Religious and Moral Exemptions: What You Need to Know

The U.S. Department of Health and Human Services has just enacted a new regulation that allows healthcare providers to opt out of procedures and health-related services that go against their moral and religious beliefs. The Trump administration has long sought to reaffirm the religious rights of healthcare workers, but opponents of the new rule say it could decrease access to care and lead to discrimination against women, members of the LGBTQ community and religious minorities.

If you or someone you know may want to take advantage of this rule or you’d like to know more about how it could affect your facility and patients, keep reading to learn more about the latest regulations from HHS.

The Fight Over Religious and Moral Exemptions for Healthcare Providers

Religious organizations and those on the Right have long pushed to recognize the religious freedoms of healthcare workers by giving them a way to opt out of certain procedures like abortion, sex reassignment surgery, and assisted suicide. Participating in or assisting with some of these procedures may go against a healthcare provider’s religious and moral beliefs.

When abortion became legal in 1973 after Roe v. Wade, religious groups began drafting conscious clauses to give providers a way out of performing abortion. In the years that followed, the same fight has erupted over sex reassignment surgery and assisted suicide.

However, under federal law, medical offices and insurance companies must provide their services to everyone, regardless of their race, color, sex, national origin, age, disability or sex. Right before he left office, former President Obama extended these protections to include a person’s gender identity, securing protections for transgender individuals as well.

In response, the Christian Medical & Dental Association, other faith-based organizations, and five states sued to reverse these protections, arguing they undermine the religious freedoms of healthcare workers.

Dr. David Stevens, CEO of the Christian Medical & Dental Associations, said, “It wasn’t that we weren’t willing to take care of transgender patients. They said that if we provided a service or a medication for anyone, we had to provide it for a transgender patient on demand. If you gave hormones for birth control, you had to give hormones to an 11-year-old [for transition therapy]. If you didn’t do this, then you lost all your Medicaid and Medicare funding and the patient could sue you.”

However, many argue that honoring the religious freedoms of healthcare workers can lead to discrimination against women, religious minorities, and members of the LGBTQ community. Women seeking abortions may have trouble finding providers if healthcare workers can opt out of performing the procedure. Furthermore, members of the LGBTQ community may be denied care all together under these rules.

Earlier this year, the Trump Administration unveiled the final rule protecting the religious freedoms of healthcare workers, while arguing that the rule does not discriminate against women, religious minorities, or members of the LGBTQ community.

Soon after the rule was announced, San Francisco City Attorney Dennis Herrera brought a lawsuit against the Trump administration, arguing the new rule would reduce patient access to critical healthcare. In an official statement, Herrera said, “People’s health should not be a political football. The intent of this new rule is clear: it’s to prioritize religious beliefs over patient care, thereby undermining access to contraception, abortion, HIV treatment and a host of other medical services.”

What This New Rule Means for You and Your Patients

Under the new rule, healthcare providers can now refuse to perform procedures and services that go against their moral and religious beliefs. The rule extends these protections, giving providers the freedom to refuse services on much broader grounds than those enacted under previous administrations.

For example, a healthcare provider may refuse to perform an abortion on a patient, but they can also refuse to participate in anything “with a specific, reasonable and articulable connection” to an abortion procedure, including Plan B and other contraceptives.

These same standards apply to patients seeking sex reassignment surgery or hormone therapy. Some worry these exemptions could also apply to those seeking treatment for HIV, including HIV prevention and the drug naloxone, which is used to reverse opioid overdoses.

Many healthcare providers that oppose performing these kinds of procedures will typically go to work elsewhere to avoid the issue entirely. For example, a nurse that opposes abortion may go to work for a cardiologist. But under the new rule, providers with strong moral and religious beliefs may seek employment elsewhere, knowing they will be free to opt out of procedures that violate their beliefs.

The rule applies to all healthcare organizations that receive federal funds from the Department of Health and Human Services, including funds supplied through Medicare and Medicaid, and international organizations such as United Nations agencies. If an organization violates a provider’s religious freedom, the facility may lose access to these funds.

Some also worry these new exemptions could lead to the stigmatization of certain healthcare services, such as HIV treatment, sex reassignment surgery, and abortion. Fewer clinics across the country may offer these services in order to comply with the law, reducing patient access to care. A map of healthcare providers offering these services may start to look more like a political map than a business directory, which different clinics picking and choosing which services they offer based on their religious and moral beliefs.

While these protections have yet to be tested in court, the new rule remains in effect for the time being. Stay tuned as this debate continues within the medical community.