New Trump initiatives: A win for anti-abortion activists, protections for ‘conscience’ objections

Coinciding with Friday’s March for Life in Washington, President Donald Trump’s administration announced new measures to support the anti-abortion cause.

Included is a move that may allow states to cut Medicaid funding to reproductive healthcare programs like Planned Parenthood.

Specifically, the Department of Health and Human Services issued a letter to state Medicaid directors rescinding an Obama administration directive from April 2016, which warned cuts to family planning providers would break federal law.

“We are reinstating flexibility for state Medicaid directors to establish reasonable standards and protect program integrity in their own state programs,” said Charmaine Yoest, assistant secretary of public affairs at HHS, in a Friday press call.

“It’s essential to protect and defend the prohibition of Medicaid coverage from most abortion procedures. … This is part of the Trump administration’s commitment to rolling back regulations the Obama administration put out to radically favor abortion,” said Yoest, who formerly served as the president and CEO of Americans United for Life, an anti-abortion group.

This development threatens to do more than combat abortion access; it could block birth control access and other preventative care by denying Medicaid patients coverage from the only health care provider they have, Planned Parenthood argues.

“On the anniversary of the historic Women’s March, the Trump-Pence administration makes their agenda crystal clear: They are laser-focused on using their power to control women’s bodies and lives,” Dawn Laguens, executive vice president for Planned Parenthood Action Fund, said in a written statement.

“They couldn’t get the votes to pass it in Congress, so now they are pushing states to try and block care at Planned Parenthood,” she said. “Longstanding protections within Medicaid safeguard every person’s right to access care at their qualified provider of choice.”

Also on the Friday call was Roger Severino, a former director at the conservative Heritage Foundation, where he then spoke out against attempts by the Obama administration to protect transgender patient care. Now he is the director of HHS’ Office of Civil Rights.

On Thursday his office introduced a new unit, the Conscience and Religious Freedom Division, meant to protect health care providers “from being coerced into participating in activities that violate their consciences, such as abortion, sterilization, or assisted suicide,” a press release stated.

His office laid out on Friday a 216-page proposed rule – “Protecting Statutory Conscience Rights in Health Care; Delegations of Authority” – to bolster the mission. It requires, for instance, that providers seeking federal grants certify compliance with conscience-protection statutes.

“America’s doctors and nurses are dedicated to saving lives and should not be bullied out of the practice of medicine simply because they object to performing abortions against their conscience,” Severino said in a press release. “Today’s proposed rule will provide our Conscience and Religious Freedom Division with enforcement tools that will make sure our conscience laws are not empty words on paper, but guarantees of justice to victims of unlawful discrimination.”

Ever since the announcement of this new division, there’s been speculation about how this idea of “conscience protection” might play out in real life. Could a health care provider who objects to the LGBTQ community deny treatment of, say, a transgender woman who has the flu?

“We want people from all walks of life to be served and to be able to serve so that everybody has an equal seat at the table in the receipt of medical care and the provision of care regardless of their religious beliefs or moral convictions,” he said during Friday’s call. “The way these conscience claims work is that providers do not deny service to patients because of identities. What happens is providers choose not to provide or engage in certain procedures at all.”

A quick word search in the 216-page proposed rule shows that the word “abortion” is mentioned 155 times, while “transgender” does not appear once.

But this gives little comfort to organizations like Lambda Legal, which works on behalf of the LGBTQ community.

“The proposed rule doesn’t just protect health care institutions and medical providers who refuse care on religious grounds, it shields anyone who claims a ‘moral’ objection too,” Camilla Taylor, acting legal director for Lambda Legal, said in a written statement. “Health workers would not only get to refuse to provide care themselves; they will be protected even when they refuse to give a patient a referral.”

The rule succeeds in “weaponizing HHS’s Office of Civil Rights against us,” she said. “It turns the Hippocratic Oath into the Hypocritical Oath and violates the most basic tenets of medical ethics.”

Other organizations, including the United States Conference of Catholic Bishops, commended HHS’ new initiatives.

“For more than 40 years – dating back to the Church amendment of 1973 – Congress has enacted federal laws protecting rights of conscience in health care,” the conference chairmen said in a written statement. “We are grateful that HHS is taking seriously its charge to protect these fundamental civil rights.”

How frequently health care providers will file complaints on religious or moral grounds remains to be seen. Over the past eight years, there have been a total of 10 religious complaints filed, Serevino said.

But as of mid-January, 34 complaints have come in this year, which he credits to the new administration.

“Since the election of President Donald Trump and the change in tone we’ve communicated to Americans that their rights will be respected, their cases will be investigated and treated appropriately,” Serevino said. And the spike in numbers show that “the issues are real … the complainants are there, and that we’ve opened the doors and let people know that we actually will take your complaint seriously and intend to enforce the law.”