Washington • President Donald Trump on Thursday announced new “conscience protections” for health providers, insurers and employers who refuse to provide or pay for services, including abortion, sterilization or assisted suicide during a speech in front of faith leaders gathered for the National Day of Prayer.
Conservatives who have raised religious-liberty concerns about such services welcomed the rule, which was first proposed last year, while LGBTQ and women’s groups, among others, fear it could lead to discrimination and a dearth of certain services, as doctors and others might decline to offer certain treatments, or to treat gay and transgender people.
The rule represents Trump’s latest effort to highlight religious-liberty claims when they come into conflict with issues such as access to medical care. There are 25 provisions passed by Congress protecting conscience rights in health care. Health and Human Services (HHS) officials contend these were inadequately enforced so this new rule clarifies those protections and includes additional enforcement.
“Conscience protections” have become a flashpoint in culture war debates in recent decades. In a high-profile battle with the Obama administration, several religious institutions objected to HHS’ mandate that employers must cover employees’ contraception.
The final rule, issued Thursday by the HHS, explicitly mentions abortion, sterilization, assisted suicide and advance directives as issues, saying that individuals and entities would be allowed to refrain from having to provide, participate in, pay for, provide coverage of, or refer for, such services.
The rule expands on the powers of the HHS Office for Civil Rights (OCR) — requiring health care entities to maintain records and report and cooperate with OCR requests.
HHS said that existing protections for health care providers have “proven inadequate” and that the new rule ensures the agency will have access to the “full set of tools appropriate for enforcing the conscience protections passed by Congress.”
“Finally, laws prohibiting government-funded discrimination against conscience and religious freedom will be enforced like every other civil rights law,” OCR Director Roger Severino said in a release.
Since it was first proposed last year, the proposal has drawn widespread criticism from civil rights advocates who say it will provide cover for discrimination.
“This is a vicious and underhanded attack on the health and lives of patients, particularly targeting women and LGBTQ individuals,” Fatima Goss Graves, president and CEO of the National Women’s Law Center, said in a statement.
But religious conservatives who are a key part of the president’s base, say such protections are needed in the face of laws like the Affordable Care Act that mandate provision of certain services.
“No health care worker should ever be forced to choose between their practice or their faith,” said Ashley McGuire, a senior fellow at The Catholic Association. “That principle is enshrined in countless laws and regulations but has been violated for far too long.”
Under then-President Barack Obama, HHS replaced a rule passed during the George W. Bush administration that was interpreted as allowing medical workers to opt out of a broad range of medical services. Obama’s narrower version left in place long-standing federal protections for workers who object to performing abortions or sterilizations, and it kept the ability for workers to file complaints.