The Doctor Is Out: Conservative Governors Are Pushing Abortion Politics onto Health Boards-And Threatening Doctors' Independence on Other Medical Issues

By Thomson-Deveaux, Amelia | The American Prospect, March-April 2014 | Go to article overview

The Doctor Is Out: Conservative Governors Are Pushing Abortion Politics onto Health Boards-And Threatening Doctors' Independence on Other Medical Issues


Thomson-Deveaux, Amelia, The American Prospect


On a Friday evening in June 2012, Jim Edmondson walked out of a meeting room in a sprawling government conference center north of Richmond, Virginia, and into a jostling scrum of reporters. "They were asking me questions with all these microphones in my face," he says. "It was a shock to see so many media people."

In Edmondson's eight-year tenure as a consumer advocate on the Virginia Board of Health, he could count on one hand the number of times he'd looked up and seen even a single newspaper reporter in the room. State regulatory boards' proceedings rarely catch the public's eye, and the health board was no exception. The members approve most regulations unanimously; the most dramatic issue they'd handled during his time, Edmondson says, was a decision about where companies should be allowed to dump solid waste. Although the governor controls appointments to the board, Edmondson, a real-estate developer who had served on a Northern Virginia health regulatory panel for 15 years before his appointment to the state board, had no inkling of his colleagues' political leanings. "We were regulating shellfish-packing plants," he says. "Politics didn't come into it."

That was before the 2011 legislative session, when the Virginia General Assembly rammed through an 11th-hour amendment to a bill about nursing homes. The amendment subjected the state's 21 abortion clinics, which by law could only perform first-trimester procedures, to the same health standards as hospitals--including wide corridors, sinks in every room, and customized awnings over the front door. The regulations, part of a national anti-choice strategy to shrink the number of abortion providers, were a victory for Virginia's Republican governor, Bob McDonnell, who was being touted as a potential vice-presidential nominee. But the law didn't spell out the details of the new guidelines. That task was delegated to the Board of Health.

Typically, whenever the state imposed new health-care guidelines, the board would "grandfather" existing facilities, allowing them to delay any necessary architectural changes until the next major renovation. "Our job was to work with hospitals or restaurants, or whatever it was, to keep them open," Edmondson says. But Ken Cuccinelli, the Republican attorney general elected alongside McDonnell, told the board that because abortion providers had not previously been licensed or regulated by the Department of Health, a grandfather clause was inappropriate.

"The message was, 'We're going to make an exception only for these clinics,'" Edmondson says. Without the grandfather clause, abortion providers would face unfeasible renovation costs. Pro-choice groups estimated that 17 could close, leaving just four clinics to care for Virginia's two million reproductive-age women.

Activists on both sides of the abortion debate began to deluge the health board's quarterly meetings in Richmond. On that day in June, the low-ceilinged conference room was packed with doctors and protesters; posters with gruesome images of aborted fetuses bobbed next to signs imploring the board to "protect choice." After Edmondson proposed an amendment to the regulations that would exempt the existing clinics, Anna Jeng, a public-health professor in her second year on the board, came close to tears as she admonished her other colleagues for wavering on the issue. "I told them, you can be conservative or liberal, but you have to be fair," she says. Late in the day, the board voted 7-4 to grandfather the existing abortion clinics.

Almost immediately, a staff attorney from Cuccinelli's office rose to chastise the board. "She basically said, 'What you just did is not going to fly,"' Edmondson says. One of the board members who had supported the amendment, stricken with sudden qualms, tried--and failed--to call a revote. Later that month, Cuccinelli announced that not only would he refuse to certify the vote--a necessary step before the rules could go to the governor for final approval--his office would not defend individual board members who might be sued by anti-abortion activists over the amended regulations. …

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