Medical care can be denied on religious and moral grounds, NC House committee agrees

Those who provide or fund health care would be allowed to deny or refuse to pay for medical care they deem to be in violation of their religious, moral, or ethical beliefs or principles, under a proposal moving forward in the North Carolina House.

Parents, medical providers and transgender young people spoke to state lawmakers about House Bill 819 on Thursday.

Those in favor of the bill said doctors and other providers should not be forced to go against their beliefs, while those against it said it could lead to the denial of life-saving care, including care for transgender people and those seeking abortions.

Republicans filed the bill and several other pieces of legislation related to transgender medical care earlier this month. On Thursday, it became the first of those bills to receive a vote, clearing one committee and moving on to another.

Separately, the GOP-led legislature is also expected to pass new abortion rules, as previously reported by The News & Observer. Lawmakers are closing in on a 12-week abortion ban.

Denial of health care?

Lawmakers who spoke in opposition to the bill objected to its broad language.

Asked by Rep. Sarah Crawford, a Democrat from Wake County, how the bill would define an ethical belief, Rep. Donna McDowell White, a primary bill sponsor, said that “what’s ethical to you and what is ethical for me” can be different.

“If you’re asking me to do something for you, (and) our positions of ethicality would be challenged, then I should have that right,” to not provide services, said White, a Republican from Johnston County and a nurse.

Crawford said she was concerned “that there would be a kind of regular refusal of care for people who need it” and that the bill appeared to also limit the ability of patients to be referred for care from another provider.

Other lawmakers asked what would happen in an emergency or if no other medical option were available, such as in rural areas. White said she was open to discussing the bill’s language about referring patients.

Supporters of the bill told lawmakers that they should have the right to deny health care based on their personal beliefs.

Michele Morrow, who said she has been a nurse for 30 years in Chapel Hill, said she supported the bill because “we are in a crisis right now in the medical community.”

“The trust with our community has been broken,” said Morrow, a former candidate for Wake County school board. “We’ve lost many great medical professionals and it’s because their convictions and their conscience, the very thing that probably got them into the health care field to begin with, have not been respected.”

Tami Fitzgerald, the executive director of NC Values Coalition, a socially conservative Christian organization, said many “health care providers and pharmacists have been asked and in some cases forced to provide drugs and services which run counter to their deeply held religious beliefs.”

Susan Bay, an obstetrician and gynecologist, said she respects patients’ diverse beliefs.

“I ask you to do the same and respect the diversity (in) health care and protect conscience rights of health care professionals.”

Transgender health care

Ray Bandy of Equality North Carolina, which advocates for LGBTQ+ rights, said the bill threatens the health care that saved his life and the lives of transgender people across the state.

Bandy said “I was 16 and nearly committed suicide because of the abuse and hatred that I faced from those who are supposed to love me. All because I am transgender. I’m 22 now; I cannot describe the joy I feel now that I have begun (hormone replacement therapy).”

Kirstin Cassell, a licensed clinical social worker from Greensboro, said she was the “proud” mom of a transgender teen. She said her child’s “safe and reversible gender-affirming medical care” was denied by her husband’s insurance because of his employer’s personal beliefs.

“Someone’s opinion is never more important than our access to health care. Gender affirming care for our kids is life-saving. It is an emergency,” she said.

Abortion called out in bill

Critics also say the bill could lead to denial of abortion care.

The bill says “a health care practitioner may not be scheduled for, assigned, or requested to directly or indirectly perform, facilitate, refer for, or participate in an abortion unless the health care practitioner affirmatively consents in writing prior to performing, facilitating, referring, or participating in the abortion.”

Elizabeth Campbell, an oncology and hematology physician, said the bill will “harm the health care workforce and the health of our state.”

She spoke about her experience receiving “excellent medical care” after a placental abruption. She said if she had been forced to continue the pregnancy, it “would have killed both of us” instead of the baby alone.

More details of the bill

The bill prohibits liability for denial of care based on beliefs, but it allows civil action for violations of the bill.

It protects whistleblowers who report those violations.

The bill also forbids the state or licensing boards from taking disciplinary action against a medical practitioner for engaging in speech protected under the First Amendment without proof it was “the direct cause of harm” to a person.

It says the changes do not override any requirements to provide medical treatment under federal law.