HHS rescinds Bush era reg that gave doctors a broad religious excuse to to refuse care

Kathleen Sebelius

The U.S. Department of Health and Human Services last Friday issued a statement saying it “strongly supports” regulations which protect the rights of health care providers from being “compelled to perform or assist in an abortion.” But what the February 18 press release did not say was of even greater interest to the LGBT community.

The press release did not say that the department was rescinding a regulation, forged under President George W. Bush, to enable doctors to refuse services to LGBT people by claiming a religious objection.

The Bush rule was called the “Ensuring That Department of Health and Human Services Funds Do Not Support Coercive or Discriminatory Policies or Practices in Violation of Federal Law.” It was added in the final days of the Bush administration to an existing set of laws called the “Regulation for the Enforcement of Federal Health Care Provider Conscience Protection Laws.”

The Federal Health Care Provider Conscience Protection Laws have been in effect since the 1970s to prohibit recipients of federal funds from discriminating against health care providers who refused to perform certain services they find religiously or morally objectionable. They were mainly aimed at protecting doctors who refused to perform abortions and sterilizations.

The change made under the Bush era HHS came just months after the California Supreme Court had ruled that a clinic violated state law when he refused to provide insemination services to a lesbian couple. Doctors at the clinic claimed their religious beliefs that no one should have a child outside heterosexual marriage prevented them from treating the lesbian couple.

The Human Rights Campaign said it urged the Obama administration to rescind the Bush era regulation and that the administration began work toward that change shortly after President Obama took office.

“This blanket right to refuse posed a real threat to, and could have severely impaired, the LGBT community’s ability to obtain health services,” noted HRC Friday in its own press release.

HHS received comments from more than 97,000 individuals and groups on its proposed rule change, and it said an “overwhelming number” complained that the Bush era rule “unacceptably impacted patient rights and restricted access to health care and conflicted with federal law, state law, and other guidelines addressing informed consent.”

“The Department received several comments suggesting that the 2008 Final Rule could limit access to reproductive health services and information, including contraception, and could impact a wide range of medical services, including care for sexual assault victims, provision of HIV/AIDS treatment, and emergency services,” noted HHS in its final rule, which will be published in the Federal Register February 23. “Additionally, a number of commenters expressed concern that the 2008 Final Rule could disproportionately affect access to health care by certain sub-populations, including low income patients, minorities, the uninsured, patients in rural areas, Medicaid beneficiaries, or other medically-underserved populations.”

The new rule change designates the HHS Office of Civil Rights to receive complaints regarding health care providers misusing the conscience protection regulations.

“Protecting the free exercise of one’s personal religious beliefs is an important public policy goal,” said HRC in its statement. “No American however, should face discrimination in the healthcare system simply because of his or her sexual orientation or gender identity.  We extend our heartfelt thanks to [HHS] Secretary [Kathleen] Sebelius and others in the Administration for finding an appropriate balance and protecting the rights of all Americans.”

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