Already, OCR has reversed decisions of its Obama-era predecessor. In 2016, for example, OCR concluded that a California law requiring that health insurance plans include coverage for elective abortions did not violate the Weldon Amendment -- a measure barring federal funding to those that discriminate against professionals or institutions for not providing, or otherwise assisting patients in obtaining, abortions.
In a call with members of the conservative Federalist Society in February, Severino said OCR no longer stood by that 2016 decision.
OCR has also said it will not enforce Section 1557's protections based on gender identity -- the same protections Severino railed against in his 2016 paper -- as well as its protections based on "termination of pregnancy." Officials have attributed that decision to an injunction by a federal judge.
Asked whether the conscience-protection efforts would shield those who object to hormone therapy or other treatments for transgender patients, Severino told Federalist Society members the office was abiding by the judge's injunction "to the fullest extent." He added that he had never heard of anyone citing conscience-protection laws in such a case.
In the waning days of George W. Bush's presidency in 2008, HHS introduced a rule that would prohibit discrimination against those who refuse to perform abortion or other procedures on religious or moral grounds, as well as established a way to file related complaints to OCR. The Obama administration replaced it with a more narrowly tailored rule.
However, the big-picture efforts by the Trump administration have gone further than that Bush administration rule -- a point underscored by a note in the proposed rule that explicitly grants OCR "full enforcement authority over a significantly larger universe of Federal statutes" protecting religious- and conscience-based objections than the 2008 rule.
Some have greeted the change with open arms, praising HHS for abandoning what Severino called the "outright hostility" of the Obama years.
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Said Everett Piper, the president of Oklahoma Wesleyan University, an evangelical Christian school that sued to be exempted from the Affordable Care Act's requirement that employer insurance plans cover contraceptives: "I just want to say how good it is to be here thanking Health and Human Services and the Office of Civil Rights rather than suing them."
Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.
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