Defense of Conscience in Health Care Act
Key claim: HR2874 would require HHS to reinstate the 2019 rule protecting health care providers’ statutory conscience and religious rights in federally funded programs, which was previously vacated by federal courts.
Abstract
(HR2874 · 119th Congress) Defense of Conscience in Health Care Act This bill requires the Department of Health and Human Services (HHS) to issue a final rule on protecting statutory conscience rights in health care that is identical or equivalent to the rule titled Protecting Statutory Conscience Rights in Health Care; Delegations of Authority , which was scheduled to take effect on July 22, 2019, but was vacated by courts. Federal law generally prohibits discrimination based on conscience or religious beliefs with respect to federally funded health care programs, including prohibiting recipients of certain federal funding from requiring health care providers to take actions that they find religiously or morally objectionable (e.g., providing referrals for abortions). In 2019, HHS issued a final rule revising the applicable regulations, including imposing certification and cooperation requirements, as well as establishing additional enforcement provisions and penalties. However, this rule was later vacated by federal courts and never took effect. In 2024, HHS issued another final rule that generally applied a pre-2019 enforcement framework while also maintaining certain aspects of the 2019 rule (e.g., specifically designating HHS’ Office for Civil Rights as the entity with the authority to handle relevant complaints). The bill requires HHS to reinstate the 2019 rule in its entirety. Latest action (2025-04-10): Referred to the House Committee on Energy and Commerce.
Why this matters
Conscience-clause rules determine when federally funded providers may decline to participate in services such as abortion, sterilization, assisted suicide, or gender-affirming care, directly shaping patient access for affected groups. Because the underlying 2019 rule was vacated by multiple federal courts, statutorily reinstating it would foreclose the administrative-law objections that defeated it and shift the contest back to the merits of balancing provider rights against nondiscrimination and emergency-care obligations.