As a former federal government employee, I have observed firsthand how policies affecting our everyday lives are often crafted and administered by unelected federal bureaucrats. Coupled with presidential executive orders, this gives the executive branch a remarkable amount of power. Within the executive branch exists the regulatory framework, which is overseen by a little-known office under the purview of the White House called the Office of Information and Regulatory Affairs. Proposed actions from this office are published in the “Unified Agenda” twice a year in the spring and fall, giving the public a glimpse into what future regulatory action is on the horizon. Most of us are unaware (some may say blissfully so) of the volume of regulatory and deregulatory actions under development and review in more than 60 federal departments, agencies and commissions across the government. To give some perspective, the U.S. Department of Health and Human Services (HHS) currently has more pending actions than any other cabinet level department, which underscores the sheer size and reach of this titan agency with a budget that surpasses the gross national product of several countries!

One of these regulatory actions will soon be on full display when HHS releases a rule to modify Section 1557, the “Nondiscrimination in Health Programs and Activities Clause” of the Affordable Care Act.

If this administrative action seems innocuous, or even boring, don’t be fooled. Instead, HHS is working behind the scenes to greatly expand the scope of the current rule, which was finalized in 2020. The Ethics & Public Policy Center suggests changes will likely include:

• Re-defining discrimination “on the basis of sex” to include sexual orientation and gender identity (SOGI), gender transition, sex stereotypes, reproductive health decisions and termination of pregnancy as protected.
• Requiring healthcare professionals (regardless of their conscience rights or sincerely held religious beliefs) to perform or assist in gender reassignment surgeries, prescribe puberty blockers or cross-sex hormone treatment on children any associated cosmetic procedure and perform or assist with abortions.
• Requiring insurance plans and some employers to pay for experimental procedures/treatments especially on children.
• Withholding of federal funding to institutions that receive federal grants if a healthcare professional refuses to participate in these procedures due to their sincerely held beliefs.

The history of this expanding definition of sex discrimination began with the establishment of the Affordable Care Act and the 2010 rule requiring employers to cover contraceptives, abortifacients and sterilization. The 2016 rule required employers and insurance companies to cover gender transition-associated services, and it compelled healthcare professionals to provide these services. These radical policies were increasingly out of step with the American public and were in contradiction with previously passed legislation.

The 2020 rule attempted to right the ship and remove the more expansive elements of the definition of sex and “get back to basics” of the definition of discrimination. See the following excerpts from the Federal Register Executive Summary from June 2020:

“Through Section 1557 of the ACA, Congress has applied certain long-standing civil rights nondiscrimination requirements to any health programs or activities that receive Federal financial assistance, and any programs or activities administered by an Executive agency under Title I of the ACA or by an entity established under such Title. It did so by cross-referencing statutes that specify prohibited grounds of discrimination, namely, race, color, national origin, sex, age, or disability, in an array of Federally funded and administered programs or activities. This final rule is needed because the Department has determined that portions of the 2016 Rule are duplicative or confusing, impose substantial unanticipated burdens, or impose burdens that outweigh their anticipated benefits. Additionally, two Federal district courts have determined that the Department exceeded its authority in promulgating parts of the regulation, and one has vacated and remanded those parts of the 2016 Rule. By substantially repealing much of the 2016 Rule, including removing the vacated provisions from the Code of Federal Regulations, the Department reverts to longstanding statutory interpretations that conform to the plain meaning of the underlying civil rights statutes and the United States Government’s official position concerning those statutes.”

Unfortunately, portions of the 2020 rule were subsequently challenged in federal court, and the gender identity language was reinstated. The current White House Administration has effectively reverted to operating according to the old 2016 rule.

The administration’s proposed 2022 rule is expected to again require insurance coverage of transgender-associated procedures and drugs, as well as perform and/or assist with abortions without a religious exemption “escape clause.” Without the ability to claim a religious exemption, Section 1557 will coerce healthcare professionals into performing these services while essentially running over the conscience and religious rights of anyone who might object.

The proposed 2022 rule is problematic and raises a variety of questions. How could this proposed rule be in concert with legislation such as the Religious Freedom Restoration Act, and the Church, Weldon and Hyde Amendments? The spirit of these and other laws are in effect to ensure that conscience rights and the sincerely held religious beliefs of the American people in the marketplace are protected, as well as ensure federal funding doesn’t subsidize abortion. The proposed rule is in opposition to long held traditions of protecting the religious freedom of American citizens.

With this pending rule on the horizon, it seems we have entered a phase where politicized policies are inching toward mandating the standard of care between a healthcare professional and patient, as well as treading on the sincerely held religious beliefs of America’s healthcare professionals.

Case in point, numerous healthcare professionals object to the government’s endorsement of “gender-affirming care,” which collides with the Hippocratic Oath of “do no harm.” In fact, the Society for Evidence Based Gender Medicine released a publication titled Fact-Checking the HHS to address a HHS official document entitled “Gender-Affirming Care and Young People,” which outlines any number of misleading and unproven claims in this area of “treatment.”

Finally, it seems we are bombarded almost daily by government policies that are contrary to a biblical worldview. It’s the real-time playing out of the Scripture in Isaiah that says, “Woe to those who call evil good, and good evil; Who put darkness for light, and light for darkness; Who put bitter for sweet, and sweet for bitter!” (Isaiah 5:20, NKJV). As believers, we have the assurance and safety of immutable truth, so we don’t have to be “tossed by the waves and be blown around by every wind of teaching” (Ephesians 4:14, HCSB). We do have the responsibility to be vigilant to proclaim the truth and stand, even when it goes against the prevailing winds.

The following are some practical strategies you can employ to promote policies that reflect a biblical worldview:

• Get involved in your local government, i.e., attend city council meetings, etc.
• Interact with your state and federal representatives and communicate with them regularly.
• Share your policy positions on important issues by submitting written testimony or offering your expertise through in-person testimony.
• Run for office.
• And, by all means, VOTE!

Thank you for standing for truth as you serve.