Plaintiffs claim the rule will undermine reproductive healthcare access and embolden clinicians to discriminate against LGBTQ patients and others.
Facing multiple legal challenges over an effort to bolster healthcare workers' rights to abstain from work-related tasks that violate their conscience or religious views, the Trump administration agreed late last week to delay implementation of the policy at least four months.
The rule, which Health and Human Services (HHS) finalized two months ago, had been set to take effect July 22. But HHS attorneys agreed in a filing Friday to delay the effective date until November 22, for the sake of efficiency, while the parties in a lawsuit brought by the city and county of San Francisco dispute the merits of the case.
San Francisco City Attorney Dennis J. Herrera, a Democrat, argues that the new final rule would require cities like San Francisco to put healthcare staffers' personal or religious beliefs ahead of patients' health and safety. The rule would apply not only to clinicians who object to the actual provision of healthcare services but also to workers whose duties are tangential to the provision of care, such as receptionists, Herrera's office said in a statement lauding the HHS-approved delay as a victory.
"We have won this battle—and it was an important one—but the fight is not over," Herrera said in the statement accusing the Trump administration of "trying to systematically limit access to critical care for women, the LGBTQ community, and other vulnerable populations."
"We're not going to let that happen. We will continue to stand up for what's right," he added. "Hospitals are no place to put personal beliefs above patient care. Refusing treatment to vulnerable patients should not leave anyone with a clear conscience."
San Francisco's lawsuit was filed on the same day that the HHS Office for Civil Rights (OCR) announced the final rule, but various other organizations have since filed similar suits, including one brought by the state of New York.
Related: Final Rule Bolsters Providers' Rights to Refuse Services They Deem Objectionable
Related: Battle Lines Drawn in Fight Over HHS Conscience Rule
Related: HHS Policy Pendulum Swinging Back Toward Providers' Rights of Conscience
The controversial policy was proposed more than a year ago after HHS OCR launched its Conscience and Religious Freedom Division to ramp up enforcement of existing legal protections. While critics have warned the policy could harm healthcare access for LGBTQ patients, some religious groups have praised the policy as buttressing more than two dozen statutory provisions that they say went underenforced under former President Barack Obama's eight-year administration.
Supporters of the rule say it appropriately affirms physicians' right to refrain from healthcare services they see as contrary to their ethical obligations. But that's different from situations in which a physician might decline to care for a particular class of people, said Farr A. Curlin, MD, a professor of medicine and medical humanities at the Duke University School of Medicine and co-director of the Theology, Medicine and Culture Initiative at Duke Divinity School.
"They are not refusing to care for gays or transgender patients or anyone else who is sick and in need of healing," Curlin told HealthLeaders via email in May. "Rather, they are objecting to practices that they believe contradict their profession to heal only, and never to harm."
Steven Porter is an associate content manager and Strategy editor for HealthLeaders, a Simplify Compliance brand.
Photo credit: The homepage of the official website for the United States Department of Health and Human Services. (Editorial credit: chrisdorney / Shutterstock.com)
KEY TAKEAWAYS
The administration agreed to delay implementation of the rule while the lawsuits proceed.
Opponents of the rule say it requires employers to prioritize workers' religious views over patients' healthcare needs.
Supporters say the rule appropriately affirms the discretion physicians need to provide ethical care.