A Seattle area mother is distraught because a school-based clinic at her daughter’s high school arranged for the girl to have an abortion, even providing a taxicab to the clinic, without notice to her parents. A spokesman for the King County Health Department summarized the situation simply when he commented, “At any age in the state of Washington, an individual can consent to a termination of pregnancy.”
Washington is one of a handful of states that do not have a parental notice or consent law, according to Americans United for Life. In fact, the group’s rankings of the 50 states on the extent to which they provide for such policies as informed consent, parental notice, and conscience protection ranks Washington at a very low 42nd nationally. In states where parental notice/consent laws exist, they typically also require judicial bypasses for minors who can demonstrate, independent of their parents, that they are “mature” or that the abortion would be in their “best interest.”
As a result, it’s possible that the school-based clinic might have been able to arrange a clandestine abortion for the girl even if Washington had a consent or notice law. In the larger picture, school-based clinics have been controversial for some time. While they provide many helpful medical services, offering basic physicals and mental health services to low-income students, they also bring birth control devices and, on occasion it seems, abortion referrals into the schoolhouse.
Parents are asked to sign consent forms for their children to use the clinics, but these are not always itemized and consent on specific matters like abortion is determined by state law not particular clinic policies. Moreover, teenagers who attend the clinics and are Medicaid-eligible are covered by a provision of federal law that says the teen must consent before information about their accessing contraceptives can be shared with the parent or guardian. Liberals in Congress blocked Bush Administration attempts to reduce fraud and strengthen parental prerogatives by barring the use of Medicaid funds for school-based services, including the cost of medical referrals.
Interestingly, the mammoth health care reform bill just signed into law by President Obama includes authorization for a major expansion of federal financing of school-based clinics. The National Assembly of School-Based Health Centers hailed the bill’s signing because of the $50 million it provides over five years for a new federal grant program and the “emergency appropriation” of $200 million it makes for the clinics over the next two years.
Unlike community health centers in the bill, which were not covered by a specific abortion limitation, the health reform bill bars funds from going to any school-based clinic that “performs abortions” and funds may not be used to “provide abortions.” It also specifies that the clinic shall not provide services to an individual without the consent of a parent or guardian if the individual is “considered a minor under applicable state law.”
Which is well and good, except that the “applicable state law” in the area of abortion and birth control services may not exist, may authorize judicial bypass, or even mandate confidentiality for minors when the service is contraceptives. As for abortion referrals and taxicabs to the abortion clinic, whether funding them or entities that offer them is permitted will turn on whether the U.S. Department of Health and Human Services regards these acts as part of what it means to “provide abortions.” Until proved otherwise, a parent would be prudent to assume that the Obama administration’s HHS will conclude that the referral and the taxicab are just fine with Washington.