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The U.S. Department of Health and Human Services on Thursday released a final rule allowing doctors, nurses and other health workers to opt out of procedures such as abortions and sterilizations which violate their personal or religious beliefs. The rule, proposed more than a year ago, reinforces a set of 25 laws passed by Congress that protect "conscience rights" in healthcare, HHS said. Those laws allow health providers and entities to opt out of providing, participating in, paying for or referring for healthcare services that they have personal or religious objections to, HHS said. (5/2)

"Just today we finalized new protections of conscience rights for physicians, pharmacists, nurses, teachers, students and faith-based charities," Trump told an interfaith audience in the White House Rose Garden. "They've been wanting to do that for a long time." The conscience rule was a priority for religious conservatives who are a key part of Trump's political base, but some critics fear it will become a pretext for denying medical attention to LGBT people or women seeking abortions, a legal medical procedure. (Alonso-Zaldivar, 5/2)

The rule was issued by the Department of Health and Human Services’s Office for Civil Rights, which has been substantially expanded under President Trump. The administration has created a conscience and religious freedom division within the office, and the president’s budget sought to expand its funding. It is part of a portfolio of policy changes meant to broaden religious exemptions for certain types of medical practice. The administration has already created new exemptions for the Affordable Care Act’s requirement that employer health plans cover contraceptive care, though that change has been delayed in court. Another rule, still in its proposed stage, would modify civil rights requirements that bar discrimination by hospitals and insurance companies against transgender patients and women with a history of abortion. (Sanger-Katz, 5/2)

"This rule ensures that healthcare entities and professionals won't be bullied out of the health care field because they decline to participate in actions that violate their conscience, including the taking of human life," OCR Director Roger Severino said in a written statement. "Protecting conscience and religious freedom not only fosters greater diversity in healthcare, it's the law." (Kodjak, 5/2)

Conservative groups welcomed what they call “conscience protections” for health care workers and others, while LGBTQ and women’s groups warned the rule would reduce services and potentially harm patients if providers refuse to deliver certain care, or treat gay and transgender people. “Religious liberty is a fundamental right, but it doesn’t include the right to discriminate or harm others,” said Louise Melling, deputy legal director at the American Civil Liberties Union. “This rule threatens to prevent people from accessing critical medical care and may endanger people’s lives. … Medical standards, not religious belief, should guide medical care.” (Cha, Bailey and Goldstein, 5/2)

Consumer advocacy groups said Thursday that they planned lawsuits to block the rule, setting the stage for a pitched legal fight against the Trump administration and religious-rights advocates. California Attorney General Xavier Becerra, who vowed litigation, said the rule jeopardizes crucial funding and exceeds the administration’s legal authority. “We won’t go back to the days when Americans seeking healthcare faced discrimination simply because they were female or LGBTQ,” he said, referring to lesbian, gay, bisexual, transgender and queer patients. (Armour, 5/2)

The city of San Francisco is suing the Trump administration over its new regulation allowing health care professionals to opt out of providing treatments they oppose. City Attorney Dennis Herrera filed the lawsuit in U.S. District Court for Northern California on Thursday, hours after President Donald Trump made the announcement. He argues the U.S. Department of Health and Human Services exceeded its statutory authority when it created the rule. (5/2)

The first conscience protections were passed 46 years ago, as lawmakers sought to accommodate health care workers who had objections to theRoe v. Wade Supreme Court decision that legalized abortion nationwide. Those measures and subsequent laws have been at the center of political battles in recent years — George W. Bush's administration pushed to expand conscience protections for religious workers, and the Obama administration rolled them back. (Diamond, 5/2)

California Attorney General Xavier Becerra hinted the state may sue over the new rule. "It’s 2019, not 1920. We won’t go back to the days when Americans seeking healthcare faced discrimination simply because they were female or LGBTQ. California stands ready to take any and all legal action to prove the Trump Administration wrong," Becerra said in a statement. (Weixel, 5/2)

The administration has not always successfully navigated the line between promoting religious freedom in a legally defensible way while maintaining access to health services. Two other HHS final rules that would allow any employer to cite a religious or moral exemption to avoid covering contraceptives were temporarily blocked by a federal judge earlier this year. Oral arguments in that case are June 6. (Raman, 5/2)

HHS said it received more than 242,000 public comments regarding the proposed version of the conscience rule it released in 2018. At the time, the department said it issued the proposed rule after hearing reports of healthcare providers being made to perform abortion, sterilization or euthanasia procedures despite their faith and moral objections. (Cohen, 5/2)