(Des Moines) Health care professionals, institutions and payors would not be required to provide medical services that they say violates their conscience under a bill advanced by a House subcommittee Wednesday.
House Study Bill 139 would grant medical practitioners, health care organizations and health insurance companies the right not to participate in or pay for a health care service that goes against their conscience, saying these entities cannot be held civilly, criminally or administratively liable for exercising their right to not provide a service. There are exceptions made for emergency medical services.
Luke Vader, a second year medical student at Des Moines University, said he supported the legislation as a future physician and was “shocked” the measure was not already in law.
“As I anticipate the start of my clinical rotations in August, I can’t help but fear that as a student, I will be made to participate in medical treatments contrary to my own well-informed sense of medical ethics and human rights, under duress of academic retribution,” he said. “This bill would put these fears to rest and allow me to better experience the joy of learning to care for my patients.”
But other advocates, like Connie Ryan with Interfaith Alliance of Iowa, said the measure would allow for discrimination in providing medical care to Iowa patients.
“It creates a health care system where the health of patients become secondary to health care providers’ personal beliefs,” Ryan said. “Where in this legislation are patients’ rights prioritized and protected? Where in this bill are parents’ rights protected, should they need their child to receive a type of medical care someone else deems wrong? Where in this bill does it acknowledge the medical care deserts we have in Iowa, where you can’t go somewhere else if a medical provider refuses to provide the services you need?”
Rep. Steven Holt, R-Denison, said he disagreed with Ryan’s and others’ arguments that medical providers should not be granted the right to refuse to provide services over issues of religious or moral beliefs.
“I found that argument to be bankrupt and repugnant, because there will be other doctors, there will be other individuals who could perform these procedures or whatever,” Hold said. “Why should we not respect the conscience of those who, for religious reasons, would find certain things that they could not do within their conscience?”
Rep. Lindsay James, D-Dubuque, said she was supportive of protecting physicians’ rights, but was also aware of the “political realities” of accessing health care services that she said have been deemed political, like abortion and gender-affirming health care. She did not sign off on the legislation, saying she had remaining concerns about the impact of the legislation.
“Let’s think critically about how we both serve, protect physicians and how we protect patients — and are we jeopardizing potential services and health of patients as well?” James said. “And so I think that is a tension there that we have to wrestle with.”
A similar bill, Senate File 220, was passed by a Senate subcommittee Tuesday. Keenan Crow with One Iowa said many parts of the bill were already in place through federal rules and they objected to new parts of the bill allowing for health care payors to not pay for medical services due to issues of conscience.
“It strains credulity to think that insurance companies aren’t going to suddenly acquire new moral beliefs about expensive things that they would rather not pay for should this pass,” Crow said, noting that senators said they plan to amend the legislation to address this concern.
Jim Carney with the Iowa State Bar Association also asked lawmakers to add language that people choosing not to provide or pay for services are acting “reasonably and in good faith” when being provided legal immunity in these cases.
Rep. Bill Gustoff, R-Des Moines said he believes there may be some areas for clarification in the bill’s language, but that he believed the legislation offers a “much-needed protection” for Iowa’s medical industry. He and Holt moved the legislation forward for consideration by the House Judiciary Committee.
