CMDA's The Point

Protect Your Conscience Rights

August 8, 2022

by Anna Pilato

On August 4, 2022, the U.S. Department of Health and Human Services (HHS) published its notice of proposed rulemaking (NPRM) to the Federal Registry to modify Section 1557, the “Nondiscrimination in Health Programs and Activities Clause” of the Affordable Care Act. The proposed rule will:

  • Re-define 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.
  • Require 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, and any associated cosmetic procedure and perform or assist with abortions.
  • Require insurance plans and some employers to pay for experimental procedures/treatments especially on children.
  • Withhold federal funding to institutions that receive federal grants if a healthcare professional refuses to participate in these procedures due to their sincerely held beliefs.

For more information about this rule change, check out my previous blog post at this link.

The proposed rule will be enforced by government under civil rights statutes. Those who do not comply will be subject to federal lawsuits and termination of Medicare and Medicaid funding.

The public commenting period began on Thursday, August 4 and is open through close of business on October 3, 2022. We urge you to comment on this CRITICAL regulation that will impinge on the conscience freedoms of healthcare professionals everywhere in the United States.

You can submit your comment by going to the Federal Registry here. Then click on the green “Submit a Formal Comment” button. You can directly write your comment into the text box, or we encourage you to attach your comment as a file and/or attach supporting documents to your comment. Thank you for standing up for freedom and for biblical values as you submit your comment!


  1. Avatar Carolyn Klaus on August 25, 2022 at 12:09 pm

    Thanks so much for publishing this! Here’s what I just sent to the feds:

    I strongly object to the modification of Section 1557, the “Nondiscrimination in Health Programs and Activities Clause” of the Affordable Care Act proposed on August 4, 2022. That these changes are even being considered is an affront to our democracy and the principles of our Bill of Rights.
    The first basis on which I object is scientific. Many of us health professionals took the Hippocratic Oath upon our induction into our professions that we would “do no harm.” There is room for debate as to what that means in many contexts when health professionals are divided on the meaning of the evidence that is available, but there is no debate that a health provider should not prescribe a treatment that he or she believes lacks scientific evidence of “doing no harm.” In recent months a growing number of public health authorities (Sweden, UK, Finland) have come to the conclusion that the “gender-affirming care pathway” can indeed cause harm and have more tightly restricted the access to such treatment. I have heard American physicians specializing in gender dysphoria describe their conclusions that gender transformation is not in the best interests of most of their patients. At the present time, I could not in conscience provide such care to my patients because I believe the risks of doing harm outweigh the likelihood of benefit. And yet I would lose my job for such a stand? My organization would lose its ability to bill Medicaid and Medicare?
    The second basis on which I object is religious. A true believer in any religion cannot check her religious beliefs at the door when she goes to work. Yet that is precisely what these rules would demand. Many religions see abortion and other practices listed in these proposed rules as morally wrong. To comply with federal guidelines, then, would require adherents of such religions deliberately to disobey what they believe God has commanded. How is this consistent with the First Amendment’s statement, “no law…prohibiting the free exercise of [religion]”?
    The passing of these rules would not only be discriminatory and wrong, but foolish. Many health providers who work in medically underserved areas do so because of religious motivations. I worked for several years at Esperanza Health Center in inner city Philadelphia. To work there required most physicians to take a salary cut of 50-75% of what we could have earned elsewhere. It meant accepting the vandalization of our cars. Most of the providers learned to carry Narcan with them because they so frequently encountered drug addicts who had overdosed on their way into work. One of our executive directors was held up at gunpoint at a nearby intersection. What was our recruiting tool? “This is God’s work! Come and join God in loving this neighborhood!” And it worked. Esperanza now has 33 medical providers, 3 dentists, and 9 behavioral health specialists. Yet this legislation would quickly strip Esperanza of the federal funding that allows it to provide exemplary care to a very needy population—and cause most of its providers to leave. Esperanza is only one of hundreds of such health centers across the USA (see Christian Community Health Fellowship for its list of 328 Christian-based clinics). Thousands of other doctors in practice in diverse settings in the USA hold to the same principles. Is it wisdom to force us out of practice by forbidding us to follow our consciences, and in the process leave hundreds of thousands of patients in difficult-to-serve areas without care?
    At the present time our society is sharply divided as to the morality of some of these procedures. However, there are enough providers willing to do these procedures that everyone who seeks them enough can obtain them, even if they have to travel some distance. Perhaps that distance is the price we pay in this country for the very important right we have of freedom of conscience, something for which our ancestors paid dearly. When a small majority can suppress the rights of the large minority to follow God as their consciences dictate, we are in deep trouble as a country.

  2. Avatar Paige McCrea on October 2, 2022 at 4:47 pm

    Well written and I agree 100 💯 percent !

  3. Avatar Margaret Ingraham on October 2, 2022 at 7:39 pm

    I am opposed to making people perform acts that are against their religious beliefs. The science behind this is not settled and very likely could cause great harm to the people having these procedures. Many other countries, UK, Sweden and Finland have stated this could do much harm and have stopped it. If passed it wold violate our constitution’s Right to Freedom of Religion. Our country wil be in trouble if we allow a small majority to stop people from acting on their religious beliefs.

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