The House Public Health Committee today declined to endorse SB 289 which allows a medical practitioner, healthcare institution, or health insurance payer not to participate in a healthcare service that violates their conscience.
The vote was 8 for to 10 against, with Rep. Jim Dotson not voting and Chair Jack Ladyman abstaining.
An extensive presentation for the bill was followed by abbreviated public testimony, but it included heavyweight opposition from a former Supreme Court justice, UAMS and the Arkansas State Chamber of Commerce.
Testimony included support from Surgeon General Gregory Bledsoe, speaking individually, who opposed the legislation in 2017. Since then, he said, circumstances have changed. Bledsoe, a candidate for lieutenant governor, said he saw no problem needing a solution then. Now, he said, said he feared federal intervention to force providers to do procedures they oppose.
He spoke specifically of surgery involving sex change, such as mastectomies for transgender men, and genital surgery for children. He said doctors fear refusing services because of the potential loss of federal money.
He said the bill applied only to procedures and did not discriminate broadly against groups of people as has been argued. He said he wouldn’t think people seeking such procedures would want to have a physician forced to perform something to which they might object.
Stephanie Nichols, a Jonesboro lawyer who represents a conservative Christian legal group, also injected the issue of pressuring people to prescribe contraceptives or abortions.
She argued the bill is “content-neutral,” though she acknowledged it doesn’t guarantee a right to procedures should a provider or institution refuse them. She said the “free market” should take care of that. She emphasized repeatedly that it applies only to service.
There’s a moral clause in federal law, but Nichols noted the state proposal provides a way for people forced to provide services to file a claim for damages and seek injunctive relief. Another witness, Louis Brown, an anti-abortion Republican lawyer who heads a national Catholic nonprofit, said a state law would force health providers to pay closer attention to the moral protection already provided in federal law.
Nichols defended including health institutions as a liability protection and said she doubted most “secular” insurance companies would likely continue to cover a full range of procedures.
Rep. Michelle Gray (R-Melbourne), the supervisor of a urology clinic, pressed Nichols on comparing the Arkansas proposal to one in Mississippi, where some specific language protecting minority groups is included. She contended the law would prevent her from firing a nurse who refused to work with male genitalia.
Rep. Justin Boyd, a Republican pharmacist from Fort Smith, said he was concerned about unintended consequences. Why make the bill so broad, rather than identifying specific procedures, he asked.
Boyd also raised questions about a small business with an inability to move employees around in, say, the case of an employee who refused to administer a vaccination developed from cell lines originally derived from aborted fetuses (COVID vaccine today, for example). To provide coverage for economic necessity would “gut” the bill, Nichols said. She said it was an unlikely scenario.
Rep. Jim Dotson (R-Bentonville) also noted the bill doesn’t require a physician to provide other medical services should they object to one specific service. Nichols claimed that was just a given. But Dotson said the words in the statute don’t provide that.
Former Supreme Court Justice Annabelle Imber Tuck was among witnesses against the bill. She said it was a ‘complete erosion of all patient rights.” Patients are entitled to no information, she said. It overrides all licensing requirements and standards of praz\ctice. Patients have no redress when denied. It is devoid of any patient protection and it is an open invitation for doctors to discriminate based on group membership, she said. “This is a bill that is totally out of balance between patients’ rights and medical providers.”
Dr. Johanna Thomas, a licensed social worker, said the state is medically underserved already. “If this bill becomes law we’ll have an even more difficult time recruiting health care providers.”
Sarai Portillo of Arkansas United opposed the bill. She said Spanish-speaking people already face discrimination in medical services and she feared this bill would worsen such discrimination.
Dr. Tom Van Hook, representing emergency physicians, says the bill was too broad. It would, for example, allow refusal of an initial examination. How can you do that without discriminating, he asked. He said the law “is not ready for prime time.”
Randy Zook of the Arkansas State Chamber of Commerce spoke against the bill listing three points: 1) concerns by major employers, specifically Walmart and Tyson. It would put in question whether employees will be able to get needed medical attention. It is “profoundly disturbing” to these employers, he said. 2) It would fundamentally alter the relationship between employers and employees, and 3) the bill is too broad.
Maurice Rigsby, vice chancellor at UAMS, opposed the bill because of unintended consequences. For one, it lacks a duty to refer patients if a provider refuses to provide a service. For another, the law is flawed for lack of specific definitions.
Testimony was cut off af5er almost two hours by a motion for immediate consideration. A bipartisan group opposed approval of the bill — three Democrats and seven Republicans.