Biden administration rescinds much of Trump ‘conscience’ rule for health workers

by Nathaniel Weixel - 01/09/24 1:05 PM ET

The Biden administration will largely undo a Trump-era rule that boosted the rights of medical workers to refuse to perform abortions or other services that conflicted with their religious or moral beliefs.

The final rule released Tuesday partially rescinds the Trump administration’s 2019 policy that would have stripped federal funding from health facilities that required workers to provide any service they objected to, such as abortions, contraception, gender-affirming care and sterilization.

The health care conscience protection statutes represent Congress’s attempt to strike a balance between maintaining access to health care and honoring religious beliefs and moral convictions, the Department of Health and Human Services said in the rule.

“Some doctors, nurses, and hospitals, for example, object for religious or moral reasons to providing or referring for abortions or assisted suicide, among other procedures. Respecting such objections honors liberty and human dignity,” the department said.

But at the same time, Health and Human Services said “patients also have rights and health needs, sometimes urgent ones. The Department will continue to respect the balance Congress struck, work to ensure individuals understand their conscience rights, and enforce the law.”

Secretary of Health and Human Services Xavier Becerra answers questions during a Senate Appropriations Committee hearing to discuss the President’s supplemental request for the Departments of Homeland Security and Health and Human Services on Wednesday, November 8, 2023. (Greg Nash)

The move comes as many Republican-led states have enacted abortion bans in the wake of the Supreme Court’s decision to overturn Roe v. Wade. An increasing number of states have also put limits or bans on gender-affirming care for minors.

There are federal laws in place that allow health care providers to refuse care in certain circumstances based on their religious beliefs. The Trump administration’s rule would have dramatically expanded how those laws were interpreted and implemented.

Critics said they would have emboldened health care professionals to discriminate against women, minorities and underserved communities, LGBTQ people, and people with disabilities.

“Protecting conscience rights and ensuring access to health care are critically important, no matter who you are, where you live, who you love, or your faith and conscience. Our office has statutory mandates to protect people across the country and takes this responsibility very seriously,” said Melanie Fontes Rainer, director of the Department of Health and Human Services Office for Civil Rights.

“We are proud of today’s rule, which advances conscience protections, access to health care, and puts our health care system on notice that we will enforce the law. As a law enforcement agency, we are committed to this work,” Fontes Rainer added.

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The Trump administration’s 2019 rule was blocked by three federal courts and never took effect after several states, cities and advocacy groups — including New York, California, San Francisco, the American Civil Liberties Union and Planned Parenthood — sued.

The rule would have allowed doctors, nurses, medical students, pharmacists and other health workers to refuse to provide any procedure to which they objected, including abortions, contraception, gender-affirming care, and HIV and STD services.

Alexis McGill Johnson, president and CEO of Planned Parenthood Federation of America, applauded the final policy in a statement.

“It’s critical that everyone has all the relevant information they need to make informed decisions about their health and families and access to the health care services they need. Today’s action from the Biden-Harris administration is an important step in that direction,” McGill Johnson said.