Ohio Governor OK's 'License to Discriminate' in Health Care

Ohio's Republican governor, Mike DeWine, last week green-lit a last-minute amendment to a budget bill that allows medical providers and insurers "the freedom to decline to perform, participate in, or pay for any health care service which violates the practitioner's, institution's, or payer's conscience as informed by the moral, ethical, or religious beliefs."

The amendment, part of a 700-page document of amendments to the budget bill DeWine signed into law, is widely viewed as a license to discriminate against LGBTQ+ patients and others. With the language, gender-affirming care for transgender patients and preventive HIV medication for gay and bisexual men is now up to the whim of doctors and nurses. The amendment's language was written to allow health professionals to right to refuse specific "services," as opposed to refusing to treat a person or group of people because of a certain characteristic. The amendment includes another caveat, stating medical providers are "responsible for providing all appropriate health care services, other than the particular health care service that conflicts with the medical practitioner's beliefs or convictions, until another medical practitioner or facility is available."

But as Rolling Stone points out, millions of Ohioans live in rural areas where medical care options are limited, especially LGBTQ-inclusive care. "And for queer elders living in long-term care facilities, options are even slimmer," the publication notes.

DeWine has defended the amendment, saying other practitioners would provide the services another refused to perform. "Let's say the doctor is against abortions, [then] the doctor is not doing abortions," he said at a press conference, according to Cincinnati TV station WXIX. "If there's other things that maybe a doctor has a problem with, it's worked out. Somebody else does those things. This is not a problem. This has not been a problem in the state of Ohio, and I do not expect it to be a problem."

DeWine, however, was "referring to a loosely written clause that requires that the medical professional, when possible, 'attempt to transfer the patient to a colleague who will provide the requested procedure,' as long as making that referral doesn't violate their conscience as well," Rolling Stone reports.

DeWine could have used a line-item veto to strike the amendment, as he did with 14 others, but chose not to. The conscience provision was inserted as an amendment because lawmakers "know that they couldn't pass this on its merits as a stand-alone bill, because literally no one is asking for this to be passed," Dominic Detwiler, a public policy strategist for LGBTQ+ rights group Equality Ohio, told The Columbus Dispatch.

The Human Rights Campaign denounced the move in a statement from its president, Alphonso David: "Governor DeWine enshrined LGBTQ discrimination into law, threatening the medical well-being of more than 380,000 LGBTQ people in Ohio, one of the largest LGBTQ populations anywhere in the country. Because of his decision not to line-item veto the discriminatory language adding a medical refusal provision to the state budget, medical practitioners in Ohio can deny care or coverage for basic, medically necessary, and potentially lifesaving care to LGBTQ people simply because of who they are. With Ohio hospital and insurance associations standing against this dangerous measure, Governor DeWine is going against medical best practice and recommendations to score cheap political points. The Human Rights Campaign will do everything in our power to fight this dangerous provision that threatens the well-being of so many people across the state of Ohio."

Several medical groups opposed the amendment as well, including the Ohio Hospital Association, the Ohio Children's Hospital Association, the Ohio State Medical Association, and the Ohio Association of Health Plans. But the Catholic Medical Association issued a press release praising it. "The support of leaders like Governor DeWine will protect health care professionals and patients for years to come. Conscience freedom is a civil right which must be protected so that medical professionals have the freedom to care for patients from a scientific, moral and ethical standpoint," said the organization's president, Dr. Michael Parker.