A bill that allows healthcare providers and payors to refuse to provide healthcare services based on their subjectively held moral, ethical, or religious beliefs is moving swiftly through the legislature and will soon be headed to the governor for signature. This bill (SB 1580/HB 1403) creates a state-sanctioned license to discriminate in the provision of any healthcare service.
This bill is quite frankly shocking in its breadth and vagueness and government overreach into the private sector and regulated businesses.
In addition to allowing providers and entities to refuse to provide healthcare, the bill will also prevent employers from taking any adverse actions against any healthcare provider employee who refuses to provide such care if they allege their refusal is due to ethical, moral, or religious beliefs. Thus, forcing employers to retain employees who refuse to do their jobs.
This governor and legislature need to think long and hard about the potential public health and private sector consequences of such a wide-ranging and detrimental bill.
This bill is so overly broad that it includes not just doctors, but any health care provider or facility licensed under a dozen different statutes, including doctors, nurses, pharmacies, hospitals, mental health providers, medical transport services, clinical lab personnel, and more. It applies to both public and private schools, colleges, and universities. It applies to health insurers, employers, HMOs, “or any other entity that pays for, or arranges for payment of, any health care service.” It applies to any type of “healthcare service,” broadly defined as including, but not limited to, medical research, medical procedures, testing, diagnosis, referral, dispensing medications, therapy, recordkeeping, and “any other care or service.”
This bill goes far beyond any alleged claims of religious freedom, as it applies not just to religious objections, but also to moral and ethical beliefs. Does the legislature really want to force private businesses to retain employees who refuse to do their job based on a subjectively held alleged ethical or moral belief?
What does this even mean? There is no definition of moral or ethical in the bill. Who determines what constitutes a sincerely held moral or ethical belief, and more importantly, why should access to health care be denied based on such vague, imprecise, and subjective terms?
What if someone’s ethical or moral belief is that women should not have babies unless they are married? Or that poor people shouldn’t have more than one child? Or if they believe it’s unethical to bring a child into the world given overpopulation and climate change? Can they refuse to provide prenatal health care to that pregnant person? Can they refuse to assist in labor and delivery? Can their employer refuse to provide health insurance to cover pregnancy and labor and delivery? Can a nurse refuse to return calls to the patients or schedule follow-up appointments?
What if a healthcare worker believes it is unethical to interfere with conception: can a pharmacist refuse to sell the morning-after pill? Can a nurse refuse to refill a prescription for birth control?
While the bill contains a narrow exception that supposedly prevents providers from refusing to provide care “because of” the patient’s “race, color, religion, sex, or national origin,” it goes without saying that whenever barriers are erected between patients and their ability to access healthcare, the people who are harmed the most are those that are already marginalized – Black and brown people, people with fewer resources, LGBTQ+ individuals, women, and rural communities.
Marginalized communities — who already struggle to access quality and affordable healthcare – will be disproportionately harmed by this sweeping bill allowing healthcare providers and healthcare payors to refuse to provide care. Floridians need greater access to affordable care, this bill does the opposite.
Freedom of religion is one of our most fundamental rights as Americans, but that freedom does not give any of us the right to harm others, and this bill goes far beyond religious objections and allows people to refuse to provide healthcare services based on alleged ethical or moral beliefs.
This bill goes too far and threatens the delivery of healthcare as we know it for Florida’s over 22 million residents and is out of step with the rest of the country. Medical standards, not ethical, moral, or religious beliefs, should guide medical treatment and health care services.
Kara Gross is the legislative director and senior policy counsel of the ACLU of Florida.
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