Bishops call on the faithful to 'support religious freedom,' oppose changes to Affordable Care Act

The United States Conference of Catholic Bishops (USCCB) Committee for Religious Liberty is urging concerned members of the public to file comments with the U.S. Department of Health and Human Services (HHS) opposing proposed changes to Section 1557 of the Affordable Care Act, which the USCCB believes would interpret a health care worker’s objection to performing gender transition procedures and potentially abortions as discrimination. In a recent statement, the committee said the changes “would seriously impede Catholic hospitals, clinics, assisted living facilities, and health care workers from carrying out their work.”

Public comments are close to closing on the proposed updates to Section 1557 that affirms protections against discrimination based on sex when seeking healthcare. The rules proposed in July by the HHS would now require protections based on sex to include sexual orientation and gender identity. It would also mandate protections based on pregnancy or related conditions, including “pregnancy termination.”

The last day to make comments is Oct. 3.

The current law, passed in 2020, prohibits discrimination based on “race, color, national origin, sex, age, and disability in specific health programs and activities.”

Health and human services officials said this current version of the rule limits its scope and power to cover programs and services.

The proposed rule ensures accessibility to all to health care, free from discrimination, said U.S. Secretary of Health and Human Services Xavier Becerra in a press release issued in July.

“Standing with communities in need is critical, particularly given increased attacks on women, trans youth, and health care providers. Health care should be a right not dependent on looks, location, love, language, or the type of care someone needs,” Becerra said.

But the bishops said in their comments to the HHS that the new ruling would make it “discrimination” for health care workers or Catholic hospitals to object to performing gender transition procedures, regardless of “whether it is a matter of religious belief or clinical judgment.”

“The proposed regulation also appears to suggest that HHS may ultimately determine that Section 1557 imposes similar requirements with regard to abortion,” the statement reads.

Catholics have been called to care for the sick since the earliest days of their faith, with the Ursuline nuns running the Royal Hospital in New Orleans before America’s independence from England. Today, Catholic entities are the largest nonprofit health care provider in the country, the bishops wrote.

“We do this work in fulfillment of the direct command of Jesus Christ and in imitation of his divine ministry here on Earth,” according to the statement.

Furthermore, the bishops said Catholic health-care facilities and workers do not discriminate.

“Catholic health care ministries serve everyone, no matter their race, sex, belief system, or any other characteristic. The same excellent care will be provided in a Catholic hospital to all patients, including patients who identify as transgender, whether it be for a broken bone or for cancer, but we cannot do what our faith forbids. We object to harmful procedures, not to patients,” the statement reads.

Section 1557 Notice of Proposed Rulemaking includes the following actions:

Reinstates the scope of Section 1557 to cover HHS’ health programs and activities.
Clarifies the application of Section 1557 nondiscrimination requirements to health insurance issuers that receive federal financial assistance.
Aligns regulatory requirements with federal court opinions to prohibit discrimination on the basis of sex, including sexual orientation and gender identity.
Makes clear that discrimination on the basis of sex includes discrimination on the basis of pregnancy or related conditions, including “pregnancy termination.”
Ensures requirements to prevent and combat discrimination are operationalized by entities receiving federal funding by requiring civil rights policies and procedures.
Requires entities to give staff training on the provision of language assistance services for individuals with limited English proficiency (LEP), and effective communication and reasonable modifications to policies and procedures for people with disabilities.
Requires covered entities to provide a notice of nondiscrimination along with a notice of the availability of language assistance services and auxiliary aids and services.
Explicitly prohibits discrimination in the use of clinical algorithms to support decision-making in covered health programs and activities.
Clarifies that nondiscrimination requirements applicable to health programs and activities include those services offered via telehealth, which must be accessible to LEP individuals and individuals with disabilities.
Interprets Medicare Part B as federal financial assistance.
Refines and strengthens the process for raising conscience and religious freedom objections.