A U.S. Department of Health and Human Services proposed rule that would more vigorously protect health care providers’ ability to deny coverage in certain circumstances because of moral or religious beliefs should be withdrawn, according to a coalition of state attorneys general.
The proposed rule would strengthen the enforcement of existing regulations that allow providers to invoke conscientious objections as a basis for refusing to provide care that involves certain medical issues, including abortion, sterilization, assisted suicide and others. It also would allow individual providers to object to informing patients about their medical options or referring them to providers of those options.
“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,” HHS Deputy Secretary Eric Hargan, a former shareholder at Greenberg Traurig, said in a statement in January when he was acting secretary that accompanied the release of the proposed rule in January. “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.”
But 19 state attorneys general, led by New York’s Eric Schneiderman, argue that it is the patients who will be discriminated against under the proposed rule. This is particularly true, they argue, in the cases of marginalized patients who already face discrimination in trying to obtain health care, such as lesbian, gay, bisexual and transgender patients and male patients seeking HIV/AIDS preventative medications, according to the comments filed in opposition to the rule.
“If adopted, the proposed rule … will needlessly and carelessly upset the balance that has long been struck in federal and state law to protect the religious freedom of providers, the business needs of employers, and the health care needs of patients,” they state.
The proposed rule also requires some recipients of federal funds to certify to HHS that they are in compliance with federal conscience laws. This move, according to the attorneys general, seeks to coerce states’ compliance by threatening to terminate billions of dollars in federal health care funding if HHS determines that they have failed to comply with the rule.
Also of particular concern to the attorneys general is the proposed rule’s failure to address the treatment of patients in emergency situations. According to their comments, allowing providers to object in emergency situations conflicts with federal law that requires hospitals to provide for emergency care, and “could jeopardize patient lives.”
“Under the Proposed Rule, a woman suffering an ectopic pregnancy, for example, could be turned away from her nearest provider and forced to locate a doctor willing and available to provide her with an appropriate treatment before it is too late,” they state.
The other states joining New York in submitting the comments are Connecticut, Delaware, Hawaii, Illinois, Iowa, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New Mexico, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, Washington, D.C., and Washington state.
“Donald Trump is proposing a ‘license to discriminate’ for health care and insurance companies against LGBTQ Americans, but our coalition of attorneys general will fight to kill this outrageous rule,” New Mexico Attorney General Hector Balderas said in a statement. “As President Trump continues to attack the LGBTQ community, I will continue to fight him every step of the way to protect all New Mexico families.”