HHS proposes new rule to protect ‘conscience rights,’ issues guidance to allow states to bar groups from Medicaid

HHS has issued a proposed rule to further protect healthcare workers' "conscience rights.' (Sarah Stierch/CC BY 4.0)

The Department of Health and Human Services Friday proposed a rule to further protect healthcare workers’ “conscience rights” and issued new guidance that would make it easier for states to bar groups such as Planned Parenthood from Medicaid.

HHS’ Office for Civil Rights (OCR) announcedproposed rule (PDF) intended to enforce 25 existing laws that provide conscience protections for doctors and other healthcare workers in HHS-funded programs. The laws protect people from being coerced into participating in activities that violate their conscience, such as abortion, sterilization or assisted suicide, HHS said in the announcement. The proposed rule includes a 60-day public comment period.

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The proposed rule follows on the heels of the creation last week of a “conscience and religious freedom” division within HHS’s OCR, a move the agency said will protect healthcare workers who have moral or religious objections to providing a medical services, such as abortion or treating transgender patients. Opponents reacted swiftly to the controversial plan saying it will promote discrimination against women and LGBTQ patients.

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In a separate action Friday, HHS’ Centers for Medicare & Medicaid Services issued new guidance to state Medicaid directors restoring state flexibility to decide program standards. The letter (PDF) rescinds 2016 guidance that specifically restricted states’ ability to take certain actions against family-planning providers that offer abortion services, the HHS announcement said.

“Today’s actions represent promises kept by President Trump and a rollback of policies that had prevented many Americans from practicing their profession and following their conscience at the same time,” Acting HHS Secretary Eric D. Hargan said in the announcement. “Americans of faith should feel at home in our health system, not discriminated against, and states should have the right to take reasonable steps in overseeing their Medicaid programs and being good stewards of public funds.”

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Critics worry that some HHS leaders are going too far and blurring the lines between church and state, according to Politico. A small number of evangelicals inside HHS have looked for ways to weaken federal protections for abortion and transgender care, which has now taken shape in political policies, the report said. The report said the changes, which have taken staff members by surprise, have been spearheaded by Roger Severino, an anti-abortion lawyer who heads HHS’ OCR and Shannon Royce, an agency official who has ties with religious and grass-roots organizations.

Severino also commented in the HHS announcement. “America’s doctors and nurses are dedicated to saving lives and should not be bullied out of the practice of medicine simply because they object to performing abortions against their conscience,” Severino said. “Conscience protection is a civil right guaranteed by laws that too often haven’t been enforced. Today’s proposed rule will provide our new Conscience and Religious Freedom Division with enforcement tools that will make sure our conscience laws are not empty words on paper, but guarantees of justice to victims of unlawful discrimination.”

In a tweet, the American Civil Liberties Union, which opposed the creation of a new division within OCR saying it was a license to discriminate, said the proposed new rule would allow healthcare institutions and workers to refuse to provide medical care and “puts patients last.”