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NWLC and CRR Filed FOIA Requests Seeking Transparency on HHS’s Refusal of Care Agenda
NWLC and CRR Filed FOIA Requests Seeking Transparency on HHS’s Refusal of Care Agenda
Why It Matters
The Trump administration is taking steps that could expand the reach of refusal of care laws that embolden health care providers to deny care based on personal beliefs, not patient’s best interests, including by considering new rules and restructuring the U.S. Department of Health and Human Service’s (HHS) Office for Civil Rights (OCR) to revive a division focused on so-called “conscience rights.” These actions could put patients’ access to essential care at risk, particularly for people seeking abortion and other pregnancy-related care, LGBTQI+ patients, and people already facing barriers to health care. NWLC and our partners are fighting for transparency into who is shaping these policies, why HHS is prioritizing them, and how they could affect patients’ rights.
Summary
In September 2026, the National Women’s Law Center and the Center for Reproductive Rights filed two Freedom of Information Act (FOIA) requests seeking answers from HHS about the Trump-Vance administration’s renewed focus on federal refusal of care laws, which encourage health care providers to deny essential care to patients because of personal objections to that care. One request seeks records about how HHS is handling complaints related to these laws. The other seeks records about HHS’s restructuring of OCR, including the re-establishment of a Conscience and Religious Freedom Division first created during the first Trump administration.
Together, the requests seek to uncover how HHS is identifying, reviewing, investigating, and resolving refusal of care complaints; why the agency decided to restructure OCR and allocate staff and resources to the revived division; and whether outside organizations or political actors influenced these decisions. The requests come as HHS is considering new regulations that could expand the scope of these laws even though similar regulations adopted during the first Trump administration were struck down by federal courts.
A broad interpretation of these laws could pose significant challenges to equitable health care access. Ideologically motivated actors have relied on overexpansive interpretations of federal refusal of care laws to defend discriminatory denials of care, information, and referrals based on personal beliefs—particularly against people seeking abortion, other pregnancy-related care, and care for LGBTQI+ patients. When providers are emboldened by the administration to refuse care in this way, they can worsen health outcomes, deepen existing disparities, violate federal protections against discrimination in health care, and create confusion about providers’ responsibilities in urgent situations.
What these FOIA Requests Seek
The requests seek records that would help the public understand:
- How HHS is defining, tracking, reviewing, and resolving refusal of care complaints.
- Why HHS decided to restructure OCR and re-establish the Conscience and Religious Freedom Division.
- How staff, funding, and resources are being allocated to this revived division.
- Whether outside organizations or political actors influenced HHS’s refusal of care agenda.
- Why HHS is prioritizing this issue now, despite the risks to patients’ access to care and OCR’s broader civil rights enforcement responsibilities.
