Columbus sues state over law allowing medical providers to deny care based on 'conscience'

Columbus City Attorney Zach Klein is suing the state of Ohio over a 2021 law known as the “conscience clause,” which provides medical professionals legal protections from patients and health care employers for denying any care or treatment that violates their conscience or religious beliefs.

Critics of the law say it will allow doctors, nurses, pharmacists and other health care providers to deny certain vaccines, birth control, blood transfusions or blood products, treatments or counselling for HIV/AIDS and transgender individuals, and potentially any medical care to which a provider may be personally opposed. 

In a lawsuit filed in Franklin County Common Pleas Court Wednesday morning, the city notes that the Columbus Department of Public Health runs a Women’s Health and Wellness Center that provides birth control and reproductive life planning for all genders, contraceptive education, and all birth control methods and pregnancy testing. 

The department also provides a range of other health care services, including vaccines.

If, for example, nurses employed by the city decided they opposed a medical procedure, "they can refuse it and we as a city can't do anything about it," Klein told The Dispatch Wednesday. Also, insurance companies could refuse to pay for certain procedures, and "that obviously causes significant problems for our employees."

The law states that "whenever a situation arises in which a requested course of treatment includes a particular health care service that conflicts with the moral, ethical, or religious beliefs or convictions of a medical practitioner, the medical practitioner shall be excused from participating."

Gov. Mike DeWine said last summer that the law doesn't change much, because most health care professionals don't work in medical fields they oppose.

More:Conscience clause increases barriers to mental health care for LGBTQ youth, advocates say

“Let’s say the doctor is against abortions, [then] the doctor is not doing abortions,” DeWine said last year. “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.”

When possible or willing, the law requires that the practitioner "shall seek to transfer the patient to a colleague who will provide the requested health care service," unless the act of transferring also violates the practitioner's beliefs or convictions.

The law also protects health care "institutions" and "payers" from being legally liable for "declining to participate in or pay for a particular health care service," and the employees of those organizations can't be retaliated against by their employers for refusing to provide a service.

LGBTQ advocates opposed the law, saying it would lead to less care and more discrimination for LGBTQ Ohioans.

“Ohio’s Conscience Clause is an egregious, unconstitutional overreach by the legislature, and the city of Columbus is ready to pursue every legal avenue to ensure discrimination is not the law of our state,” Columbus Solicitor General Rich Coglianese said in a written statement. “We take seriously our obligation to provide equal access to city services for all residents, and this law infringes upon our authority to do so.”

In addition to violating home rule, the city argues in its complaint that the law also violates the Ohio Constitution by prohibiting the city’s ability to discipline or transfer employees and forcing it to maintain insurance coverage from a company that could reject to pay for treatments or drugs. It also violates the "single subject" clause of the state constitution, because the legislature inserted it into the state's budget rather than debate it on its merits.

The city also argues that the law violates the federal Affordable Care Act, which mandates that health insurance providers cannot discriminate and must cover certain benefits including free access to birth control.  

The news site Politico reported Tuesday that the Biden administration was close to eliminating a Trump-era rule that also allows medical workers to refuse to provide services that conflict with their beliefs. The 2019 federal measure never went into effect after dozens of states filed lawsuits to block it.

wbush@gannett.com

@ReporterBush