I had a brief discussion with commentator msb in an earlier thread about the question of how, exactly, the so-called Freedom of Choice Act could be used to force hospitals and doctors to be complicit in abortion. My only question has been how that coercion would work, legally. What, exactly, would the removal of special conscience protection for abortion mean? Are doctors usually required to provide or refer for any procedure if the state they are in does not have an explicit conscience provision allowing them not to provide or refer for that procedure? What would the mechanism of coercion be if explicit state conscience protections for abortion were removed?
Here's the basic idea: The most recent, and most radical, version of FOCA proposed states that the government is not permitted to "discriminate" against abortion (how do you discriminate against a procedure?) in, among other things, the "regulation or provision of benefits, facilities, services, or information." (See discussion here.) Now, if a hospital expressly refuses to allow abortion on its premises, and that hospital receives federal or state funds through a program like Medicare (which of course Catholic hospitals do), this could easily be interpreted as being a case of "discrimination" against abortion in the provision of facilities, services, and information. And the same for doctors who receive public funds but will not refer for abortions (there's that "provision of information" bit). It would in all probability be argued that this was government discrimination, because the government would be funding facilities and providers who block out abortion provision and referral as a matter of principal, even when they provide other related services such as maternity care.
This helps to explain the point made in an article that msb linked. It describes pro-abortion Senator Carol Moseley Braun's argument against a less radical version of FOCA that upheld conscience provisions. She argued that the less radical version restricted "access" to abortion; she apparently believed that the retention of conscience provisions would somehow permit limitations on such access. Did she just not know what she was talking about? Well, the answer probably is that the conscience provisions prevent doctors and hospitals from having federal and state funding blocked if they refuse to allow abortions on their premises, to perform them, or to refer for them. Absent the conscience provisions, that threat of loss of funds can come into play.
I applaud wholeheartedly the Cathoic bishops' shot across the bow to Obama: Catholic hospitals will not submit.