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Ohio Gov. Mike DeWine (R) has signed a budget into law containing a provision that grants medical professionals the right to refuse to perform procedures that they believe violate their religious or moral beliefs — which critics say could result in denying LGBTQ people treatment for medically necessary care.
The so-called “medical conscience” provision was approved by the Republican-led State Senate’s version of the budget and then adopted by a conference committee, with the overall budget then green-lighted by both chambers.
Under the provision, health care workers, hospitals, and health insurance companies are allowed to refuse to provide, perform, or pay for specific medical procedures or services that violate their conscience “as informed by the moral, ethical, or religious beliefs or principles held by the practitioner, institution or payer.” The right of refusal is limited to conscience-based objections to particular services, and cannot be applied broadly to deny any or all care sought by a patient.
Although DeWine used 14 different line-item vetoes on the budget, he declined to veto the medical conscience provision.
“I think we have to respect people’s rights and people’s ability to make those decisions,” DeWine told ABC affiliate News5Cleveland when asked why he did not veto the provision. He also claimed that it will not lead to any discrimination.
“People are not going to be discriminated against in regards to medical care,” the governor said. “This is not a problem, has not been a problem, in the state of Ohio and I do not expect it to be a problem.”
He added that those denied certain procedures can always just seek out another provider.
“If there’s other things, that may be a doctor has a conscience problem with, it gets worked out, somebody else does those things,” DeWine said.
Similarly, even though the conservative publication National Review is correct in stating that an LGBTQ patient could not be denied treatment for a broken leg or life-saving treatments to keep them alive, due to the narrow restrictions on when providers and insurers can refuse treatment, the law will enable providers to deny other “medically necessary care” — which LGBTQ patients might view as a form of discrimination.
For instance, the conscience provision would enable a nurse to refuse to prepare a room for, a doctor to refuse to perform, or an insurer refuse to cover a gender confirmation surgery, based on their individual objections to transgenderism or religious beliefs that God only created two genders that cannot be changed.
As a result, the patient in question would have to seek out care elsewhere, and could be denied the surgery any number of times by a potentially endless number of providers, even if the procedure has been deemed “medically necessary.”
This is especially true for patients who live in rural areas of the state, where there are fewer medical provider options. Thus, many transgender people in Southeast Ohio, as an example, could be forced to forego care because it would be unrealistic and logistically difficult for them to have to travel to Cincinnati, Cleveland, or Columbus before they found a provider willing to perform the surgery. And even then, they could be forced to pay out of pocket, at personal cost, if their insurer — or the employer who provides their insurance plan (as in the Hobby Lobby Supreme Court case) — cites religious or moral objections.
The same thing could be applied to a situation where a lesbian or a transgender man sought to terminate a pregnancy, as providers or insurers could cite moral or religious objections to abortion.
Additionally, the law is vague on whether a health care provider could refuse to artificially inseminate a lesbian woman, for example, based either on her marital status or her sexual orientation. While the provision allows an provider to object to performing a procedure because of their moral or religious opposition to said procedure, it is unclear how that applies in cases where they might be perfectly willing to perform an insemination on a married, heterosexual woman, but object to it only because of the lesbian patient’s personal characteristics.
Gwen Stembridge, the statewide civic engagement director for Equality Ohio, criticized Republican lawmakers for jamming the provision into the budget in an underhanded manner, in order to avoid public scrutiny. She also worries that the right to refuse treatment will lead to more barriers preventing members of the LGBTQ community from accessing the care they need.
“The fear of going to the doctor and of knowing are they going to treat me equally? Am I going to get the care that I need? That is already the question and this just exacerbates that,” Stembridge told News5Cleveland. “We know that the LGBTQ community, for one we still lack the basic non-discrimination protections, so employment, housing, public accommodations, we still don’t have those protections in Ohio and this just adds insult to injury and says that, even in medical care spaces, we can be denied these basic protections.”
The Human Rights Campaign denounced DeWine’s refusal to veto the provision.
“Today, Governor DeWine enshrined LGBTQ discrimination into law, threatening the medical well-being of more than 380,000 LGBTQ people in Ohio, one of the largest LGBTQ populations anywhere in the country,” Alphonso David, the president of HRC, said in a statement. “Because of his decision not to line-item veto the discriminatory language adding a medical refusal provision to the state budget, medical practitioners in Ohio can deny care or coverage for basic, medically-necessary, and potentially life-saving care to LGBTQ people simply because of who they are.
“With Ohio hospital and insurance associations standing against this dangerous measure, Governor DeWine is going against medical best practice and recommendations to score cheap political points,” David added. “The Human Rights Campaign will do everything in our power to fight this dangerous provision that threatens the well-being of so many people across the state of Ohio.”
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