The Trump administration on Thursday finalized a "conscience rule" to protect healthcare workers who refuse to perform certain services—such as abortion—due to religious beliefs.
The HHS' Office for Civil Rights issued the 440-page final rule, which offers protections for providers, health insurers and employers that decline to provide, participate in, pay for, provide coverage of or offer referrals for services that violate their religious or moral beliefs. The rule also covers healthcare staff that "assist in the performance" of such services, including schedulers and those who prepare rooms.
The rule is meant to protect individuals and healthcare organizations in HHS-funded programs from discriminating on the basis of religion, according to Roger Severino, director of the OCR.
"Finally, laws prohibiting government-funded discrimination against conscience and religious freedom will be enforced like every other civil rights law," he said.
The OCR said that the rule largely reinforces current laws and regulations that protect a medical provider's rights to refuse to perform certain procedures, while adding new standards that Medicare and Medicaid providers will need to follow to comply with. Under the rule, applicants for HHS funding must provide assurances and certifications that they are complying with its regulations.
"No new law is being made here," Severino said on a call with reporters Thursday. "What is being done is the provision of enforcement tools for existing conscience and religious freedom protections in healthcare."
If providers don't comply with the conscience regulations, they could lose federal funding. The OCR's Conscience and Religious Freedom Division, which the office established in 2018, will oversee complaints from providers that feel their rights have not been respected.
To date, Severino said protection and enforcement of conscience and religious freedom regulations in healthcare have been "inadequate." OCR said it has received 343 complaints related to alleged conscience violations during its fiscal 2018.
"It's evidence that there is a problem," he said. "There are people here who feel that their conscience and religious freedom rights have been violated."
HHS said it received more than 242,000 public comments regarding the proposed version of the conscience rule it released in 2018. At the time, the department said it issued the proposed rule after hearing reports of healthcare providers being made to perform abortion, sterilization or euthanasia procedures despite their faith and moral objections.
Sen. Patty Murray (D-Wash.), ranking member of the Senate health committee, expressed concern the new rule would undermine access to care for women, people of color and those in the LGBT community.
"(President Donald Trump's) latest harmful rule once again takes our country in entirely the wrong direction and makes it harder for people to get the care they need—this time by putting up ideological barriers for communities who already face major health care disparities," she said in a statement Thursday.
Some have questioned whether the conscience rule will add barriers to care for patients in rural areas, where local hospital markets are often dominated by religious hospitals. Catholic hospitals, for example, operate under a set of directives that prohibit procedures that are "intrinsically immoral," including abortion and contraception.
Severino dismissed this concern, and highlighted the benefit religious hospitals bring patients.
"If those religious institutions are not there … no one gets care in many circumstances," he said. "There's benefit to allowing for diversity of belief in healthcare providers. In very few areas of law do we require particular hospitals to do particular procedures."
