Fact Sheet: HHS Takes Comprehensive Action to Enforce Conscience Rights and Protect Human Life

Fact Sheet: HHS Takes Comprehensive Action to Enforce Conscience Rights and Protect Human Life

OVERVIEW: The Office for Civil Rights Announced Major Enforcement & Policy Actions

The HHS Office for Civil Rights (OCR) announced major enforcement and policy actions that promote compliance with federal health care conscience protection statutes, end certain egregious federal overreach, and align OCR policies with E.O. 14182, Enforcing the Hyde Amendment.

  • A Notice of Violation to the State of Illinois finds that the referral requirements of the Illinois Health Care Right of Conscience Act violate two federal health care conscience protection statutes.
  • Three public notices describe OCR deregulatory actions that repudiate or rescind Biden era documents that are outdated or inconsistent with the law.
  • A Dear Colleague Letter on federal health care conscience protection statutes educates the public.

ACTION 1: Notice of Violation to Illinois under the Weldon and Coats-Snowe Amendments
Background

  • OCR’s Notice of Violation to Illinois presents the findings from OCR’s investigation of five complaints from physicians, pro-life crisis pregnancy resource centers, and a professional organization representing pro-life obstetricians and gynecologists.
  • The complainants alleged, in part, that Illinois requires them and similarly situated health care providers to compromise their conscience, informed by their religious convictions respecting abortion, as a condition of receiving conscience protections under Illinois law when exercising conscience objections to medical procedures. 

Key Finding

  • OCR found that Illinois law violates the Weldon and Coats-Snowe Amendments’ protections for health care providers who object to abortion because Illinois law requires health care workers to refer for abortion in order to receive state liability protections for conscience objections to performing abortion.
  • Under Illinois law, to receive certain protections of state law for conscience objectors, a physician, health care facility, or health care personnel must refer for abortion (“referral requirements”) even when they have a conscience-based objection to abortion or to referring for abortion—a procedure to which they will not participate in.
  • The referral requirements are triggered when health care personnel, physicians, or facilities object to providing a procedure for conscience-based reasons and the patient requests a referral. 

Relevant Litigation

  • The referral requirements had been subject to a preliminary injunction for eight years in federal district court litigation, but they were recently upheld as constitutional while the same court struck down as unconstitutional a related counseling requirement.
  • Illinois agreed to continue the injunction on enforcement of the referral requirements pending appeal. However, the district court’s decision that the referral requirements are constitutional, now pending on appeal, means that the threat of likely eventual harm to the OCR complainants from the Illinois referral requirements has not been eliminated.

ACTION 2: OCR Repudiates or Rescinds Biden Era Documents

Summary

  • Three public notices describe OCR deregulatory actions to align with E.O. 14182, Enforcing the Hyde Amendment and end certain federal overreach by the previous Administration.
  • The notices explain that eight previously issued HHS documents (both case specific and broad guidance documents) no longer represent the views of HHS, the Administration, or are otherwise no longer applicable.
  • The regulated community should no longer rely on these documents.

Documents Rescinded, Disavowed, or Repudiated

  • July 2021 Letter to University of Vermont Medical Center. OCR disavows the legal positions stated in a case-specific July 2021 letter to the University of Vermont Medical Center that interprets a conscience protection statute known as the Church Amendments (pertains to abortion, among other procedures). The July 2021 letter does not reflect the best reading of the Church Amendments and no longer represents the views of HHS or the Administration.
  • August 2021 Letter to the Attorney General of California. OCR disavows the legal positions stated in a case-specific August 2021 letter to the Attorney General of California that interprets the Weldon Amendment (prohibits discrimination with respect to abortion). The August 2021 letter no longer represents the views of HHS or the Administration.
  • September 2021 Guidance on Nondiscrimination Protections under the Church Amendments. OCR rescinds this guidance, which addresses what a lawful abortion is under section (c)(1) of the Church Amendments. The guidance promotes abortion through its narrow focus on one section of the Church Amendments, describes federal case law that is now invalid or overruled after Dobbs v. Jackson Women’s Health Organization, 597 U.S. 215 (2022), and relies on an outdated interpretation of the Emergency Medical Treatment & Labor Act.
  • November 2021 Letters on the Religious Freedom Restoration Act. OCR disavows the policies and legal conclusions found in three case-specific letters sent in November 2021 because the letters contain an interpretation of the Religious Freedom Restoration Act that HHS and the Administration no longer hold.
    • November 2021 Letter from OCR to Michigan
    • November 2021 Letter from OCR to Texas
    • November 2021 Letter from the Administration for Children and Families to South Carolina
  • December 2021 Guidance on the Equitable Administration of Vaccines. OCR repudiates guidance regarding the equitable administration of vaccines. The guidance relies on executive orders no longer in effect. The policies stated in the guidance no longer represent the views of the Department or the Administration.
  • September 2023 Guidance to Nation’s Retail Pharmacies: Obligations under Federal Civil Rights Laws to Ensure Nondiscriminatory Access to Health Care at Pharmacies. OCR rescinds this guidance because it relied on executive orders no longer in effect that promoted abortion; was undercut by admissions made in litigation regarding the guidance and uses terminology inconsistent with the Administration’s goal to restore biological truth.

ACTION 3: OCR Issues a Nationwide Dear Colleague Letter

  • OCR issued a nationwide Dear Colleague Letter to educate the public about federal health care conscience protection statutes, including those laws specific to abortion, sterilization, and assisted suicide.
  • OCR facilitates and coordinates the Department’s enforcement of the federal health care conscience protection statutes. This includes the Church Amendments, Coats-Snowe Amendment, Weldon Amendment, Section 1553 of the Affordable Care Act, and provisions related to advance directives and the Vaccines for Children program.
  • These statutes protect covered individuals, health care entities, and providers from discrimination in health care by government or certain government-funded entities, generally based on the exercise of religious beliefs or moral convictions.
  • The Dear Colleague Letter is designed to be a single reference point summarizing these federal health care conscience protection statutes and provides practical clarity on protected versus prohibited conduct. It is the first in a planned series of OCR resources consistent with the Administration’s priority to ensure that health care providers and entities can serve American communities without being penalized for their religious beliefs and moral convictions.
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