HHS issues new rule with 'conscience' protections for healthcare workers

HHS' OCR website has been revised to emphasize "the protection of conscience and free exercise of religion." (Sarah Stierch/CC BY 4.0)

The Trump administration has issued a new rule that will protect healthcare workers’ “conscience rights.”

The final rule, issued by the Department of Health and Human Services (HHS) Office for Civil Rights (OCR), will take effect 60 days after publication in the Federal Register. The rule is intended to protect individuals and healthcare entities from discrimination on the basis of their exercise of conscience in HHS-funded programs.

"Just as OCR enforces other civil rights, the rule implements full and robust enforcement of approximately 25 provisions passed by Congress protecting longstanding conscience rights in healthcare," according to an HHS announcement

The rule will allow healthcare workers to refuse care based on religious or moral objections.

It will grant protections to healthcare workers who refuse to provide services, such as abortion or transition-care for transgender individuals, based on religious or moral objections.

The long-anticipated rule, published as a proposed rule last year, was met with alarm from patient and health groups who fear such regulations could hurt access to care for patients. On the other hand, religious-rights groups have lobbied for the changes. Opponents say the controversial rule will promote discrimination against women and LGBTQ patients.

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Implementation of the rule to provide conscience protections for doctors and other healthcare workers in HHS-funded programs, will cost $125.5 million annually according to a government estimate.

As HHS prepared the final rule, the HHS’ Office of Civil Rights website was revised to now include religious protections for healthcare workers that were not previously emphasized.

The changes to the web site were highlighted Wednesday by the Sunlight Foundation, a national, nonpartisan, nonprofit organization, whose Web Integrity Project monitors changes to government websites.

At the end of April, the Department of Health and Human Services (HHS) overhauled the mission and vision statements listed on its OCR website to emphasize its role in protecting “conscience and free exercise of religion”, the Sunlight Foundation said. It published a side-by-side comparison of the OCR’s mission statement from early March and April 30, noting the differences.

“The language introduced into OCR’s mission and vision statements appears to reflect new priorities of the office and foreshadows yet-to-be-released new rules that are expected to downplay LGBTQ rights in favor of religious freedoms,” the Sunlight Foundation noted.

The new language on the OCR website prohibits discrimination on the basis of race, color, national origin, disability, age, sex, and religion, but excludes sexual orientation.

The language on the website has been expanded to speak to the protection of religious freedom and conscience and moral objections. It specifies that OCR’s mission includes “ensuring that HHS, state and local governments, healthcare providers, health plans, and others comply with federal laws that guarantee the protection of conscience and free exercise of religion and prohibit coercion and religious discrimination in HHS-conducted or funded programs.”

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In a report (PDF) on the changes, the Sunlight Foundation noted that the section of the website did not previously include any references to “conscience and religious freedom” or “religious discrimination.”

HHS in early 2018 announced plans to set up a “conscience and religious freedom” division within OCR, a move the agency said will protect healthcare workers who have moral or religious objections to providing medical services, such as abortion, sterilization or treating transgender patients.