A new HHS office set up to support providers who refuse to perform services that are against their religious beliefs is causing concerns among civil rights groups and some in the healthcare industry.
Dr. Lealah Pollock, a family physician in California, says she fears for the well-being of LGBT patients who might forego seeing a provider they think might discriminate against them.
"Part of professional obligation is to provide high quality care to the patient in front of us regardless of what our moral beliefs or biases may be," Pollock said. "If you open the door to allow providers to deny care based on their perceptions of a person's moral or religious lifestyle choices, that puts our patients' lives and healthcare at risk."
Last week, HHS announced the creation of the Conscience and Religious Freedom Division within its Office of Civil Rights. The office will protect doctors, nurses and other clinicians who refuse to perform abortions and other medical procedures such as sex-reassignment surgery or fertility treatment to lesbian couples.
Some legal experts echoed religious organizations who said the Trump administration was simply correcting what had previously been the Obama adminstration's favoring of patients' rights at the expense of the religious right of healthcare professionals.
"Ensuring that these providers can practice medicine and serve their communities consistent with their faith will ensure that individuals and organizations can continue to provide high-quality care for those living in poverty and most vulnerable," said Anthony Tersigni, President and CEO of Ascension.
Except that research shows people who identify as LGBT face significant healthcare disparities due to stigma and lack of provider awareness and sensitivity. That's especially troubling since the community is at a higher risk for substance use, sexually transmitted diseases, advanced cancers, isolation, rejection, anxiety, depression, and suicide than the general population.
The number of people who identify as LGBT is also growing. A Gallup poll released last year showed about 10 million Americans or 4% of the population identify as LBGT.
Pollock says sometimes patients with stigmatized ailments like HIV face must travel far to find willing or sensitive providers. Now she worries the prevalence of such cases will grow if it becomes unclear that gay and transgender patients will be protected by state and federal anti-discrimination laws.
"This is the latest example of this administration's efforts to block women, transgender people, and other marginalized communities from accessing healthcare," Dana Singiser, vice president of public policy and government relations for Planned Parenthood said in a statement. "No patient should have to fear that their very identity could prevent them from getting the healthcare they need."
The federal Emergency Medical Treatment and Active Labor Act prevents clinicians and hospitals from turning people away if they're in need of emergency care. But providers, even those who are usually held to high standards in order to receive Medicare or Medicaid payment, can refuse patients as long as they don't discriminate against them based on race, religion or gender.
The Department of Justice has said sexual orientation is not a protected category despite President Barack Obama's moves before leaving office to protect patients under gender identity.
Catholic hospitals have been sued for denying services such as gender reassignment surgery.
And legal experts believe that the Trump administration would support providers who refuse to perform such services based on their religious beliefs. Already, faith-based employers have won court battles so they might not be required to pay for insurance coverage for birth control.
Aside from Ascension, one of the largest Catholic health systems in the country, none of the other major religiously affiliated health systems such as Mercy Health, Hospital Sisters Health System or Trinity Health were willing to endorse or even comment on the announcement.
The Catholic Health Association, which has in the past raised concerns about the implications of HHS rule makings on faith-based providers, had a muted response and said it needed to learn more about the new office.
It also hoped that the office's creation would not lead some to believe that faith-based hospitals were against seeing certain patient populations according to from Sr. Carol Keehan, CEO of the organization.
"While there are certain procedures we do not do in our hospitals, there is no one who is not welcome for the care that we do provide in our hospitals," Keehan said in a statement.
"One more polarized and politicized argument is not going to serve the people of this nation well."
At the unveiling for the new office at HHS headquarters, officials said they've been flooded with complaints since President Donald Trump took office—34 to be exact. The Obama administration reported 10 such complaints in eight years.
"For too long healthcare practitioners s have been bullied or discriminated against because of their religious beliefs and moral convictions leading many of them to wonder if they have a future in our healthcare system," Eric Hargan, acting HHS secretary said.
An edited version of this story can also be found in Modern Healthcare's Jan. 22 print edition.
