Regulations - Conscience


HHS Regulations

Conscience regulations

2008 conscience rule


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Health professionals' comments on need for

2008 proposed rule

2011 conscience rule*


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analysis of

2011 rule

2019 conscience rule*


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comment on

2019 proposed rule

*While the  2019 conscience protection rule by the U.S. Dept. of Health and Human Services (HHS) is in litigation, the 2011 rule remains in effect:

Becket announced in December 2019 the intent to appeal a New York federal court's ruling against the 2019 reg.


The HHS Office of Civil Rights "will continue to receive and investigate complaints:"  Read more...

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Becket news release - 2019 conscience rule court decision appeal

Gender Regulations

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After a court case, HHS moved to change its policy regarding 2016 gender identity (transgender mandate) provisions


In 2016, the U.S. Dept. of Health and Human Services (HHS) issued a rule under Obamacare that attempted to stretch the definition of sex discrimination beyond biology, to include a person's perception of gender. The rule subjected health professionals to punishment if they declined on the basis of morality or medicine to participate in transgender procedures and prescriptions.

In 2019, HHS explained the rule that had been promulgated by the previous administration:

Although Congress prohibited discrimination on the basis of sex in 1972 (Title IX), and Section 1557
applied that law to healthcare and the Exchanges established under the ACA, HHS’s 2016 Section 1557
regulation redefined discrimination “on the basis of sex” to include gender identity and termination of pregnancy and defined gender identity as one’s internal sense of being “male, female, neither, or a combination of male and female"
[emphasis added]. 

A court case (Franciscan Alliance, Inc. et al. v. Burwell,) challenged the gender portion of the rule. A federal court in 2016 issued a preliminary injunction that stopped implementation of that portion of the rule. In 2019, the court finally vacated (made void, annulled) the gender portion of the rule.

Text from HHS website:

On December 31, 2016, the U.S. District Court for the Northern District of Texas issued an opinion in Franciscan Alliance, Inc. et al v. Burwell, enjoining the Section 1557 regulation’s prohibitions against discrimination on the basis of gender identity and termination of pregnancy on a nationwide basis. Accordingly, HHS’ Office for Civil Rights (HHS OCR) may not enforce these two provisions of the regulation implementing these same provisions, while the injunction remains in place. 

To comply with the court's decision, in May 2019, HHS issued a proposed rule to revise the 2016 rule regarding gender identity provisions:

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Equal treatment rule enacted

HHS Announces Joint Final Rule Regarding Equal Treatment of Faith-Based Organizations in HHS-Supported Social Service Programs

HHS news release: December 14, 2020 - Today, the Department of Health and Human Services (HHS) announced a joint final rule with eight other agencies—the Department of Justice, the Department of Homeland Security, the Department of Labor, the Department of Education, the Department of Housing and Urban Development, the Department of Agriculture, the Agency for International Development, and the Department of Veterans Affairs—to implement President Trump’s Executive Order No. 13831, on the Establishment of a White House Faith and Opportunity Initiative (May 3, 2018).  This rule ensures that faith-based and secular organizations are treated equally in HHS-supported programs, and it clarifies that faith-based organizations do not lose their legal protections and rights just because they participate in federal programs and activities.  
“Faith-based organizations, Americans of faith, and civil society organizations play a vital role in providing Americans with access to healthcare and human services,” said HHS Secretary Alex Azar. “This new rule reflects the commitment President Trump has upheld during his time in office to protect the religious freedom and conscience rights of all Americans, including those who receive support from federal programs to do their good work.”

Read final rule

Title X Family Planning rule


Contraceptives Mandate

Labor Regulations


DOL proposes religious freedom
protection rule

News Release - U.S. Department of Labor | August 14, 2019

U.S. Department of Labor Proposes a Rule Clarifying Civil Rights Protections for Religious Organizations

WASHINGTON, DC – The U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) announced a Notice of Proposed Rulemaking intended to clarify the civil rights protections afforded to religious organizations that contract with the federal government. The proposed rule ensures that conscience and religious freedom are given the broadest protection permitted by law. The proposed rule is currently available for public inspection and will be published in the Federal Registertomorrow, August 15, 2019. Read more...


Read Dept. Labor proposed rule

Education Regulations


Education rule seeks to

protect student rights

U.S. Secretary of Education Betsy DeVos Announces Proposed Rule Regarding Equal Treatment of Faith-Based Education Institutions, Provides Updated School Prayer Guidance
JANUARY 16, 2020 U.S. Dept. Ed. news release: Today, U.S. Secretary of Education Betsy DeVos announced that the Department of Education is taking several concrete actions to protect religious liberty and ensure the Department is acting in accordance with the First Amendment. The Department announced a proposed rule ensuring the equal treatment and constitutional rights of religious organizations and faith-based institutions, as well as First Amendment freedoms owed to students on campus. As directed by Congress, the agency will also release updated guidance regarding constitutionally protected prayer in schools. Read more...