Trump Administration Finalizes Health-Care Discrimination Rule (Updated)

The rule released Thursday would grant wide legal protections to those who refuse to provide health-care services based on their religious or conscience objections.

[Photo: A transgender woman in a hospital gown speaking to her doctor, a transgender man, in an exam room.]
The Trump administration on Thursday took another significant step in rolling back legal protections for LGBTQ patients. The Gender Spectrum Collection

UPDATE, July 1, 8:55 a.m.: The Trump administration said it would postpone the implementation of its “conscience” rule while it is challenged in court, the New York Times reported on Saturday.

The Trump administration on Thursday took another significant step in rolling back legal protections for LGBTQ patients, finalizing a rule that, if allowed to take effect, would allow individuals and health-care entities to refuse care to patients based on religious or moral objections.

In January, the U.S. Department of Health and Human Services (HHS) announced it was close to finalizing an expansive new conscience protection rule for health-care providers. The rule permits providers to refuse to provide treatment, referrals, or assistance with procedures if these activities would violate their stated religious or moral convictions. The rule goes beyond refusing to provide health care; it also includes refusal for any health-related services, including research activities, health studies, or the provision of health-related insurance coverage.

The final rule requires applicants for federal funding to provide assurances and certifications of compliance. The rule also specifies how individuals and health-care entities would comply with the new obligations, including cooperation with the HHS Office of Civil Rights (OCR), maintenance of records, reporting, and non-retaliation requirements.

“Laws prohibiting government funded discrimination against conscience and religious freedom will be enforced like every other civil rights law,” said OCR Director Roger Severino in a statement announcing the final rule. “This rule ensures that healthcare entities and professionals won’t be bullied out of the healthcare field because they decline to participate in actions that violate their conscience, including the taking of human life. Protecting conscience and religious freedom not only fosters greater diversity in healthcare, it’s the law.”

Trump’s announcement follows HHS’ overhaul at the end of April of the mission and vision statement listed on OCR’s website. The changes emphasize OCR’s role in protecting “conscience and free exercise of religion,” and were made at the same time as an HHS budget request that would weaken enforcement of civil rights protections for LGBTQ people.

Louise Melling, deputy legal director at the American Civil Liberties Union, said in a statement, “Once again, this Administration shows itself to be determined to use religious liberty to harm communities it deems less worthy of equal treatment under the law. This rule threatens to prevent people from accessing critical medical care and may endanger people’s lives.”

“Religious liberty is a fundamental right, but it doesn’t include the right to discriminate or harm others,” Melling continued. “Denying patients health care is not religious liberty. Discriminating against patients based on their gender or gender expression is not religious liberty. Medical standards, not religious belief, should guide medical care.”