The Department of Health and Human Services said Sunday that it had reorganized its Office for Civil Rights to bring “conscience and religious freedom” to the top of its priorities. According to a public notice, the restructured office will require federal agencies, state and local governments, healthcare providers, and health plans to focus on “protecting the free exercise of religion and conscience and the right to be free from coercion in HHS-conducted or funded programs.”
On Friday, the Justice Department released a report on religious liberty that includes multiple references to abortion, vaccines, and gender-affirming care. The report quotes anti-vaccine activists and parents who do not want their children vaccinated, according to the report’s text.
Liz Sepper, a professor of law at the University of Texas at Austin, said the HHS reorganization signals the administration is “at least preparing the administrative functions for when” a new rule of religious conscience is issued. The Trump administration is expected to release such a rule, according to Sepper.
“The question becomes: Are you dedicating lots of resources to enforcement of religious refusal laws in the place of enforcement of national origin discrimination protections, for instance, or translation services or accommodations for disability?” Sepper said.
Dorit Reiss, a professor at UC Law San Francisco, said the HHS reorganization indicates the administration will use its funding authority to pressure states, local governments, and private groups. “They are very much putting religious freedom front and center,” Reiss said. She added that the policy “tends to privilege a conservative form of Christianity and, for example, protect discrimination against LGBTQ people.”
Most of the religious conscience statutes the HHS civil rights office says it plans to enforce are laws about refusing reproductive healthcare to patients and beneficiaries of insurance, Sepper said. One of the cited laws, known as the church amendment, is most commonly violated by discrimination against abortion providers, Sepper said. “I would guarantee that we will not see the Trump administration’s HHS go to work to stop that kind of discrimination,” she said.
The statutes could also be interpreted broadly to cover politicized healthcare areas like vaccines or gender-affirming care, Sepper said. The DOJ report took aim at vaccine mandates, which Reiss said are “not traditional things for the government to intervene with.” School vaccine requirements, for instance, are typically set at the state level.
Sepper said the U.S. Supreme Court, in its opinion on the Emergency Medical Treatment and Labor Act, “kind of punted” on the conflict between Idaho’s abortion ban and federal emergency care law, suggesting that providers would have a conscience right to refuse emergency care under EMTALA. “I think we could see the administration take that perspective,” she said.
The conscience laws HHS enforces are usually focused on providers, not patients, Sepper said. “That really means they’re focused on the rights of a very small segment of the population, and the rights of those providers to refuse medical care come into conflict with the rights and interests of the American people to receive medical care that’s nondiscriminatory or that doesn’t impose someone else’s religion on them,” she said.
The HHS civil rights office has also downplayed areas of discrimination that were previously top priorities, such as discrimination against disabled people and transgender patients, Sepper added. The Guardian has contacted HHS for comment.
MSI previously reported that a religious liberty advisory panel appointed by President Donald Trump proposed policy changes including rejecting the constitutional separation of church and state. Read more