• These can be considered the original Conscience Rules. The Church Amendments were enacted in the 1970s and protect individuals and entities receiving federal funds from being required to perform or assist in abortions or sterilizations if it is against their religious beliefs or moral convictions. Also prohibits discrimination against healthcare professionals based on their involvement in such procedures.   

• Prohibits entities that receive federal funds from denying admission or discriminating against any applicant for training or study based on their reluctance or willingness to counsel, recommend, perform, or assist in certain health services or research activities because of their religious beliefs or moral convictions. 

• The Coates-Snowe Amendment prohibits the federal government and any state or local government receiving federal financial assistance from discriminating against any health care entity on the basis that the entity:

• Refuses to undergo training in the performance of abortions;
• Refuses to require or provide abortion training;
• Refuses to perform abortions, or to provide referrals for abortion training or for abortions;
• Refuses to make arrangements for any of the above activities related to abortion; or
• Attends (or attended) a post-graduate physician training program, or any other program of training in the health professions, that does not (or did not) perform induced abortions or require, provide, or refer for training in the performance of induced abortions, or make arrangements for the provision of such training.

Enacted in 2009, prohibits federal funding from going to federal agencies and programs or state and local governments that discriminate against health insurance plans, health care institutions or health care professionals that refuse to provide, pay for, provide coverage of, or refer for abortions. This statute permits health care providers to refuse to provide, pay for, provide coverage or, or refer for abortions should the providers have a religious or conscience objection to abortion. 

It also defines “health care entity” to include “an individual physician or other health care professional, a hospital, a provider-sponsored organization, a health care maintenance organization, a health insurance plan, or any other kind of health care facility, organization, or plan.”

Section 1557: Section 1557 of the ACA prohibits any health care provider that receives funding from the federal government to refuse to treat an individual – or to otherwise discriminate against the individual – based on race, color, national origin, sex, age or disability. Originally, this applied regardless of whether a conscience objection arose. Essentially, you can object to a procedure, however you cannot discriminate/object to a person.

• Requires that the Church, Weldon and Coats-Snowe Amendment protections be incorporated into Medicaid and Title X family planning programs. 

• Maintains the complaint process provision of the 2011 HHS Rule, but allows for the Office of Civil Rights to conduct investigations into the complaint and issue enforcement measures if necessary.

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