June 23, 2018
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New HHS ‘conscience’ division to protect health-care workers with moral objections

Adam Beam | AP
Adam Beam | AP
Acting Health and Human Services Secretary Eric Hargan, center, speaks with University of Kentucky HealthCare Vice President Mark Birdwhistell, left, and project manager Beth Snider, right, at the Polk-Dalton Clinic in this file photo from October 2017.
By Ariana Eunjung Cha and Juliet Eilperin, The Washington Post
Updated:

WASHINGTON — Acting Health and Human Services secretary Eric Hargan on Thursday announced the creation of a new conscience and religious freedom division aimed at protecting doctors, nurses and other health-care workers who decline to participate in care that goes against their moral or religious convictions.

Speaking at an event featuring Republican lawmakers and religious leaders, Hargan noted that many of the nation’s hospitals, clinics and hospices are run by faith-based groups. And many have found themselves forced to provide services or referrals that violate what they believe.

“For too long, too many of these health-care practitioners have been bullied and discriminated against,” he said.

While federal officials did not immediately offer details about the new enforcement office, a Conscience and Religious Freedom section appearing Thursday on the HHS site — which shows a female health-care worker in a Muslim headscarf — provides some hints. The description of the division’s mandate cites abortion, sterilization and assisted suicide as examples of the types of procedures that would be covered. But the language is broad, and health experts said it appears likely to also cover a host of other scenarios, such as treating transgender patients seeking to transition to another sex.

HHS said the protections will apply to discrimination or coercion of “providers who refuse to perform, accommodate or assist with certain health-care services on religious or moral grounds.” They would also apply to training and research activities, according to the department.

The announcement represents the latest move by the Trump administration to allow individuals and institutions to opt out of providing certain services or benefits based on their moral objections. In 2017, the administration issued new rules allowing exemptions for more employers, including for-profit businesses, from providing no-cost contraceptive coverage through their health insurance plans.

Speakers at Thursday morning’s event repeatedly criticized the Obama administration. House Majority Leader Kevin McCarthy, R-California, for example, said the previous administration expected health care workers “to conform” rather than follow their religious beliefs. “What a difference a year makes,” he added.

Roger Severino, director of the department’s Office for Civil Rights, echoed that theme, saying that “HHS has not always been the best keeper of this liberty.”

“Governments big and small have treated conscience claims with hostility instead of protection, but change is coming, and it begins here and now,” Severino said.

And Montse Alvarado, executive director of the Becket Fund for Religious Liberty, a nonprofit law firm, stressed, “It is important to recognize that we have come to a point where a division like this would be necessary.” What happened under the previous administration, she said, resulted in “forcing Americans to choose between their beliefs and their livelihood.”

Medical organizations and women’s and LGBT rights groups expressed concern that the policy would hurt vulnerable populations and create an unequal system of health care. The Obama administration had bolstered civil rights protections in health care, including barring medical providers as well as insurers from discriminating, based on gender identity, in services or access to coverage.

The American Civil Liberties Union expressed concern that the “broad language” of the announcement shows that the administration “doubling down on licensing discrimination against women and LGBT people, all in the name of religion.” And Kelli Garcia, senior counsel at the National Women’s Law Center, said that “definitely the wording on the rule creating the office appears to open the door for discrimination against patients because of their sexual orientation, gender identity or a whole host of other reasons.”

Garcia said in a phone interview that she worries cases of denied or delayed care could multiply, describing several past controversies. A pediatrician in Michigan made headlines in 2015 for refusing to see an infant because the parents are lesbians. Catholic Hospitals have been sued for delaying care to women in the midst of miscarriages, putting their health at risk, because there was still a fetal heartbeat.

“We are not fooled: The new office announced this morning is meant to make it easier for people to discriminate, not to protect people of faith. Health professionals have a duty to care for all their patients regardless of one’s gender identity, sexual orientation, faith, creed, race, political views, gender, or disability, and no one should be denied care for being who they are,” The National LGBTQ Task Force said in a statement.

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