A provision in Ohio’s new two-year budget will allow health care workers, hospitals and health insurance providers to deny services that violate their moral or religious beliefs, the Journal-News reported Monday.
Local advocates warn this rule legalizes discrimination against LGBTQ patients as well as members of other marginalized groups like drug addicts or people living with HIV or sexually transmitted diseases. Planned Parenthood Southwest Ohio said the budget amendment gives medical practitioners the right to deny patients treatments like birth control.
While talking Thursday about the budget he signed Wednesday night, Ohio Gov. Mike DeWine said the conscience clause will change very little and no Ohioans will be discriminated against.
“This simply puts in statute what the practice has been anyways,” he said. “Let’s say the doctor is against abortion, the doctor is not doing abortion. If there’s other things that maybe a doctor has a conscience problem with, it gets worked out, somebody else does those things.”
Dr. Todd Kepler, southwest medical director of Equitas Health, a nonprofit health care system serving LGBTQ patients in the Midwest, said the ”widely broad” language in the new rule will exacerbate existing barriers to care for many marginalized groups.
The statute language would allow health care workers, hospitals and health insurance companies to “decline to perform, participate in, or pay for any health care service which violates (their) conscience as informed by (their) moral, ethical or religious beliefs.”
This clause could hit the hardest people already living with few options for medical care in their community, Keppler said.
“Say I happen to be a gay patient and I wanted to see a provider in my town,” he said. “And there weren’t really any other providers in town. But they find that morally unacceptable, they could turn me away, and the language is so broad that that could even be done at an institutional level. So, if you have a hospital that perhaps has an affiliation with a religious institution, and again, that happens to be the only institution in town, theoretically they could turn that patient away for health care.”
A Center for American Progress survey found that in 2017, 8% of lesbian, gay and bisexual respondents and 29% of transgender respondents were refused care by a health care provider because of their sexual orientation or gender identity. The survey also found that 18% of LGBT Americans believe that if they were refused care at a hospital, it would be “very difficult” or “not possible” to find an alternative provider. Outside of major metropolitan areas, that number rose to 41%.
State Sen. Steve Huffman, a Republican doctor from Tipp City, said he supports the new rule.
“In my career as a doctor, I have consistently and wholeheartedly prioritized my patients, and I do everything in my power to improve their overall health and wellness in a way that best fits their needs. However, when a patient requests elective services, like abortion, that could infringe on a doctor’s personal religious, moral or ethical code, it is simply time they find a new provider,” Huffman said. “I fully support the language in this budget that protects all medical professionals by ensuring they are not obligated to perform or pay for procedures that conflict with their conscience.”
Justin Cole, chair of pharmacy practice at Cedarville University, said this clause does not allow a doctor to refuse to care for a person but allows for a doctor to exercise a conscientious objection to a specific health service.
“Americans are afforded the freedom to live according to deeply held ethical, moral and religious beliefs,” Cole said. “This necessarily includes doctors, nurses, and other clinicians … Without these provisions, medical providers could be forced to participate in procedures or treatments that conflict with their own convictions and may be felt to be harmful to the patient.”
Dr. Misti Grimson, medical director of the physician assistant program at Cedarville University, said extending this freedom to institutions and payers would “need to be substantiated by clearly stated policies of the institution or a track record of consistently held beliefs.”
Randy Phillips, executive director of the Greater Dayton LGBT Center, said professionals, including health care providers, should be able to separate their own agenda from their work.
“It begins a slippery slope when we start picking and choosing who we can treat and who we don’t want to treat,” Phillips said. “How many are going to be denied care simply because they are living authentically?”
What the conscience clause in the Ohio budget says:
“Notwithstanding any conflicting provision of the Revised Code, a medical practitioner, health care institution or health care payer has the freedom to decline to perform, participate in, or pay for any health care service which violates the practitioner’s, institution’s, or payer’s conscience as informed by the moral, ethical, or religious beliefs or principles held by the practitioner, institution, or payer. Exercise of the right of conscience is limited to conscience-based objections to a particular health care service.
"… The medical practitioner is responsible for providing all appropriate health care services, other than the particular health care service that conflicts with the medical practitioner’s beliefs or convictions, until another medical practitioner or facility is available.”