In January, the U.S. Department of Health and Human Services (HHS) released a proposed rule that would expand protections for physicians and other health care providers who object to performing certain procedures. The proposal covers a wide array of existing federal laws that provide “conscience” protections, including those related to abortion, sterilization, assisted suicide and the performance of advance directives.

While the California Medical Association (CMA) is a strong advocate for the conscience rights of physicians, we do not believe this proposed rule accomplishes its purported aims. We are concerned that it may lead to discrimination that is prohibited under both federal and California law, adversely impact patient access to comprehensive care, and inappropriately insert politics into the patient-physician relationship. Moreover, current federal and California law provide extensive protections for the conscience rights of health care providers, and the supplemental administrative burdens imposed by this rule do not add any meaningful benefit.

CMA is also concerned that the overly broad language in the proposed rule would allow any entity involved in a patient’s care—from a hospital board of directors to the receptionist that schedules procedures—to use their personal beliefs to dictate a patient’s access to care.

CMA policy has always sought to balance the rights of patients to access needed health care with the rights of physicians to exercise their conscience. CMA believes that the proposed rule would undermine anti-discrimination protections, especially regarding reproductive health, sexual orientation and gender identity. California law explicitly prohibits discrimination based on sex, sexual orientation or gender identity. The proposal lays the groundwork to preempt California laws that have been put into place to ensure that patients in the state have access to comprehensive health care.

Existing federal and state laws protect the rights of physicians by allowing states to take nuanced positions on protecting the conscience rights of health care workers, particularly with regard to abortion, sterilization and aid-in-dying.

“The Proposed Rule’s provisions are not only redundant but will have a chilling effect on the enforcement of and passage of state laws that protect access to health care,” CMA wrote in comments submitted to HHS on the proposed regulations. “California law already properly balances the rights of physicians and their patients…Adding a confusing and unnecessary layer of federal regulations may prevent [other] states from successfully passing and implementing their own conscience protections.”

View CMA’s comments here.