HHS required adoption and foster care agencies to work with same-sex couples in order to receive federal funding.
In 2011, the U.S. Conference of Catholic Bishops (USCCB) saw its anti-trafficking grant application denied by HHS because it would not refer trafficking victims for abortions or contraceptives. Agency leadership reportedly overruled other staffers who said the USCCB had superior qualifications to those of the other grant applicants.
HHS also helps resolve health care-related discrimination complaints through its Office of Civil Rights (OCR). This office may often be involved HIPAA-related cases, defending the privacy of patients’ medical records, or in ensuring access to health care for disabled persons with communication issues.
However, OCR can also be involved in other discrimination complaints regarding religious freedom or gender identity.
In 2015 the Obama-era OCR settled a dispute where an individual identifying as a transgender female had requested not to share a room with a male at a Brooklyn hospital. The administration sided with the transgender female.
Beginning in 2017, however, the Trump administration began moving in the opposite direction in the “culture wars,” prioritizing conscience protections, religious freedom, and curbing funding of groups promoting abortion.
Although the administration clashed repeatedly with the U.S. bishops on immigration and refugee resettlement, it often offered much-desired relief for religious groups in health care.
The administration crafted conscience protections for health care workers, granted relief to the Little Sisters of the Poor from the contraceptive mandate, declared “there is no international right to abortion” at the United Nations General Assembly, and made religious and conscience exemptions for federal grantees in adoption and health care.
The Trump HHS blocked family planning grants from groups that refer for abortions, or are co-located with abortion clinics. As a result, Planned Parenthood backed out of the program and forfeited an estimated $60 million annually in grants rather than comply with the new regulations.
In 2018, the administration established a new Conscience and Religious Freedom Division within the HHS OCR. The office said it experienced a surge in religious freedom-related discrimination complaints following the move.
Under head Roger Severino, the HHS OCR has been involved in settling several religious disputes in the last two years involving access of patients to clergy during the pandemic, and a Vermont hospital that allegedly forced a nurse to participate in an abortion against her conscientious beliefs.
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HHS was at the center of an immigration battle in 2017, when the ACLU sued the administration for an undocumented teenage immigrant not being able to obtain an abortion while at a federally-operated shelter.
The policy of ORR—an office at HHS—said that government shelters should not be compelled to transport women to have abortions. After three years of litigation, however, the administration recently changed the policy and said ORR providers would not obstruct abortions for “unaccompanied alien children.”
The HHS also enforces existing federal protections for persons and organizations that object to providing abortions.
When California in 2014 forced employers to cover abortions in their health plans, a number of religious organizations appealed to the HHS OCR; the state’s act violated the Weldon Amendment, the pro-life groups said.
The Obama administration at the time said that California had not violated the Weldon Amendment in forcing employers to cover abortions. However, in 2020 the HHS OCR sent California a notice of violation over the requirement. Becerra, acting as attorney general of California, refused to comply with the HHS notice.
These are just a number of areas where the HHS can square off against—or work with—religious and pro-life groups. With the possible confirmation of Becerra, many Catholic institutions will be counting up the myriad of Obama-era “culture war” fights that could reignite—and burn hotter than ever before.