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Trump Rule Helps Health Care Workers Who Refuse Care For Religious Reasons


So here's a question. What do you believe? It's a really personal question, right? It's one that now stands to have major implications for health professionals and patients. The Trump Administration issued a new rule that gives health care workers leeway to refuse to provide services like abortion, sterilization or assisted suicide if they cite a religious or conscientious objection. The Department of Health and Human Services issued this rule to protect the religious rights of medical providers and also religious institutions. And this is an expansion, we should say, of existing protections.

Let's talk it all through with NPR health policy correspondent Alison Kodjak, who's here. Hi, Alison.


GREENE: OK. So if there were already some protections in place, what exactly does this change?

KODJAK: So what this really does is it strengthens those existing protections. It expands enforcement and puts in place, actually, a clear enforcement mechanism so people who believe that their religious rights have been trampled on - health care workers - have a place to go to make complaints. We talked with Jennifer Taub (ph). She's a lawyer with this First Liberty Institute which represents religious liberty cases. And she's pretty happy that this has been put in place.

STEPHANIE TAUB: We've represented health care professionals who were discriminated against because of their pro-life beliefs, for example. So this rule ensures that the 25 conscience protections that are already codified in law are actually enforceable. It's an important step to prevent discrimination against health care professionals.

KODJAK: So people like Taub and her clients, they now have a more receptive ear for these complaints.

GREENE: Well, so critics are saying - I mean, they're worried that this will block a lot of patients - I mean, especially women, gay, transgender people - from accessing care they need. Talk me through that argument and how serious a concern that is.

KODJAK: Well, so this rule specifically talks about health care services and not people. But those areas of health care that people often face religious objections are the ones that women, transgender people and sometimes gay and lesbian people access - so abortion, contraception, fertility treatment, gender reassignment surgery. Here's Reverend Jennifer Butler. She is the head of Faith In Public Life. It's a national organization of clergy and faith leaders.

JENNIFER BUTLER: This rule will enable people to discriminate against people because of their sexuality - because of their gender. It will remove some of the protections we have for children. As people of faith, we're called to love our neighbor as we love ourselves and treat every single person that's created in God's image. And so it's hard for me to understand how somebody's religious beliefs would dictate that they discriminate against another human being and deny them life-saving care.

KODJAK: So this rule goes beyond gender-specific services, so perhaps end of life care - if you think of that - somebody who has a living will. There could be cases where health care providers refuse to withdraw life support, even if somebody has said that that's what they want.

And when it comes to gay and lesbian and transgender people, we are expecting an additional rule from the Department of Health and Human Services that could specifically remove discrimination protections from those people that have been in place since the Obama administration.

GREENE: Let me bring up another scenario, if I can. I mean, I know these protections will now extend to even medical receptionists - I mean, anyone in the health setting. Does this mean, for example, like, someone could even refuse to prepare a document and refer a patient for care?

KODJAK: Yeah. And that's pretty controversial. Roger Severino, who is the head of the HHS Office for Civil Rights, said that this rule extends to anyone with a, quote, "connection" to the objectionable service. So it's pretty expansive. Somebody could refuse - yes, like you said - to fill in forms, to take blood pressure. It could go pretty far.

GREENE: NPR's Alison Kodjak reports on health care policy for NPR. Thanks so much.

KODJAK: Thank you, David. Transcript provided by NPR, Copyright NPR.

Alison Fitzgerald Kodjak is a health policy correspondent on NPR's Science Desk.