The governor of Ohio has signed a bill that allows doctors to refuse medical care to LGBT+ patients if they have an objection based on “moral” grounds.

The provision was buried in a 700-page document of last-minute amendments to the state’s two-year budget bill, which governor Mike DeWine approved last Wednesday (30 June).

t allows any medical provider – from doctors and nurses to researchers, lab techs and insurance companies – “the freedom to decline to perform, participate in, or pay for any health care service which violates the practitioner’s, institution’s, or payer’s conscience as informed by the moral, ethical, or religious beliefs”.

This sweeping religious exemption raised major red flags for LGBT+ and women’s rights groups, with multiple advocates in the state expressing serious concern.

“Today governor DeWine enshrined LGBTQ discrimination into law, threatening the medical well being of more than 380,000 LGBTQ people in Ohio, one of the largest LGBTQ populations anywhere in the country,” said Human Rights Campaign president Alphonso David in a statement.

“Medical practitioners in Ohio can deny care or coverage for basic, medically-necessary, and potentially life-saving care to LGBTQ people simply because of who they are.”

The sinister religious exemption came as a surprise to many, as it wasn’t one of the many initiatives in the budget bill that were highlighted on the governor’s website.

“They know that they couldn’t pass this on its merits as a standalone bill, because literally no one is asking for this to be passed,” Dominic Detwiler of Equality Ohio told the Columbus Dispatch.

Sure enough, the law is overwhelmingly opposed by the state’s medical community, as underlined in a letter to budget negotiators signed by the Ohio Hospital Association, the Ohio Children’s Hospital Association, the Ohio State Medical Association, and the Ohio Association of Health Plans.

“The implications of this policy are immense and could lead to situations where patient care is unacceptably compromised,” they warned.

Yet governor DeWine defended the bill, pointing out that it only permits a refusal of care in cases of “conscience-based objections to a particular health care service”.

He insisted the conscience clause will change very little, and claimed that no one in Ohio will be discriminated against.

“This simply puts in statute what the practice has been anyways,” he said. “Let’s say the doctor is against abortion, the doctor is not doing abortion. If there’s other things that maybe a doctor has a conscience problem with, it gets worked out, somebody else does those things.”

Here he referred to a loosely-written clause which requires that the medical professional – when possible – “attempt to transfer the patient to a colleague who will provide the requested procedure,” as long as making that referral doesn’t violate their conscience as well.

But Dr Todd Kepler, southwest medical director of Equitas Health, said the “widely broad” language in the bill will exacerbate existing barriers to care for many marginalised groups, like drug addicts, people living with HIV, and the LGBT+ community.

It’s people like these, already living with few options for healthcare in their community, that would be hit the hardest.

“Say I happen to be a gay patient and I wanted to see a provider in my town, and there weren’t really any other providers in town. But they find that morally unacceptable, they could turn me away,” he said to WCPO.

“And the language is so broad that that could even be done at an institutional level. So, if you have a hospital that perhaps has an affiliation with a religious institution, and again, that happens to be the only institution in town, theoretically they could turn that patient away for health care.”

As Randy Phillips of the Greater Dayton LGBT Centre added, “It begins a slippery slope when we start picking and choosing who we can treat and who we don’t want to treat.”

He asked: “How many are going to be denied care simply because they are living authentically?”