"We are delighted that Sen. Johnson independently put the amendment in the legislation," said Mike Gonidakis, president of Ohio Right to Life. "We think it's fantastic."
The intent behind the conscience clause is not to attack anyone or anything, said Senate leadership, but to defend individual rights from government overreach.
"It’s disturbing that we’ve watched big government bureaucrats try to force health care organizations and doctors into providing services they didn’t offer because of... religious reasons," said John Fortney, spokesperson for the Ohio Senate GOP. "This simply makes it clear, that the First Amendment matters, and bureaucrats should respect the Constitution.”
At least a dozen other states have enacted medical conscience clause laws. There's also already similar protection on the federal level, but Johnson's amendment really solidifies those protections in Ohio, said Gonidakis.
"We needed this to ensure on the state level that our state-licensed medical professionals... whoever it may be, can sleep well at night, knowing that they don't have to wake up the following day and do something that violates a deeply held religious belief," he said.
Gonidakis said he wasn't aware of instances in Ohio where a doctor had to perform an abortion or other service against his religious beliefs, but it was better to be proactive than reactive.
However, Jaime Miracle, deputy director of NARAL Pro-Choice Ohio, sees the clause as a more intrusive and broader version of existing federal rules, which she said is enough.
"This bill creates even more places that can put people's health and life in danger. This is a direct risk for the health of Ohioans," she said.
For instance, health insurance companies, despite not practicing medicine, are included in the proposal. A biller might be able to refuse to fulfill a claim for a service on moral grounds, she said. She also criticized the clause for not compelling doctors to find another physician to perform the service for the patient, only making that move optionable.
And there's the legal immunity aspect, too.
Miracle worries that if passed, access to birth control could be significantly limited if any pharmacist has the right to question a person before providing certain pills or medication. She wonders, too, about situations where abortion is necessary to save a woman's life.
"This doesn't apply to the duty of a physician to provide life-saving care," countered Gonidakis. "So that's specifically in the amendment so that you can take away that worry or fear."
Concerns among LGBTQ Ohioans
LGBTQ advocates fear the clause could repeat the experience of businesses refusing to provide services for LGBTQ couples and individuals.
"It's another way, another opportunity for health care providers to discriminate against LGBTQ people," said Detwiler, with Equality Ohio. "Seeing the Senate kind of encourage people to discriminate against others is really just not the right direction."
Aaron Baer, president of the Center for Christian Virtue, said that's not the case.
Medical professionals could decline to perform a procedure, not decline to treat a specific patient. Baer said no doctor could deny a patient medical treatment because they are LGBTQ.
"It focuses on the procedure not the person," he said. "It’s actually insane what they are saying. If you deny someone a service because he is gay, you have no protection under this."
Detwiler argued that it's more complicated than that, noting that there are specific health services disproportionately needed by the queer community. Less physical health services, such as marriage counseling or mental health, could also be denied.
"The person might not be saying, 'I'm discriminating against you, because you're LGBTQ,'" he said. "But a person being LGBTQ and having HIV could give that doctor a reason to not treat them for HIV."
Surgical transition procedures for transgender Ohioans would also seem uniquely targeted by the conscience clause, though Detwiler thinks the impact is minimal given those offering such procedures probably aren't morally objectionable to it.
He also said the shield from lawsuits would be damaging to accountability for any possible discrimination that could occur. But that shield is something advocates on the other side believe strengthens the power and intent of the clause.
Health insurance industry opposes it
The state association representing hospitals is still looking into the conscience clause and its impacts, a spokesperson said. The head of the Ohio State Medical Association, representing physicians, could not be immediately reached.
It seems, though, that most health insurance companies in Ohio have no active intent of taking advantage of the conscience clause if it becomes law.
"We believe the policy could prohibit individuals from getting the care they receive when they need it," said Dan Williamson, representing the Ohio Association of Health Plans , which opposes the clause. "It's their business model to ensure people who are enrolled in plans get access to care."
The Ohio Psychological Association, in past statements , has indicated that they aren't a fan of legislation like Sen. Johnson's.
Will the conscience clause stay in the final version of the state budget bill, to be hashed out between the Senate and House by the end of June? Gonidakis is betting yes, especially with Republican supermajorities.
"We will always in the future at Ohio Right to Life... during budgetary season, or just during regular legislative session, ensure that no one ever tinkers with the Johnson amendment," he said if it becomes law. "We have to have that on the books."
Titus Wu and Jessie Balmert are reporters for the USA TODAY Network Ohio Bureau, which serves the Columbus Dispatch, Cincinnati Enquirer, Akron Beacon Journal and 18 other affiliated news organizations across Ohio.
