healthcare, Michigan Republicans, RFRA — March 11, 2015 at 11:51 am

Michigan bill would allow discrimination against patients on religious or moral grounds


If it becomes law, any healthcare provider or payer could turn away any patient based on personal or organizational beliefs.

With so much work to be done to make Michigan a better place to work and live, you’d think legislators would have more important things to do than enact laws that are nothing more than a license to discriminate using religion as an excuse.

Rep. Cindy Gamrat, along with Rep. Todd Courser and other religious extremists in the Michigan House, have introduced House Bill 4309 and referred it to the House Committee on Health Policy.

H.B. 4309 was first brought to my attention by the MI Lead women’s coalition, which aptly described it as follows:

The bill would create the “Religious Liberty and Conscience Protection Act” that allows medical facilities [and] healthcare payers/purchasers to refrain from offering healthcare services and procedures based on moral or religious beliefs. Such refusal clauses are promoted as a means of protecting the consciences of those healthcare providers who have a religious or moral objection to providing some or all reproductive health services. If passed, the bill could also allow for discrimination against individual patients or groups of people, rather than specific services. The bill lacks exceptions to ensure a patient’s health is never compromised by the religious objections of their healthcare provider.

This bill is an alarming and irresponsible piece of legislation. If you’ve been reading my series on how Catholic health systems are restricting access to care, then you know how religious doctrine can be used to overrule established medical standards of care and even patient wishes at Catholic-affiliated facilities. H.B. 4309 would allow any hospital, provider, research institution or insurance company to refuse to perform or pay for any service they object to on religious or moral grounds. Employers could also refuse to pay for services for their employees.

It doesn’t even have to be an established religion, as long as it’s a “sincerely held” belief. From H.B. 4309:

‘Conscience’ means sincerely held convictions arising from a belief in God or the tenets of an established religion, or from the ethical or moral principles of a generally recognized philosophy or belief system that an individual asserting those convictions can reference as a basis for those convictions. For purposes of this act, the conscience of an entity shall be determined by reference to existing or proposed religious, moral, or ethical guidelines, mission statement, constitution, bylaws, articles of incorporation, or regulations adhered to by the entity.

Given the Supreme Court ruling that allowed Hobby Lobby to opt out of providing birth control coverage to employees on religious grounds, the idea that articles of incorporation would be a sanctioned cause for discrimination is particularly troubling.

According to Shelli Weisberg, legislative director of the ACLU of Michigan, articles of incorporation can be changed at any time.

It’s a vehicle that could allow healthcare providers to completely control who they choose to serve. For example, you could write in something that would make it less likely that you’d have to serve poor people. It’s wide open for manipulation, without any oversight or accountability, without any reason.

Getting out of performing or paying for a procedure is as simple as saying, “I object” under H.B. 4309, and there is no recourse for a patient who is harmed by a lack of appropriate medical care. The bill specifies that a moral or religious objection can not be a cause for legal action, and patients will be held financially responsible for anything their insurance company chooses not to pay for, as long as the objection is raised at some point before the service is provided. In other words, you can’t file a malpractice suit if you receive substandard care because of a religious refusal, and if your insurer doesn’t like a service you chose to have you might be stuck with the bill.

You might think H.B. 4309 is just about abortion, but it would apply to any service, in any situation, and any person the provider or payer objects to. The bill specifically mentions the removal of life support and feeding tubes in a nursing home or hospice facility — authorizing anyone who works at one of those facilities to opt out of complying with a patient’s wishes. Patients and families should not have to be fighting for their rights in someone’s final hours of life.

There is nothing in the bill that would prevent members of the LGBT community from being discriminated against. In fact, H.B. 4309 would allow healthcare practitioners, hospitals and insurers to turn away anyone whose lifestyle they find objectionable. That might include unmarried pregnant women, men and women seeking to use birth control or sterilization services, people who drink or smoke cigarettes, people of different religious views or ethnicities — the potential for discrimination is limitless.

Healthcare providers are troubled by bills like this. An almost identical bill was proposed in 2012 (Senate Bill 975), and many providers spoke out against it at the time, including the Michigan Health & Hospital Association and the Health Care Association of Michigan. They expressed concern about the vague language of the bill and the way it put employees’ religious views above patient care. But that hasn’t stopped Michigan legislators from continuing to push for a healthcare-specific religious refusal law.

H.B. 4309 is full of protections for providers and payers who want to object to providing care — including rules against discriminating against them in employment, funding and more — but the protections for patients only allow religious objections to be overruled in the case of an emergency. Even then the provision leaves far too much wiggle room to be decisive, especially in a situation where every minute’s delay can make a life-or-death difference.

This is what has worried healthcare providers in the past, Weisberg says.

You won’t know walking into a facility if anyone there — from the admitting nurse to the orderly — has an objection. The hospital associations, doctors and nurses who spoke out against S.B. 975 said it made their job too unstable, because they would never know who was going to decide that they couldn’t provide services to a particular patient.

Religion has no place in medical care. Providers are already given the option to refuse to perform abortions or sterilization procedures under existing laws, so what exactly is H.B. 4309 about? It’s a license to discriminate. It’s a license to turn away anyone, under any circumstances, and that is a serious threat to public health.

I have a moral objection to religious zealots trying to impose their beliefs on the rest of us through legislation. Despite separation of church and state, we have to wait until the next election to remove these legislators from office.

So, at least for now, we have Republican legislators like Representatives Cindy Gamrat and Todd Courser, who have made their extremist agenda clear, including Courser’s statement that his first duty is to God, not his constituents. Gamrat ran for office on a platform endorsed by Right to Life and clearly stated her support for “religious liberty” — but her religious liberty only includes Christians, which makes a complete mockery of the religious freedom to which every American, of every faith or no faith, is entitled.

I believe most healthcare providers want to do what’s right by their patients, but the risk of even one being able to turn away a patient in need, or cause them suffering, is too great.

We must pay close attention to the creeping intrusion of religious doctrine into secular activities — particularly in healthcare. H.B. 4309 isn’t the first religiously fueled or discriminatory bill brought before the Michigan Legislature this year, and Chris wrote about some of them earlier this week.

These bills are an attack on individual liberty, despite what the bills’ sponsors claim. Their beliefs are not the only beliefs sincerely held by Americans, and our government simply should not be allowed to legislate religious beliefs, discrimination or hate. It’s a violation of our Constitution and everything this country stands for. And if bills like H.B. 4309 become law, they will put the health — and lives — of Michigan’s communities at risk.

[CC photo credit: BJ Bumgarner | Flickr]