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Biden Administration Working to Rescind Trump-Era 'Conscience Clause' Rule

— Regulation would have enforced health workers' rights to decline participation in some procedures

MedpageToday
A photo of a female healthcare worker holding a cross in her blue rubber gloved hands.

WASHINGTON -- The Biden administration is working to rescind a rule from the Trump administration that would have enforced the rights of healthcare workers when it comes to not participating in healthcare procedures to which they object, such as abortion or the provision of contraception.

The so-called "conscience clause" rule, issued in May 2019 by the Trump administration, did not add any new regulations, but instead strengthened enforcement of rules already on the books to protect providers' religious beliefs, including:

  • The , which bars federal agencies from providing grants to entities that discriminate against healthcare providers who don't provide abortions
  • The , which prohibits the federal government from discriminating in grants or loans on the basis of whether the entity is willing to perform sterilizations or abortions
  • The , which says the federal government and state governments can't discriminate against entities that refuse to undergo training in how to perform abortions, or to provide such training

"Finally, laws prohibiting government-funded discrimination against conscience and religious freedom will be enforced like every other civil rights law," said Roger Severino, then-director of the Office for Civil Rights at HHS, in a statement the day the rule came out. "This rule ensures that healthcare entities and professionals won't be bullied out of the healthcare field because they decline to participate in actions that violate their conscience, including the taking of human life."

However, the conscience clause rule was never implemented because pro-reproductive rights organizations, states, and others successfully sued to block it, alleging that the rule would have restricted access to reproductive healthcare and other procedures.

Now the Biden administration is working to rescind the rule, and on March 25, HHS called "Rescission of the Regulation entitled 'Protecting Statutory Conscience Rights in Health Care; Delegations of Authority'" to the Office of Management and Budget (OMB) for the required regulatory review. HHS did not respond by press time to a query about when it expected the proposed rule to clear OMB and be published in the Federal Register.

Responses to news of the proposed rule varied. "What the Biden administration is doing is not surprising," noted Carol Tobias, president of the National Right to Life Committee, a pro-life group, in a phone interview. "They obviously want to remove any and all restrictions to killing unborn children. And if that means they have to make medical professionals participate, they will do that."

"I would expect the Biden administration to basically say they are not going to enforce" the current rules or "they are going to overturn them administratively if they can," she added.

On the other side of the issue, Jacqueline Ayers, senior vice president of policy, organizing, and campaigns at the Planned Parenthood Federation of America, a pro-reproductive rights group, said in a statement, "This 'refusal of care' rule was yet another tactic the Trump administration used to try to stop people from accessing healthcare."

"As state politicians continue to strip people of their sexual and reproductive rights and freedoms, it's imperative that the Biden-Harris administration revoke this discriminatory policy and help ensure people can access the health care and information they need when they need it," she continued. "We look forward to seeing the details of the new rule and are excited about this step forward."

As the Biden administration rule awaits review, action on a similar front is taking place in Ohio, where Columbus City Attorney Zach Klein is suing the state government over its conscience clause rule. If nurses working for the city of Columbus decided they opposed a medical procedure, "they can refuse it and we as a city can't do anything about it," Klein Wednesday. In addition, insurance companies could refuse to pay for certain procedures, and "that obviously causes significant problems for our employees."

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    Joyce Frieden oversees 51˶’s Washington coverage, including stories about Congress, the White House, the Supreme Court, healthcare trade associations, and federal agencies. She has 35 years of experience covering health policy.