Health Care Groups Oppose Religious Exemptions for Providers

APA and more than 30 other health care organizations representing clinicians, patients, and administrators across the country sent a letter last month to Alex Azar, secretary of the Department of Health and Human Services (HHS), to express their concerns about actions that would allow health care professionals to refuse treatment to individuals on religious grounds.

Among those actions are the issuance of a proposed rule, “Protecting Statutory Conscience Rights in Health Care; Delegations of Authority,” published in the Federal Register on January 26. It would allow providers to opt out of certain procedures such as abortion, sterilization, and assisted suicide.

Organizations that signed on to the letter include the Academy of Psychosomatic Medicine, the American Academy of Addiction Psychiatry, the American Academy of Child and Adolescent Psychiatry, and the American Academy of Pediatrics.

The organizations fear that the new policies could lead to discrimination and/or denial of care that could harm lesbian, gay, bisexual, transgender, and questioning (LGBTQ) patients. For example, a clinician would have the right to refuse hormone therapies or counseling to a patient in gender transition if the clinician rejects such treatment.

“The mission of HHS is ‘to enhance and protect the health and well-being of all Americans.’ This should be clearly articulated in all HHS plans, with a special focus on how to achieve better health outcomes for minority populations,” stated the groups in their letter to HHS Secretary Azar. “Any authority that grants license to discriminate would be detrimental to LGBTQ patients’ safe access to care and would undermine the progress we have achieved in addressing disparities among this patient population.”

In mid-January HHS announced the creation of the Conscience and Religious Freedom Division within its Office of Civil Rights (OCR) to handle complaints from health care professionals who refuse to provide care for religious reasons.

In addition, the Centers for Medicare and Medicaid Services has issued guidelines that give states “flexibility” to take actions against providers that offer abortion services, while removing barriers for religious and faith-based organizations to participate in HHS programs and receive public funding.

“I am deeply concerned that our LGBTQ patients—who already face unique health challenges—may now be denied care because of who they are,” APA CEO and Medical Director Saul Levin, M.D., M.P.A., said in a January 19 press release. “We know that discriminatory policies harm our patients’ mental health and well-being. APA is firmly opposed to laws and regulations that trample on the civil rights of LGBTQ people, including the right to access health care.”

In their letter, the health care organizations pointed out that LGBTQ patients are already at risk for mental health issues because of social prejudice and have higher rates of suicide than their peers—40 percent of gender minorities report attempting suicide.

Noting that HHS leaders are discouraging staffers from using certain words, including “transgender,” “evidence-based,” and “diversity,” the letter also expressed concern that such omissions could have harmful repercussions on data collection for minorities.

“To reduce the cost of health care and achieve our goal of creating a healthier nation, the needs of specific populations must be examined and effectively addressed. We urge you to reconsider these actions and include strategies to focus on better access to health services and improved outcomes for minority populations, including millions of LGBTQ people in the United States,” the letter concluded. ■