeptical reception" to a bill (LB 564) that would expand protections for health care workers who refuse to participate in medical services they personally oppose, including those related to abortion and contraception, Omaha World-Herald reports.

Ala. House Passes Contraceptive Coverage Refusal Measure
The Alabama House on Tuesday voted 67-28 to approve a bill (HB 108) that would allow employers to opt out of the federal contraceptive coverage rules, the Montgomery Advertiser reports.

Mich. House Sends Sweeping Antiabortion Bill to Gov. Snyder
The Michigan House on Thursday approved legislation (HB 5711) that would impose several new restrictions on abortion, although lawmakers removed one controversial provision relating to the disposal of fetal remains, the Detroit Free Press reports.

Featured Blogs
"Why are Michigan Politicians Adopting Ireland's Deadly Abortion Policy?" (Jennifer Dalven, American Civil Liberties Union's "Blog of Rights," 12/10).

Mich. Lawmakers Push Antiabortion Legislation Package in Lame-Duck Session
Michigan lawmakers are attempting to pass a package of bills that would impose several new restrictions on women's access to abortion care and coverage during their lame-duck session, the Huffington Post reports.

Featured Blogs
"Michigan Lawmakers are Trying To Sneak Through Extreme Abortion Restrictions in Lame Duck Session," (Tara Culp-Ressler, RH Reality Check, 12/6).

Featured Blogs
"Reflections on the 2012 Election and Abortion" (Carole Joffe, ANSIRH Blog, 11/16).

Women's Ability To Access Contraception Should Override Religious Objections, Opinion Piece States
"The religious beliefs of pharmacists, doctors, nurses, or other healthcare providers should not trump a woman's ability to make decisions about her reproductive health," Gretchen Borchelt, senior counsel and director of state reproductive health policy at the National Women's Law Center, states in a U.S. News & World Report opinion piece.

Featured Blogs
"A Wink and a Nod: Anti-Choice Laws Invite Anti-Choice Harassment and Terrorism" (Jen Russo, RH Reality Check, 10/1), "Missouri Fines Insurance Provider $1.5 Million for Not Letting Employers' Personal Beliefs Dictate Contraception Coverage" (Amanda Peterson Beadle, ThinkProgress, 9/28) and "Why we Should all Care That Texas is 'Dismantling' Women's Health" (Thanh Tan, Seattle Times ' "Ed Cetera," 9/28).

Insurer To Pay $1.5M in Dispute Over Abortion, Contraceptive Coverage
Aetna will pay $1.5 million to settle charges that it did not comply with Missouri laws regarding coverage requirements for abortion, contraception and autism, the AP/Business Insider reports.

Ill. Appeals Court Rules That Pharmacists May Refuse To Dispense Emergency Contraception
An Illinois appellate court on Friday upheld a lower court ruling that the state cannot require pharmacies and pharmacists to dispense emergency contraception, Reuters reports.

Impact of Mo. Refusal Law Unknown in Face of Legal Challenge
It is unclear how women in Missouri will be affected by a new law (SB 749) allowing employers and health plans to refuse to provide insurance coverage for contraception, abortion or sterilization for religious or moral reasons, the Springfield News-Leader reports.

Mo. Enacts Abortion, Contraceptive Coverage Refusal Law; Injunction Requested To Block Measure
The Missouri Legislature on Wednesday voted to override Gov. Jay Nixon's (D) veto of a bill (SB 749) that would allow employers to refuse to provide insurance coverage for contraception, abortion or sterilization procedures for moral or religious reasons, the Huffington Post reports.

Vetoed Mo. Refusal Bill Could Resurface This Week
The Missouri General Assembly might reconsider a vetoed bill (SB 749) that would have allowed employers to refuse to provide insurance coverage for abortion or birth control for moral or religious reasons, the Springfield News-Leader reports.

Federal Judge Dismisses Wheaton College's Contraceptive Coverage Lawsuit
A federal judge has dismissed an evangelical university's lawsuit against the federal contraceptive coverage rules because the school does not face an immediate threat of having to offer the coverage, UPI reports.

Recent Court Rulings Fail To Preserve Women's Constitutional Rights, New York Times Editorial States
"At a time when abortion rights and women's access to affordable contraception are threatened by political attacks, judges in three newly decided federal cases failed to preserve constitutional protections for women," a New York Times editorial states.

Mo. Gov. Nixon Vetoes Contraception Coverage Refusal Bill
Missouri Gov. Jay Nixon (D) on Thursday vetoed a bill (SB 749) that would have allowed employers and health plans to refuse to provide insurance coverage for abortion, contraception or sterilization if the services conflict with their religious or moral beliefs, the AP/Washington Times reports.

Mo. Gov. Nixon Flooded With Messages About Contraceptive Coverage Refusal Bill
More than 4,700 messages were sent to Missouri Gov. Jay Nixon (D) urging him to sign or veto a bill (SB 749) that would allow employers to refuse to provide health coverage for services -- including abortion and contraception -- that conflict with their religious or moral beliefs, the Kansas City Star reports.

N.D. Voters Soundly Reject 'Religious Liberty' Ballot Measure
Close to two-thirds of North Dakota voters on Tuesday opposed a ballot initiative (Measure 3) that would have made it harder for the government to pass laws and regulations that indirectly impact religious practices, the Bismarck Tribune reports.

N.D. Voters To Decide 'Religious Liberty' Ballot Measure
North Dakota voters on Tuesday will decide a ballot initiative (Measure 3) that would amend the state constitution to make it more difficult for state and local governments to pass or enforce laws or regulations that indirectly impact religious practices, the Christian Science Monitor reports.

N.D. Ballot Measure Undermines Constitutional Protections, Editorial Argues
"North Dakota Measure 3 on Tuesday's ballot is, at its core, an attempted ecclesiastical mugging of the U.S. Constitution's First Amendment" and the "religious freedom guarantee" in the state's constitution, a Forum of Fargo-Moorhead editorial states.

House Bill Calls for Additional Restrictions on Abortion in D.C.
Rep. Justin Amash (R-Mich.) last week announced plans to introduce a bill that would restrict abortion rights in D.C., The Hill reports.

N.H. Legislature Abandons Effort To Amend Contraceptive Coverage Requirements
A New Hampshire legislative conference committee last week agreed to drop a provision (SB 356) that would have allowed certain employers to bypass a state contraceptive coverage law, the Manchester Union Leader reports.

Groups Say N.D. 'Religious Liberty' Ballot Measure Could Harm Vulnerable Populations
Some not-for-profit organizations in North Dakota have joined together against a ballot initiative (Measure 3) they say could harm vulnerable populations in the state, including abused women and children, KFYR reports.

N.H. Senate To Negotiate With House on Contraception Bill
The New Hampshire Senate on Wednesday agreed to negotiate with the House on a bill (SB 356) that would allow certain religiously affiliated employers to exclude contraceptive coverage from their health plans, the AP/Google News reports..

Mo. Lawmakers Send Contraceptive Coverage Refusal Bill to Gov. Nixon
The Missouri Legislature on Friday passed a bill (SB 749) that would allow employers to refuse to provide health coverage for services -- including abortion and contraception -- that conflict with their religious or moral beliefs, the St. Louis Post-Dispatch reports.

Mo. House Approves Bill Allowing Providers To Deny Contraception, Other Services
The Missouri House on Wednesday voted 117-37 to approve legislation (SB 749) that would allow health care providers to refuse to provide contraception or other services for moral or religious reasons, the AP/Waynesville Daily Guide reports.

N.H. House Approves Contraceptive Coverage Bill
The New Hampshire House on Tuesday approved a provision that would allow employers that are partly or wholly owned by a religious society or formed for a religious intent to exclude contraception coverage from their health plans, the AP/Seacoast Online reports.

Kan. Gov. Brownback Signs Law Allowing Pharmacists To Refuse To Fill Prescriptions
Kansas Gov. Sam Brownback (R) has signed into law a bill (H Sub SB 62) that will allow pharmacists and other health care providers to refuse to prescribe, dispense or administer drugs that they "reasonably believe" could end a pregnancy, the Wichita Eagle reports.

Ariz. Gov. Brewer Signs Bill Adding Protections for Workers Who Deny Services for Religious Reasons
Arizona Gov. Jan Brewer (R) on Friday signed into law a bill designed to allow workers who are licensed by the state to refuse to provide health care services based on religious objections, the Arizona Daily Sun reports.

Ariz. Gov. Brewer Signs Bill on Contraceptive Coverage
Arizona Gov. Jan Brewer (R) on Friday signed into law a bill (HB 2625) that allows more religiously affiliated employers to claim an exemption from a state law that requires employee health plans to include contraceptive coverage, the Arizona Republic reports.

Columnist Weighs In on Attack on Women's Health Care in N.D.
A recent column responded to an attack on reproductive rights in North Dakota.

Focus on the Family Drops Push for 'Religious Freedom' Ballot Measure in Colo.
An official with Focus on the Family on Friday said the conservative Christian advocacy group will withdraw a Colorado ballot measure (Initiative 78) that purports to ban government interference with the religious freedom of an individual or organization, the Denver Post reports.

Kan. Senate Sends Bill to Governor To Increase Refusal Protections for Health Care Providers
The Kansas Senate on Wednesday passed a bill (H Sub SB 62) that would amend existing law to allow health care providers, including pharmacists, to refuse to prescribe or administer drugs they "reasonably believe" could end a pregnancy, the Kansas City Star reports.

N.D. Ballot Measure Would Alter Regulation of Religious Beliefs
A North Dakota legislative committee on Tuesday discussed a proposed ballot measure (Measure 3) that would make it more difficult for state and local governments to regulate religious practices, the AP/Bismarck Tribune reports.

Colo. Senate Rejects Symbolic Measure Expressing Support for Blunt Amendment
The Colorado Senate on Friday voted to reject a symbolic measure (SM 3) that urged federal lawmakers to pass a failed amendment that would have allowed insurers to deny contraception coverage for moral or religious reasons, the Aurora Sentinel reports.

Ariz. Senate Approves Contraceptive Coverage Bill
The Arizona Senate on Wednesday approved a bill (HB 2625) that broadens the types of religiously affiliated employers that can claim an exemption from a state law requiring employers to include contraceptive coverage in their health plans, the AP/San Antonio Express reports.

N.H. Senate Votes on Series of Bills Targeting Women's Health
The New Hampshire Senate on Wednesday debated a series of abortion- and reproductive health-related measures, rejecting several and advancing two, the Concord Monitor reports.

Supposed Threats to 'Religious Freedom' Really About Access to Contraception, Women's Advocates Say
Although opponents of the federal contraceptive coverage rules claim their fight is about "religious freedom," women's and family planning groups say opponents' true objective is to restrict access to contraception, Kaiser Health News/Sacramento Bee reports.

N.H. Committee Votes To Send Bill That Would Alter Law on Contraceptive Coverage to Interim Study
The New Hampshire Senate Public and Municipal Affairs Committee voted 4-0 on Tuesday to send to interim study a bill (HB 1546) that would allow employers with a religious or moral objection to drop contraceptive coverage from their health plans, the Concord Monitor reports.

Ariz. Lawmakers Approve Narrowed Exemption to Contraceptive Coverage Law
An Arizona joint conference committee on Monday amended a bill (HB 2625) to limit which institutions can seek a religious exemption from a state law that requires contraceptive coverage in employer health plans, the Arizona Republic reports.

Ariz. Senate Approves Contraception Coverage Bill
The Arizona Senate on Thursday gave preliminary approval to a measure (HB 2625) that would allow certain employers to refuse to provide contraceptive coverage for religious reasons, the Arizona Republic reports.

Mo. House Approves Bill Allowing Health Care Providers To Refuse Care for Moral, Religious Reasons
The Missouri House on Thursday passed a measure that would allow health care providers to refuse to provide services for moral or religious reasons, the AP/Springfield News-Leader reports.

Mo. Senate Approves Bill on Contraceptive Coverage
The Missouri Senate on Thursday approved a bill (SB 749) that would permit employers to refuse to cover birth control unless it is for non-contraceptive purposes, the AP/Springfield News-Leader reports.

Re-Vote Planned After Ariz. Senate Rejects Contraceptive Coverage Bill
The Arizona Senate will re-vote on a measure (HB 2625) that would allow employers to refuse to provide contraceptive coverage for moral or religious reasons, the AP/NECN reports.

Kan. House Advances Bill Increasing Refusal Protections for Health Care Providers
The Kansas House on Thursday voted 95-29 to approve a bill (H Sub SB 62) that would allow health care providers to refuse to participate in abortion care, dispense drugs they believe could cause an abortion or refer for such services, the AP/Wichita Eagle reports.

Idaho House Approves Resolution Opposing Federal Contraceptive Coverage Rules
The Idaho House on Friday approved a nonbinding resolution urging President Obama and Congress to invalidate the federal contraceptive coverage rules, the AP/Idaho Press-Tribune reports.

Wash. Officials Appeal Decision on Rules for Dispensing Emergency Contraception
Washington state health officials on Wednesday filed an appeal against a federal judge's ruling that struck down state regulations requiring pharmacies to dispense emergency contraception, Reuters reports.

Ariz. Contraception Bill Stalls Amid Concerns About Disclosing Medical Information
Arizona Senate President Steve Pierce (R) on Monday removed a bill (HB 2625) from a Senate committee agenda that would require women seeking contraceptives to provide proof of a medical need if their employer does not cover the drugs for moral or religious reasons, the AP/San Francisco Chronicle reports.

Ariz. Senate Comm. Approves Bill To Expand Exemptions to State Contraceptive Coverage Law
Arizona's Senate Judiciary Committee on Monday approved a bill (HB 2625) that would allow any employer to refuse to provide contraceptive coverage for moral or religious reasons, the Arizona Daily Star reports.

N.H. House Approves Bill To Allow Religious Exemptions to State Contraceptive Coverage Law
The New Hampshire House on Wednesday voted to approve legislation (HB 1546) that would exempt religious employers from a state law that requires health plans to cover contraceptive services, Reuters reports.

Ariz. House Approves Bill To Expand Exemptions to State Contraceptive Coverage Law
The Arizona House on Thursday approved a bill (HB 2625) that would allow any employer to refuse to provide contraceptive coverage for religious reasons, the Arizona Republic reports.

Federal Judge Blocks Wash. Rule Requiring Pharmacies to Dispense Emergency Contraception
A federal judge on Wednesday struck down Washington state regulations requiring pharmacies to dispense emergency contraception, The Hill's "Healthwatch" reports.

Idaho Bill Targets Contraceptive Coverage
Idaho lawmakers on Monday agreed to amend a measure (H0 530) designed to let employers bypass federal contraceptive coverage rules, the AP/San Antonio Express-News reports.

N.H. Republicans Seek To Overturn State Contraceptive Coverage Law
Republican leaders in New Hampshire House are pushing to overturn a state law that requires health plans to cover contraceptive services, the Concord Monitor reports.

Wash. Judge Hears Arguments on Emergency Contraception Dispensing Rule
A federal judge heard closing arguments on Wednesday in a lawsuit over a Washington state rule requiring pharmacies to stock and dispense emergency contraception, the AP/San Francisco Chronicle reports.

Abortion-Rights Supporters Raise Concern Over Language in Kan. 'Conscience Protection' Bill
Abortion-rights advocates say a so-called "conscience protection" bill introduced in the Kansas House could allow health care providers to restrict women's access to birth control, the AP/Columbus Republic reports.

Ariz. Appeals Court Rules That 2009 Abortion Restrictions Do Not Cause Undue Burden
The Arizona Court of Appeals on Thursday ruled that key parts of a 2009 state law restricting abortion services are constitutional and do not place an undue burden on women, the AP/San Diego Union-Tribune reports.

Refusal Provisions | In the Courts

This section provides a brief overview of significant cases impacting reproductive rights and health related to Refusal Provisions.

Morr-Fitz, Inc. v. Quinn
State court challenge to an Illinois law brought in state court by anti-choice pharmacists that requires pharmacists to fill prescriptions for contraception.

Stormans, Inc. v. Selecky
Washington enacted a law in 2007 that required all pharmacies to carry and delivery prescription drugs, including emergency contraception.