Last week, the Department of Health and Human Services (HHS), Office for Civil Rights (OCR) issued a final rule to expand and consolidate OCR’s enforcement authority over a total of 25 federal health care conscience laws, including three parts of the Affordable Care Act (ACA).
These laws focus largely on abortion, but some also address sterilization procedures, assisted suicide, and advance directives, among other types of medical care. The rules seek to protect individuals and health care entities, which includes group health plans in certain contexts, from discrimination on the basis of their exercise of conscience based on their religious faith.
The ACA included a number of health care conscience provisions. Under Section 1303 of the ACA, group health plans are not required to cover abortion services as part of the essential health benefits package and cannot discriminate against providers or facilities because of their unwillingness to provide, pay for, cover, or refer for abortions.
The final rule fully implements this part of the ACA as well as the individual mandate provision which includes a religious conscience exemption for members of a health care sharing ministry and organizations or individuals that oppose insurance benefits for religious reasons.
The new rule is scheduled to take effect 60 days from its publication in the Federal Register. The city of San Francisco has already filed suit against the Trump administration, arguing that the rule is overly broad and discriminatory in practice. This article will be updated pending any future developments in that lawsuit.