May 21, 2019
HHS Final Rule Seeks to Expand Ability of Businesses and Individuals to Refuse to Provide Necessary Health Care on the Basis of Their “Religious, Moral, Ethical, or Other” Beliefs
NEW YORK––The de Blasio Administration joined New York Attorney General Letitia James and a coalition of 23 cities, states, and municipalities today in a lawsuit against a Final Rule issued by the Trump Administration’s Department of Health and Human Services, which seeks to expand the ability of businesses and individuals to refuse to provide necessary health care on the basis of businesses' or employees’ “religious beliefs or moral convictions.”
In an unprecedented and unlawful expansion of nearly 30 federal statutes, the Refusal-of-Care regulation puts providers above patients at a dangerous price: it could undermine the City’s ability to administer its health care systems and deliver patient care effectively, efficiently and without prejudice. The Rule would force the City to permit medical care professionals to deny care to transgender patients and patients seeking birth control or abortions based on their religious or personal beliefs, among other discriminatory practices, in conflict with state and local antidiscrimination laws.
“Heath care is a human right, and the Trump Administration’s repeated attempts to take it away from Americans is unconstitutional. In New York City we organized, rallied, fought and won when he tried to repeal the Affordable Care Act and we’ll do the same now,” said Mayor de Blasio. “It’s time we stop the President’s campaign on bigotry. New York City is advancing guaranteed health care for all, and we will not be stopped. As I’ve said many times: President Trump, we’ll see you in court.”
“The Refusal-of-Care Rule is another cruel attempt by the Trump Administration to control the lives of our most vulnerable communities,” said First Lady Chirlane McCray. “Health care is a right – no matter who you are – and New York City will not allow hateful politicians to dictate what we do with our bodies. Our city will fight until this discriminatory rule is defeated.”
“The Refusal-of-Care Rule would give health care providers an absolute right to deny care, even in emergencies. It would ignore the needs of patients, burden our health care system, and have devastating effects on the most vulnerable New Yorkers. Through this lawsuit, the City will defend patients against this unprecedented and illegal expansion of federal law” said Corporation Counsel Zachary W. Carter.
“We will not stand idle as the Trump Administration orchestrates new ways to deny critical health services to vulnerable patients, particularly women, people seeking reproductive health care, and LGBTQ communities,” said Dr. Herminia Palacio, Deputy Mayor for Health and Human Services. “Joining this lawsuit is one of the bold actions our City will take in order to ensure all New Yorkers truly experience access to comprehensive, high-quality health care in our public health and hospital system.”
The regulation seeks to force the City to comply with this Rule or risk losing up to billions of dollars in federal funding for health care services from the Department of Health of Human Services, as well as funds from the Department of Labor and the Department of Education for services not related to health care. The Rule allows health care providers to accommodate the religious or moral objections of any employee – from receptionists, nurses and doctors to pharmacists, anesthesiologists and ambulance drivers – and gives them the right to refuse to assist patients in real time, and without any advance notice, no matter the intense medical risk to the patient. The Rule makes this right absolute and categorical, and no matter what reasonable steps a health provider or employer makes to accommodate the views of an objecting individual, if that individual rejects a proposed accommodation, a provider or employer is left with no recourse.
The Rule would also allow businesses, including employers, to object to providing insurance coverage for procedures they consider objectionable, and allow individual health care personnel to object to informing patients about their medical options or referring them to providers of those options. The devastating consequences of the Rule would fall particularly hard on marginalized patients, including LGBTQ patients, who already confront discrimination in obtaining health care.
In New York City, NYC Health + Hospitals provides a wide array of comprehensive, high-quality health care services to New Yorkers, including those in the LGBTQ community and anyone seeking reproductive health care. The City has also made a commitment to guarantee care for all New Yorkers, including low-income and undocumented New Yorkers, through its NYC Care program. The City’s Department of Health and Mental Hygiene (DOHMH), one of the largest public health agencies in the world, also serves New Yorkers by operating clinics that provide vaccinations, tuberculosis testing and treatment, and services for sexually transmitted diseases. New York City remains committed to ensuring every New Yorker has access to the health care services they need.
“At NYC Health + Hospitals all are welcome – it is our mission to care for all, without exception, and regardless of income, immigration or insurance status,” said Dr. Mitchell Katz, President and CEO, NYC Health + Hospitals. “No federal law will stop us from treating people in need, especially transgender patients and New Yorkers seeking access to birth control or abortions. The refusal of care regulation is a refusal to care, and that’s not how New York City treats New Yorkers.”
“Denial of care based on biases and bigotry is profoundly damaging to the medical profession and the people it is sworn to serve. Licensing that denial—which affects coverage for abortion, contraceptives, health care related to gender transition, and other services—is nothing short of government sponsored malpractice and must be forcefully resisted. I applaud Mayor de Blasio and Attorney General James for defending the medical care of women, children, people with substance use disorders, and lesbian, gay, bisexual, transgender, queer, intersex and gender nonconforming persons,” said Health Commissioner Dr. Oxiris Barbot.
“HHS’ rule is contrary to the spirit of anti-discrimination law. It will cause serious harm to the health and well-being of New Yorkers based on their protected status,” said Carmelyn P. Malalis, Commissioner and Chair of the NYC Commission on Human Rights. “It will foster a new standard of selective and discriminatory treatment for many of the city’s most vulnerable populations, will create an undue burden for health care organizations, and places provider’s personal beliefs over patient wellbeing and access to health care services. The New York City Commission on Human Rights categorically opposes this overreaching and discriminatory rule.”
“Full autonomy over one’s health and reproductive life is inextricably linked to the economic mobility, safety, and overall well-being of any person, regardless of their gender identity or gender expression. The Trump Administration’s Refusal-of-Care Ruling puts at risk the lives of women, transgender, and gender non-binary patients seeking health care services in New York City and across the nation. At the Commission on Gender Equity, we remain diligent in our commitment to ensuring accessible and gender-competent physical, mental, and reproductive health services for all, and to promoting the economic mobility and well-being of women, LGBTQ persons, and their families,” said Jacqueline Ebanks, Executive Director, NYC Commission on Gender Equity.
“With this rule, the Trump Administration has affirmed its relentless and unconscionable commitment to harming LGBTQ communities, particularly transgender and non-binary people, including those seeking access to basic reproductive health care,” said Ashe McGovern, Director of the NYC Unity Project. “Our communities deserve the freedom to exist openly and authentically, in all settings, free from discrimination. With this lawsuit, New York City, New York State, and our partners across the country are stating unequivocally that we will not let the federal government’s dangerous and unconstitutional overreach go unchallenged.”
“This unconscionable rule adds more fuel to the dumpster fire of discrimination that is the Trump Administration, putting vulnerable patients and populations seeking vital medical care at risk and creating grave public health concerns for New Yorkers and the nation at large,” said Department of Social Services Commissioner Steven Banks. “No one should have to worry that they won’t be able to meet critical health needs because a health care provider opts out of their obligations, which would disproportionately impact the low-income New Yorkers we serve every day at DSS. Our City will continue to aggressively fight any federal attempt to sow fear and discriminate against New Yorkers in need.”The City of New York joins the New York State Attorney General, Colorado, Connecticut, Delaware, the District of Columbia, Hawai‘i, Illinois, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, Wisconsin, the City of Chicago, and Cook County, Illinois in filing this lawsuit.