The Trump administration recently released a long-promised rule intended to expand already generous abilities of health care providers to cite their religious or moral beliefs in denying vital care to patients, whose requests for services may offend those personal proclivities. The final rule, “Protecting Statutory Conscience Rights in Health Care,” was issued by the administration’s HHS secretary to be enforced by its Office for Civil Rights (OCR).
The rule aims to expand federal laws that already allow health care providers to put their religious or moral beliefs above health care needs and rights of patients. This new action is a part of the Trump administration’s campaign to rollback vital civil rights and health care protections for women, particularly women of color, and LGBTQ people. The administration is prioritizing the religious and moral convictions of health care providers over quality and comprehensive health care for patients.
This expansion of religious refusals limits the ability of health care entities that receive federal funding to provide comprehensive care to patients by elevating the personal beliefs of some health care providers over the medical standard of care. HHS received 242,000 public comments on its proposed rule change, many raising concerns that patients’ care would be sacrificed, and that the expanded scope of refusals would disrupt the efficient delivery of quality care. Despite these concerns, the HHS secretary issued a rule change that is all about protecting personal beliefs of health care providers.
Indeed, HHS states in the final rule that its intent is to “encourage individuals and organizations with religious beliefs or moral convictions to enter, or remain in, the health care industry.”
Existing federal and state law allows doctors and health care facilities to refuse medically necessary care that conflicts with their personal beliefs. This most commonly plays out with refusals to provide reproductive health care, such as abortion and contraception, or with refusals to provide care to LGBTQ individuals. These religious or moral refusals violate medical standards of care. In all kinds of circumstances, personal beliefs of health providers can disrupt or cause delays in the care of patients, endangering their lives and robbing them of their dignity.
The breadth of the new rule will inevitably lead some providers to think that they can deny any health care service because of a patient’s identity or personal characteristics for any number of reasons. This is particularly troubling with respect to LGBTQ individuals, who already face barriers to accessing culturally competent treatment that meets medical standards of care.
To make matters worse, the Trump administration announced in January the creation of a new division in OCR, the so-called “Conscience and Religious Freedom Division,” to focus on expanding religious refusals for health care providers. More recently, HHS announced a change in OCR’s mission from protecting the health and well-being of people across the nation to a strict enforcement entity. The new mission, “OCR enforces civil rights laws and conscience and religious freedom laws, and protects the privacy, security, and availability of individuals’ health information,” elevates religious restrictions to be co-equal with civil rights. Given this change in focus, it is not surprising that HHS seeks to consolidate enforcement authority over the 25 existing federal laws that allow religious refusals.
The voluminous comments submitted objecting to HHS’s rule change shows that most people in this country believe that health care providers should put patients first and ensure that people can get needed medical care without the possibility their provider will refuse to treat them. Ultimately, the final religious refusals rule ignores the voices of the vast majority of the public who want to know that they can get quality health care when they need it.