Chris Faddis, president of Solidarity HealthShare, is sounding the alarm over a new Biden administration change to the Affordable Care Act that he says denies religious freedom rights of Catholic and Christian health providers who object to sex change surgeries. 

The administration’s new rule amends the nondiscrimination clause in Section 1557 of the Affordable Care Act (also known as the ACA or Obamacare), by removing the word “sex” and replacing it with the phrase “sex (including discrimination on the basis of sex characteristics, including intersex traits; pregnancy or related conditions; sexual orientation; gender identity; and sex stereotypes).”

This change means that any insurer or physician receiving federal financial assistance must cover or provide sex reassignment surgeries and therapies on the grounds that refusal to do so would constitute discrimination based on sex.

This reverses changes to ACA made under the Trump administration that excluded such procedures from mandated coverage. 

According to Faddis, who leads a Catholic health share group based out of Arizona, this means that “physicians and medical staff can no longer opt out of performing morally objectionable procedures, like transgender surgeries, without the risk of losing critical federal funding.”

In responding to fears that the rule will violate religious and conscience rights, the Biden Health and Human Services Department (HHS) claims that it has included a provision within the rule that “respects federal protections for religious freedom and conscience.” 

In the final rule, which is set to be filed in the Federal Register on May 6, HHS states that any part of the new guidance that violates “applicable” federal religious freedom and conscience protections “shall not be required.”   

However, Faddis told CNA that the rule’s wording is dangerously vague and would force hospitals and providers to “beg” for religious freedom exemptions that should be automatically afforded under the First Amendment. 

“We should not have to request something that the Bill of Rights says is a God-given right … we should not have to request our religious freedom,” he said. “Even [putting] the burden on an individual doctor or health system to come beg for clemency is a problem. This is not who this country is.” 

Faddis believes that it is “very uncertain” that religious providers’ requests would be granted. 

“How can we possibly trust that they're going to be favorable and friendly and not target or avoid answering these waiver requests?” he asked. 

To be clear, Solidarity HealthShare, which says on its website that it has served 55,000 patients since its founding in 2016, will not be impacted by the Biden administration’s change. This is because the rule specifically targets health insurers and providers. However, Faddis believes the new rule presents a broader danger to not just providers but also patients and the overall healthcare system. 

One such problem Faddis foresees is the possibility that a Catholic or religious provider may not be eligible to receive Medicaid or Medicare funding while their exemption requests are being considered. 

“If suddenly Catholic healthcare systems have to stop taking Medicare or Medicaid,” Faddis said, “not only would that drastically impact them and maybe even take them out of business, but it would also drastically impact the availability of care across the country, particularly in certain states [where] a large percentage of their care is provided by Catholic systems.” 

HHS did not immediately respond to CNA’s request for comment.

In a Friday statement HHS Secretary Xavier Becerra said that the new rule is a “giant step forward for this country toward a more equitable and inclusive health care system.”

According to Becerra, the rule “means that Americans across the country now have a clear way to act on their rights against discrimination when they go to the doctor, talk with their health plan, or engage with health programs run by HHS.”

HHS also clarifies in the rule that “nothing in section 1557 shall be construed to have any effect on Federal laws regarding conscience protection; willingness or refusal to provide abortion; and discrimination on the basis of the willingness or refusal to provide, pay for, cover, or refer for abortion or to provide or participate in training to provide abortion.”

The rule will go into effect on July 5, sixty days after being filed in the Federal Register.