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Romney says no hospitals are exempt from pill law

He reverses stand on Plan B

Governor Mitt Romney reversed course on the state's new emergency contraception law yesterday, saying that all hospitals in the state will be obligated to provide the morning-after pill to rape victims.

The decision overturns a ruling made public this week by the state Department of Public Health that privately run hospitals could opt out of the requirement if they objected on moral or religious grounds.

Romney had initially supported that interpretation, but he said yesterday that he had changed direction after his legal counsel, Mark D. Nielsen, concluded Wednesday that the new law supersedes a preexisting statute that says private hospitals cannot be forced to provide abortions or contraception.

''And on that basis, I have instructed the Department of Public Health to follow the conclusion of my own legal counsel and to adopt that sounder view," Romney said at the State House after signing a bill on capital gains taxes.

The unexpected decision revived an awkward political situation for Romney, who has staked out more conservative positions on social issues as he gears up for a possible presidential run in 2008. After vetoing the emergency contraception bill this summer, he declared himself firmly ''prolife" and faulted the Roe v. Wade decision that legalized abortion.

Yesterday, abortion opponents, who see the morning-after pill as a form of abortion, predicted a court battle over the issue, while reproductive rights advocates expressed surprise at the change of heart. Democrats accused the governor of a ''flip-flop."

Romney made his announcement a week before the controversial law takes effect. His decision resolves, for now, a debate that has raged since the Department of Public Health disclosed its position Monday. The department had said that the existing statute allowed private hospitals to sidestep the new requirement if they wished. Massachusetts is one of eight states that require all hospitals to offer emergency contraception to rape victims.

A dozen Bay State hospitals that treat rape victims do not provide the morning-after pill, according to a 2004 survey by NARAL Pro-Choice Massachusetts. The interpretation that all hospitals must offer the pill could have the greatest impact on Catholic hospitals that do not provide emergency contraception because it violates their religious tenets.

Catholic hospitals are extremely reluctant to discuss the issue. Christine A. Baratta -- a spokeswoman for the Caritas Christi Health Care System, which operates six Catholic hospitals in Massachusetts -- would only answer questions via e-mail. She said Caritas will continue to provide emergency contraception to sexual assault victims as long as they're not pregnant and that the hospitals use a serum blood test to determine pregnancy. It's unclear how that policy will conform with the law.

Caritas caregivers, Baratta said, ''are committed to providing sexual assault victims the appropriate, comprehensive, and compassionate psychological, spiritual, and medical care they require."

Representatives of other Catholic hospitals -- Mercy Medical Center in Springfield, Saint Vincent Hospital in Worcester, and Saints Memorial Medical Center in Lowell -- did not return phone calls yesterday. Mercy and Saints Memorial officials have not returned repeated phone messages this week.

The emergency contraception pill, also called Plan B, is a high dose of hormones that women can take up to five days after sex to prevent pregnancy. Supporters of the new law say rape victims should have broad access to what they consider to be a safe, effective way to prevent unwanted pregnancies. But some conservatives and Catholic groups oppose the morning-after pill because they believe it amounts to abortion in some cases.

The fight over the law is unlikely to end with Romney's pronouncement.

Daniel Avila -- associate director for policy and research for the Massachusetts Catholic Conference, the public policy arm of the Boston Archdiocese -- said yesterday that despite the new administration position, Catholic hospitals will continue to have a basis for not handing out the morning-after pill.

''It's far from over," Avila said, arguing that Catholic hospitals can still rely on prior statute because the Legislature did not expressly repeal it in passing the new bill. ''As long as that statute was left standing, I think those who want to rely on that statute for protection for what they're doing have legal grounds."

Avila said it was premature to be ''disappointed with any permutation in the debate," because a legal challenge was certain.

''It will be determined in the courtroom," he said.

Attorney General Thomas F. Reilly was asked yesterday if he expected to have to take any enforcement action against hospitals that don't comply. ''I certainly hope that it won't come to that," he said.

State Public Health Commissioner Paul Cote Jr. said in an interview Monday that his department felt strongly that the new emergency contraception law did not compel all hospitals to provide the morning-after pill.

Romney said earlier through communications director,Eric Fehrnstrom that he supported the department's ruling because it respected ''the views of healthcare facilities that are guided by moral principles on this issue."

Asked yesterday to elaborate on that position, Romney said simply that the law was the law and that the state had to follow it. The governor characterized his own beliefs about emergency contraception this way: ''My personal view, in my heart of hearts, is that people who are subject to rape should have the option of having emergency contraception or emergency contraception information."

''We're certainly happy to see that the administration decided that clear state laws, even those that this administration might not agree with, really need to be enforced and followed by everyone," said Mary Lauby, executive director of Jane Doe Inc., a Massachusetts coalition against sexual assault and domestic violence.

The chief legislative sponsors of the new law also praised the decision. ''I think his lawyers are right," said state Senator Pamela Resor, an Acton Democrat. ''I am pleased to be able to say it."

Lieutenant Governor Kerry Healey, who would seek the GOP gubernatorial nomination if Romney does not run for reelection next year, has been a supporter of emergency contraception and said this week she believes rape victims should be able to get it at any hospital.

Reilly, seeking the Democratic nomination in the governor's race, took credit yesterday, as did other Democrats and reproductive rights organizations, for pressuring Romney to abandon a policy they said would have only burdened victims.

''I think we're all very happy that the administration has backed off on this," Reilly told reporters yesterday at a press conference with representatives of Planned Parenthood and NARAL Pro-Choice Massachusetts. ''This administration was on a road that would have made it worse for women in that position."

Gubernatorial hopeful Deval Patrick was one of several Democrats yesterday to attack Romney for what they said was a ''flip-flop."

''The governor got to the right decision. But, he took a long way to get there," Patrick said in a statement.

Raphael Lewis of the Globe staff contributed to this report. Scott Helman can be reached at