"[A]s the Mississippi law demonstrates, as healthcare refusal laws grew to include contraception, some states specifically covered pharmacists and pharmacies with objections to selling contraception. As changes occurred in the economic organization of the healthcare field, conscience legislation began to apply the logic of complicity to insurance plans’ and HMOs’ financial relationships. In 1997, Congress passed a Balanced Budget Act that provided conscience provisions for Medicaid and Medicare managed care providers that objected to providing, reimbursing for, or covering abortion counseling or referral. A 2004 appropriations bill broadened the de finition of a healthcare entity to include HMOs and insurance plans, and withheld federal funding from any federal agencies or state governments that discriminated against healthcare entities on the basis of their refusal to cover, pay for, or refer for abortion. In 2008, the Bush Administration adopted regulations that expanded the coverage of the Church Amendment itself, defining “Health Care Entity” to include HMOs and health insurance plans and assistance to include “counseling, referral, training, and other arrangements for the procedure."