It’s no secret that Donald Trump’s White House is hostile to women and the LGBTQ community, so it shouldn’t come as a surprise the Department of Health and Human Services proposed a rule that would put both groups at risk by letting health care workers refuse people care based on health workers’ “religious beliefs or moral convictions.” Yet few realize HHS’s proposal was written so broadly that it would affect everyone’s access to health care, and even fewer know that the public has the right to voice their concerns. But, time is running out, the 60-day public comment period on the matter ends March 27.
The regulation was modeled after a George W. Bush-era rule that granted health care providers the ability to opt out of performing medical procedures based upon their personal objections. This new proposal would go even further, allowing providers to discriminate against specific people, even entire groups of people, if a provider claimed they held a personal moral objection to treating them.
“It is outrageous that I could be denied care if medical personnel had a religious objection to caring for me,” explained James Scheid, a retired registered nurse and a gay man from Arizona. He added that he feared this rule “could cost me my life.” Scheid’s fears of being denied lifesaving care are not unjustified; LGBTQ people experience discrimination in health care services more often than many realize. In fact, medical professionals have even discriminated against the children of LGBTQ parents — one doctor even refused to treat a 6-day-old baby because she was the child of lesbian parents.
Refusing to treat patients can be be deadly, as was the case in 1995, when Tyra Hunter, a transgender woman, lost her life after emergency medical technicians refused to assist her at the scene of a car accident. According to the Center for American Progress, had Hunter received care, her chances of surviving were 86 percent — she should have lived.
Roger Severino, the director of HHS’ Office for Civil Rights, which is the office that will execute this rule, has not addressed the concerns of patients that could be discriminated against. On NPR, Severino refused to discuss how the proposed rule would lead to people being denied services and instead insisted that it would strengthen antidiscrimination laws and even claimed it “enhances diversity.”
Severino claimed on NPR that a doctor refusing to treat a patient wasn’t discrimination, it was free speech, but in making that claim he ignored that to speak or not to speak isn’t the same thing as deny care. Speech — or perhaps more accurately, not speaking — alone will not kill a patient injured in a car accident; denying them treatment often will.
Severino could learn a thing or two about the difference between free speech and putting one’s personal opinions aside while caring for patients from that retired gay nurse from Arizona. Scheid explained that medical providers have a duty to care for all their patients, regardless of who they are or what they believe. He shared countless stories over the course of his career in nursing, and cared for many he may have had moral objections to: convicted criminals, neo-Nazis — he even once treated a woman while she hurled "faggot" at him.
Susan Seney, a licensed clinical social worker from Washington State, echoed Scheid’s conviction that providers have a duty to serve their clients and explained that she provided services to all who came to her, even those who held bigoted and downright racist views, without discrimination. Seney explained that “it was not just the code of ethics that demanded this of me, it was my respect for the humanity of all my clients and patients.”
The rule Severino’s office proposed doesn’t have language to protect patients. In fact, under this rule a health provider wouldn’t even have a responsibility to refer a patient to someone else, or in any way assure that a patient is cared for or treated with respect. This will leave patients vulnerable over a wide swath of health care services.
HHS admits it isn’t trying to provide a narrow scope, laying out clearly that the rule would provide “broad protection ... to the maximum extent permitted” under federal law for religious and moral objections to “perform or assist in the performance of any part of a health service.”
It won’t be limited to hospitals and health centers; it will apply to any facility that receives HHS health care or research-related funding, from dentists, ambulance companies, nursing homes, temporary shelters, pharmacies, and colleges and universities. All told, HHS estimates 364,000 to 571,000 facilities will be required to comply with this rule.
This proposal won’t just give medical providers broad and vague abilities to deny care to patients of all kinds — it will specifically harm LGBTQ youth. HHS has included youth suicide prevention programs in this proposal, which will have put LGBTQ youth, who are three times more likely than their heterosexual peers to contemplate suicide, in danger. It's horrifying to think, if this is adopted as written, that an LGBTQ youth seeking assistance with thoughts of suicide — perhaps after dealing with bigotry at home or at school — may be refused service.
The proposal would even protect job applicants in health care who wish to deny services. That could mean LGBTQ health centers may soon be forced to hire doctors and nurses who refuse to work with LGBTQ patients. This directly contradicts Severino’s claim that it would lessen discrimination.
Susan Seney and James Scheid opposed this dangerous HHS proposal because they, as health care providers, know from experience that everyone should have access to health care, free from discrimination, and the consequences of ending that practice put everyone’s health at risk. They acted by submitting comments in opposition to HHS’s rule with The National LGBTQ Task Force, and you can too. You can also submit comments directly to the Federal Register.
ALEX MORASH is a writer based in Washington, D.C., and the media director for The National LGBTQ Task Force. He can be reached on Twitter at @AlexMorash.