Congress mandates healthcare refusal rights, risking patient access
H.R. 2874 — Defense of Conscience in Health Care Act · Filed by John Moolenaar (R-MI) · Introduced Apr 10, 2025 · Referred to committee
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What it does
This bill requires the Department of Health and Human Services to reinstate a 2019 federal rule protecting healthcare workers' and institutions' rights to refuse participation in medical procedures on grounds of conscience or religious belief. The rule would allow doctors, nurses, and hospitals to opt out of providing services like abortion or gender-affirming care without penalty, and would supersede any conflicting rules issued since 2019.
Why we flagged it
The bill's core mechanism is to restore and mandate a specific 2019 federal rule that broadened healthcare providers' legal right to refuse services on conscience or religious grounds. This is a restoration of a prior regulatory regime, not new deregulation, but it does expand refusal rights relative to the intervening Biden-era rules.
What the text implies
- The bill does not define which services or procedures fall within 'conscience' objections, leaving that scope to the 2019 rule and future HHS interpretation—potentially creating uncertainty about what refusals are protected.
- By mandating the rule 'supersede any contrary rule in existence,' the bill nullifies Biden-era guidance that narrowed conscience refusals, including rules protecting access to abortion and gender-affirming care.
The full analysis lists 4 implications of this text.
Who stands to gain
religious healthcare organizations and hospitals; faith-based health insurance plans