Thread by @PAAttorneyGen

The @realDonaldTrump @HHSGov "Refusal of Care" rule puts people’s lives at risk, which is why we've taken them to court - to try and protect patients.

This hypothetical thread breaks down what's at stake:

The rule creates multiple barriers to care at nearly every step in the process.

Let’s imagine a patient - a woman w/ an ectopic pregnancy.

She goes to her doctor for an ultrasound & the ectopic (non-viable) pregnancy is confirmed. She'll die if the pregnancy isn't terminated.

At that point, let’s imagine her doctor is anti-abortion. Under the @HHSGov refusal of care rule, he can just walk away.

He’s under no obligation to provide her additional information on her condition or provide a referral to another doctor. He can just…

Walk away.

Our patient isn’t sure what to do now.

Maybe she knows it’s an ectopic pregnancy. Maybe she knows it’s non-viable. Maybe she doesn’t. It would depend on how her doctor left her.

In any case, she needs to find a new doctor. Not a small task.

She calls another doctor’s office. Maybe she does know her diagnosis—and shares that with the receptionist.

The receptionist refuses to schedule her, objecting to a visit that could end in an abortion.

Our patient, frustrated, puts off finding a new doctor for a while.

Before she can find a new doctor, our patient starts experiencing bleeding and pain.

She calls 911.

The medic arrives, sees her symptoms, and the medic could refuse to transport her, under the @HHSGov rule.

Our patient, humiliated and bleeding, has to get a cab to the emergency room.

The nurse asking her intake questions realizes our patient is pregnant and isn’t married and can object to treating the patient—and leave, without having to cover for her own absence.

Hopefully our patient isn’t left nurse-less for long. It depends entirely on the whims of the nurse who objected to cover for herself in a busy, underfunded ER.

The risk of hemorrhage with ectopic pregnancies is high, and accounts for 93% of ectopic pregnancy-associated death.

Maybe our patient beats the odds—maybe she doesn’t bleed out. Maybe the surgeon on rotation, the anesthesiologist, and the OR nurses don’t opt out on her.

Think about how much I’m using the word “maybe” here.

How much maybe is acceptable in *your* healthcare?

Our patient survives.

She gets home for recovery and has to begin the process of trying to get her insurance company to cover her hospital visit.

When the insurance company employee finds out our patient’s diagnosis—they refuse to process her paperwork.

Now our patient has to push to find someone who *will* process her paperwork at the insurance agency. Maybe she will, maybe she won’t. Maybe her paperwork will stay in limbo so long she has to pay part of her medical bill instead of her rent.

Again - there’s too many maybes.

At every administrative and personal point in the healthcare process, the @HHSGov provides the opportunity for patients to be abandoned.

This will create chaos and confusion and frustration - and it will take a human toll.