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HHS acts against states’ freedom of conscience violations

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WASHINGTON (BP) – The Trump administration has taken action in its waning days to protect the freedom of conscience of Americans who oppose funding or helping perform abortions.

The Department of Health and Human Services (HHS) announced Wednesday (Dec. 16) it will withhold $200 million per quarter in federal Medicaid funds from California for violating federal conscience protections. The state did so by requiring health insurance plans and issuers to cover abortions without limitations, according to the announcement. California’s policy has even mandated churches must fund elective abortions.

HHS also announced the Department of Justice has filed a federal lawsuit in its behalf against the University of Vermont Medical Center (UVMMC) for requiring health-care workers to assist in abortions despite their religious or moral objections.

In the announcement of the actions, Roger Severino, director of the HHS Office of Civil Rights, said, “Entities that receive HHS funds should think twice before flouting federal law and refusing to come into compliance. Whatever one thinks of the legality of abortion, no one should be punished for declining to pay for or assist in the taking of human life.”

Religious freedom and pro-life advocates welcomed the actions.

“Abortion is not health care,” said Chelsea Sobolik, a policy director for the Southern Baptist Ethics & Religious Liberty Commission. “And it is deeply unfortunate that the state government in California would entangle abortion with actual health-care services, especially during a pandemic, and now faces the legal consequences of their continued conscience violation.”

Marjorie Dannenfelser, president of the Susan B. Anthony List, said Trump and other officials “have set the standard for future pro-life administrations.”

“Federal conscience laws are more essential than ever at a time when pro-abortion Democrat-led states have tried to force health care professionals and entities, like nurses and insurance providers, to participate in abortion,” she said in a written release. “Abortion … is the destruction of innocent human life.”

The $200 million penalty for California would begin in January and continue each quarter until the state complies with federal law protecting freedom of conscience, according to HHS.

In January of this year, the HHS Office of Civil Rights notified California it was guilty of violating federal conscience safeguards in requiring abortion coverage by all health insurance plans and issuers. The Office of Civil Rights informed the state it had 30 days to demonstrate its intent to comply or risk restrictions on funding from the department.

California Attorney General Xavier Becerra responded in February, however, by saying the state already complies with the Weldon Amendment, the federal law in question, and “no ‘corrective action’ is necessary.”

The effect of the new HHS actions may be limited. President-elect Joe Biden has announced his intention to nominate Becerra as HHS secretary. If confirmed, Becerra’s department could be expected to attempt to reverse the Trump administration’s actions against California and Vermont. In addition, the $200 million penalty is a small portion of the federal government’s contribution of $63 billion a year to California’s Medicaid program, according to The Los Angeles Times.

The Weldon Amendment, first adopted in 2004, is an annual rider to the HHS appropriations measure that bars funds for a federal program or state or local government that “subjects any institutional or individual health care entity to discrimination on the basis that the health care entity does not provide, pay for, provide coverage of, or refer for abortions.”

Conscience objections arose when the California Department of Managed Health Care informed health insurers in 2014 that they could not prohibit or restrict coverage for elective abortions. Under President Obama in 2016, the HHS Office of Civil Rights rejected complaints that California had violated the Weldon Amendment.

In January 2020, however, the Office of Civil Rights told California it had disobeyed the Weldon Amendment by compelling all plans and issuers to cover abortion. The office said the state’s action had stripped 28,000 people of plans that previously did not cover abortion. The office’s investigation of the California policy came in response to complaints by an evangelical church and a Catholic order of sisters.

A lawyer for Alliance Defending Freedom (ADF), which has represented four California churches in legal challenges to the abortion coverage mandate, applauded the administration’s action against the state’s “willful disregard for the civil rights and conscience rights of its citizens.”

“Churches should be free to operate according to their faith without being threatened by the government,” ADF Legal Counsel Elissa Graves said in a written statement. California’s government has collaborated with abortion provider Planned Parenthood for years in showing “hostility toward churches by forcing them to fund elective abortion coverage, against the deeply held beliefs of churches and their members,” she said.

California Gov. Gavin Newsom, a Democrat, decried the HHS penalty, tweeting, “Nothing like the ‘pro-life’ party eliminating healthcare during a GLOBAL PANDEMIC. California will survive without this $$ for now – but their frail, pathetic patriarchal system they are so desperate to protect won’t.”

In May, a three-judge panel of the Ninth Circuit Court of Appeals in San Francisco unanimously ruled Skyline Wesleyan Church in La Mesa had suffered an injury under the abortion coverage mandate and returned the case to federal court. ADF, which represented Skyline, also argued for three other churches challenging the state policy in a November appearance before the Ninth Circuit Court.

The HHS Office of Civil Rights announced in August 2019 the UVMMC had violated the Church Amendments and HHS regulations governing the receipt of federal funds. The Church Amendments, enacted in the 1970s, protect health-care workers who object to performing abortion or sterilization procedures because of religious beliefs or moral convictions.

The UVMMC in Burlington forced a nurse to participate in an abortion and had scheduled other workers to help with abortions though they had religious or moral objections, according to the report at that time from the Office of Civil Rights. The office gave the UVMMC 30 days to comply with federal law but said Dec. 16 that the medical center has refused to do so.

The medical center responded to the HHS announcement of a lawsuit in a Dec. 16 release by saying it had strengthened its policies on permitting workers to opt out of medical procedures that violate their beliefs. It also said HHS officials had agreed previously not to recommend enforcement of its 2019 charges.

UVMMC President Stephen Leffler described the Office of Civil Rights’ action as “baseless from a legal standpoint” and “an attack on reproductive care.”