Ohio Budget Bill Adopts Conscientious Right to Refuse Care, Will Disrupt Health Care Operations and Oversight

Late amendments to Ohio’s budget bill (Am. Sub. H. B. 110[1]) set the stage to disrupt Ohio’s health care business community and alter health care oversight, operations and quality in the state. The new law provides moral, ethical, and religious grounds to refuse health care, and in doing so, affords unprecedented rights and protections that stand to impact the Ohio health care community in a myriad of ways.

The new law gives statutory rights for “medical practitioners” (broadly defined to include any person participating in providing health care services) to refuse to provide health care services to patients at any point in time.[2] These rights can be exercised with little advance notice when the broadly defined “health care service” in question violates the medical practitioner’s “conscience as informed” by their “moral, ethical, or religious beliefs or principles.”[3] When a medical practitioner exercises these rights to refuse care to Ohio citizens, they are given statutory immunity from civil, criminal, and administrative liability. The new law also prohibits discrimination or “other adverse action” against such persons and grants a statutory cause of action to this newly protected class of persons that mandates an award of treble damages, costs and attorney’s fees for any violation.[4]

From a health care workforce perspective, this legislatively created cause of action stands to disrupt health care employer authority over its staff, as the law prohibits discrimination or “any other adverse action” against those who exercise the new rights to refuse care under the law. Employers will almost certainly face a new array of claims asserting treble damages and payment of attorney’s fees based on alleged violations of this new law in response to workplace discipline or other employment actions.

These new rights also impact other health care oversight, operational, and quality-of-care considerations. Given the supremacy these rights are granted by the new law, health care facilities of all types will need to consider whether new policies, procedures or other operational measures, such as added staff and support, will be necessary to account for the possible exercise of the right of staff to refuse to render care with little to no advance notice and where the law provides no definition of what constitutes a moral, ethical, or religious belief or principle.

The breadth of this law and the rights given will be sure to impact the quality and delivery of care, as the statutory language expressly permits gaps in care and services by not mandating that the denied service be provided when another provider is unavailable. Quality measures, outcomes, and patient satisfaction are all certain to be impacted by these new legal rights to deny care.

Lastly, the express language of the new law subordinates existing state professional licensure agency regulations, as the law grants immunity from disciplinary actions to licensed providers who exercise such new rights. Even when the denial or refusal to provide services violates existing practice standards or conflicts with established grounds of discipline, such as those governing the applicable standards of care, prohibitions on abandonment, or obligating licensed providers to conform to professional ethics or non-discriminatory treatment, no discipline may be taken, regardless of outcome or injury to patients. In short, medical practitioners exercising such rights based on their moral, ethical, or religious beliefs will be exempt from the existing standards of care and disciplinary grounds regardless of potential harm to patients under the new law.

These provisions were added to the budget bill in the late stages of the budget process and were signed into law by Governor Mike DeWine on July 1, 2021.

If you have any questions or concerns regarding these new provisions from Ohio’s budget bill, please contact your Dinsmore Health Care attorney.