Biden Administration to End Conscience Rule for Healthcare Workers

The conscience rule was implemented by the Trump administration in 2019, but it never became law after several states and organizations sued. If it had gone into effect, it would’ve allowed healthcare workers, including nurses and doctors, to opt out of certain medical procedures and treatments that violate their moral and religious beliefs. 

The rule was aimed at curbing controversial healthcare procedures in the U.S., including abortion and gender-affirming healthcare for transgender individuals. But providers would’ve been able to object to virtually any procedure that didn’t align with their beliefs, including STD testing and treatment and even vasectomies.

Reporters spoke to three individuals familiar with the negotiation process that said the Department of Health and Human Services will likely do away with the rule at the end of April. The move would make it harder for healthcare worker to opt out of procedures that violate their religious beliefs, but it may also increase access to abortions and transgender care at a time when many GOP-led states are passing legislation that criminalizes these procedures.  

A War of Objections

Politico first reported that HHS is in the process of reviewing the conscience rule for healthcare workers.

“HHS has made clear through the unified regulatory agenda that we are in the rulemaking process,” said a source familiar with the process. They said a decision on the rule will likely come at the end of the month.

Some healthcare workers celebrated the conscience rule for healthcare workers when it was announced in 2019, but pro-choice advocates slammed the decision as a violation of the fundamental right to access an abortion under Roe v. Wade. Experts in the industry also said the rule would’ve likely led to chaos as individual workers and providers pick and choose which procedures they want to be a part of.

Under the Trump administration, HHS said the rule fulfilled his “promise to promote and protect the fundamental and unalienable rights of conscience and religious liberty.”

But the rule never saw the light of day after states like New York and California sued to stop the rule from taking effect.

“Everyone is entitled to their religious beliefs, but religious beliefs do not include a license to discriminate, to deny essential care, or to cause harm to others,” the American Civil Liberties Union said when the conscience rule was struck down.

Now that the rule will likely be reversed, abortion providers may finally get some relief.

“As state politicians continue to strip people of their sexual and reproductive rights and freedoms, it’s imperative that the Biden-Harris administration revoke this discriminatory policy and help ensure people can access the health care and information they need when they need it,” said Jacqueline Ayers, the senior vice president of policy, organizing and campaigns for Planned Parenthood, which filed a lawsuit against the Trump administration rule in 2019.

“We look forward to seeing the details of the new rule and are excited about this step forward.”

Getting rid of the rule is part of the Biden administration’s campaign to undo Trump-era polices that were designed to limit access to abortion and gender-affirming care. In 2021, Biden announced that he would rescind the Title X family planning program and foreign aid, which prohibits federal funds from being used to perform, promote, refer for, or support abortion as a method of family planning.

“There is so much to unravel,” said Leila Abolfazli, the director of federal reproductive rights at the National Women’s Law Center, which sued the Trump administration over the conscience rule in 2019. “I’m encouraged that they have been working through all these pieces.”

Advocates for abortion access say they are waiting to see what the Biden administration does with the conscience rule. There is still a chance the White House could leave some of it in place.

“We look forward to seeing the proposed rule’s text to ensure that the federal government safeguards patients’ need for high-quality health care,” said Audrey Sandusky, the spokesperson for the National Family Planning and Reproductive Health Association.

“This action will go a long way toward strengthening patient access to high-quality health care and protecting the integrity of key HHS programs, including the Title X family planning program,” she added.