On Saturday, a district judge ruled that doctors and health insurance providers have a legal right to categorically refuse medical treatment and coverage to transgender people, as well as women who have had or are seeking abortions.
The Affordable Care Act forbids discrimination based on gender identity and pregnancy termination by interpreting Title IX, a federal prohibition of discrimination based on sex, to include protections for transgender people and women who are seeking or have had abortions. Healthcare and insurance providers from eight states brought a case to the district court claiming that the ACA’s interpretation of Title IX violates religious freedom and their right to deny healthcare services and coverage to those who live outside their belief system. (In other words, helping sinners is a sin the government can’t make them commit.)
In his verdict for the plaintiffs, Judge Reed O’Connor of Texas explained that the law against categorical refusal of services to transgender people and women who have had abortions requires providers to argue on a case-by-case basis why providing these services violates their religious freedom. “[This] places substantial pressure on Plaintiffs to perform and cover transition and abortion procedures.” That pressure, he ruled, “imposes a substantial burden on Private Plaintiffs’ religious exercise.”
“The Court finds that Private Plaintiffs’ refusal to perform, refer for, or cover transitions or abortions is a sincere religious exercise,” Judge O’Connor continued. “Private Plaintiffs have demonstrated they sincerely believe such procedures would harm their patients and force their employees to ‘engage in material cooperation with evil.’”
Setting aside the absurdity of legislating “evil,” the most reasonable case that could be made in favor of doctors with strong anti-abortion beliefs would be to allow them to refuse performing the procedure themselves. If they believe that performing an abortion is committing murder, they shouldn’t be forced to do so. But it makes no sense to extend the exception to women who have had abortions in the past, or to allow doctors to refuse to refer patients elsewhere and insurance providers to deny them coverage.
Extending the religious protection to include refusing healthcare to transgender people is just as absurd. Doctors may not agree with a patient’s choice to undergo sex reassignment surgery; they may even think it’s a sin. But that has nothing to do with providing them with treatment. In these cases, the doctor isn’t being asked to actually carry out a supposedly sinful act, like they would in the case of being forced to perform abortions. A doctor’s perception of a patient’s sinfulness shouldn’t determine whether that doctor provides a patient with healthcare, and certainly shouldn’t determine whether an insurance provider should cover the cost.
The religious freedom argument is obviously a smokescreen to justify discrimination, and it would be laughable if it wasn’t working. Even in a world that validates the perception of abortion as murder, there’s a clear disconnect here between that belief and the rights being claimed in this case. You don’t hear about lawyers claiming that representing clients in divorce proceedings or theft cases violates their religious freedom. Christian doctors provide health services to people who are cohabitating out of wedlock. Under Judge O’Connor’s way of thinking, these vases too would be considered “material cooperation with evil.”
The idea that the free exercise of religion has been expanded to include refusing service, especially life-saving medical care, to those who don’t subscribe to the same religious beliefs as a doctor or insurance provider is patently ridiculous. In fact, it’s in exact opposition to the teachings of Christianity. (Wasn’t it Jesus who ministered to any and everyone in need, including whores?) But this might all be moot soon anyway if the GOP is successful in its vindictive campaign to repeal the ACA; today, they took the first step by narrowly winning a Senate vote to repeal it.