In the latest state-level swing at LGBTQ health care access, Ohio will now allow medical providers to refuse to administer any medical treatment that violates their moral, ethical, or religious beliefs.
The language was buried in a 700-page document of last-minute amendments to the state’s two-year budget bill, which Ohio Gov. Mike DeWine approved last Thursday. The provision allows anyone providing medical care — from doctors and nurses to researchers and lab techs – and anyone paying for that care (namely, insurance providers), “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 bill does not allow medical professionals to deny LGBTQ people care, carte blanche; the exemption “is limited to conscience-based objections to a particular health care service.” It goes on to say that the provider is “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 the bill was overwhelmingly opposed by the state’s medical community. “The implications of this policy are immense and could lead to situations where patient care is unacceptably compromised,” read a letter to budget negotiators, signed by the Ohio Hospital Association, the Ohio Children’s Hospital Association, the Ohio State Medical Association, and the Ohio Association of Health Plans.
Gov. DeWine could have struck the language while signing the rest of the budget into law, but declined to do so, despite issuing 14 other line-item vetoes.
State and national LGBTQ advocates started sounding the alarm in June, when the language was introduced, saying that it will prevent LGBTQ people from accessing the health care they need. With this newly enacted language in place, a medical provider could refuse to prescribe PrEP to an LGBTQ patient looking to reduce their risk of contracting HIV, or refuse to provide gender-affirming care to trans and nonbinary patients, or puberty blockers to transgender minors. Equality Ohio called it a “license to discriminate,” and Human Rights Campaign President Alphonso David said that it jeopardizes “the medical well being of more than 380,000 LGBTQ people in Ohio.”
Gov. DeWine has insisted that this provision won’t change the standard of care in Ohio. “This is not a problem,” he told a local news station. “If there’s other things that maybe a doctor has a problem with, it’s worked out. Somebody else does those things” — 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.
But even if the medical professional does attempt to make that referral, a quarter of Ohio’s population lives in rural counties, where LGBTQ-friendly medical care is sparse. And for queer elders living in long-term care facilities, options are even slimmer.
Local advocates have also called foul on lawmakers’ move to insert the clause last-minute into the state’s massive two-year, 2,400-page budget bill. “They know that they couldn’t pass this on its merits as a standalone bill, because literally no one is asking for this to be passed,” Dominic Detwiler, a public policy strategist for Equality Ohio told the Columbus Dispatch.
It’s a strategy that Ohio lawmakers have attempted more than once this year, but it’s the first time it’s paid off. Earlier in June, while writing a bill that allowed college athletes to profit off of their own image, lawmakers tried to add a provision banning trans athletes from school sports. DeWine did not sign that legislation and instead drafted an executive order that mimicked the original text of the bill but omitted the anti-trans portion. Then, just days later, he signed the budget bill into law with the new health care statute.
More than 250 anti-LGBTQ bills have been introduced in state legislatures in 2021 — a trend that advocates have called an “unprecedented war on the LGBTQ community” — breaking the previous record in 2015.