Religious Freedom vs. Health care Access: How Faith Influences Health Care in Washington and Idaho

By Emma Maple | FāVS News

This is the final in a three-part series on the American Atheists Report and how it relates to the Inland Northwest. Read part one here and part two here.

The Idaho state Legislature is currently embroiled in an ideological battle on whether to allow health care professionals and entities to opt out of participating in nonemergency procedures that would violate their sincerely held moral and religious beliefs. 

House Bill 59, or the Medical Ethics Defense Act, has advocates on both sides. Bill cosponsor Sen. Carl Bjerke, R-Coeur d’Alene, said the proposed legislation is intended to protect health care professionals freedom of conscience, according to the Idaho Capital Sun. 

Sen. Ron Taylor, D-Hailey, is on the other side of the aisle, however. He said the bill confuses the relationship between an individual’s personal conscience and their professional duty as a health care provider. 

This bill highlights the complicated considerations that arise when religion intersects with health care, and these conversations are not limited to solely freedom of conscience issues. The 2025 American Atheists 2025 State of the Secular States report examines how religion might impact health care across a variety of policies including hot-button issues such as abortion, transgender care, medical aid-in-dying and more. 

American Atheists’ President Nick Fish said that policies surrounding these issues are especially topical in rural communities such as eastern Washington and northern Idaho, where health care providers may be few and far between. 

Abortion

Policy around abortion often highlights how religious influence comes into play in health care decisions. After Dobbs v. Jackson left abortion rights up to state legislatures in 2022, that issue has quickly risen to the top of importance for many religious groups. . 

While Idaho has had an almost total abortion ban since 2022, they have been legal in Washington ever since 1970, when voters legalized basic access via a state referendum. 

Since then, Washington’s Legislature has taken further steps to protect access to abortion such as through HB 1496. This shield law protects health care providers, patients and their families who provide or receive care for abortions in the state, regardless of whether the procedure is restricted in other jurisdictions. Since the Dobbs decision, researchers found a 50 percent increase in the number of out-of-state patients coming into the state to receive an abortion, largely from Texas and Alaska. 

Yet, despite increased protections for abortions, religious providers in Washington are allowed to refuse providing abortions due to religious beliefs. 

Providence, a Catholic-based health care system and the largest provider in Washington, said that each person’s situation is evaluated on a case-by-case basis when considering an abortion. 

“When it comes to complex pregnancies or situations in which a woman’s life is at risk, our clinicians exercise their best medical judgement and provide all necessary interventions to protect and save the life of the mother,” senior communication specialist Jen York said. 

However, Providence also follows the Ethical and Religious Directives (ERDs) for Catholic Heath Care Services. One of its principles states that abortion is never permitted. 

Transgender care

Access to and provision of transgender health care services is another issue where religious beliefs often bar individuals from providing that care. 

“Denying care to trans people, turning people away from being prescribed contraception,” Fish said. “Your job is to fulfill the subscription, it’s not to pass religious judgement.” 

Idaho has a trans youth health care ban, while Washington offers confidentiality and provider protections for individuals receiving trans care. 

At Providence, York said that care for transgender patients is highly specialized, and the hospital will, “provide the same range of evidence-based services to patients experiencing gender incongruence as it would to others, including medications and surgical care.” 

“When patients require providers with medical experience beyond what’s available at Providence, we ensure a safe transition of care to those providers, as needed,” she added. 

Other types of care

While transgender care and abortion are the most obvious issues in which religion and mainstream health care often disagree with each other, there are a number of other smaller issues, as well. 

One of these is medical aid-in-dying, which Idaho does not allow but Washington does. These laws permit a terminally ill, mentally competent adult to request and obtain medication for a peaceful death. 

Medical aid-in-dying goes directly against Catholic EDR’s, however. York said Providence’s end of life care is “grounded in respecting the sacredness of life, honoring each person’s inherent dignity and worth and providing compassionate care to dying and vulnerable people.” 

“As a Catholic health care organization, provider-assisted death conflicts with our values,” York wrote, noting that Providence aligns with the American Medical Association in the belief that “provider-assisted death is fundamentally incompatible with the provider’s role as healer.” 

In addition to abortion, both Washington and Idaho allow health care providers to refuse care related to contraception and sterilization, among other things. 

These freedom of conscience rules can impact those in rural communities to a greater degree, according to Fish. If someone in Seattle is denied medication, they can just walk a block to find a Walgreens or a CVS. 

“If you’re in eastern Washington, northern Idaho, where’s the nearest pharmacy?” Fish said. 

One of American Atheists’ goals, according to Fish, is to ensure there are no “massive loopholes [in the law] that end up hurting people, especially people in rural communities who bear the brunt of these…How dense of a place you are really makes a big difference.” 

States’ environment

Often, state laws surrounding the intersection of health care and religion are somewhat determined by the state’s political environment, according to Fish. 

In Washington, this has led to greater separation of religion and health care. In Idaho, religion and health care are much more intertwined, largely due to advocacy from Christian nationalists, Fish said. 

“These laws enact a regime of terror on people who are just trying to access health care and doctors who are using sound medical judgement,” he added. 

However, those from a religious perspective often believe it is a religious necessity to have greater freedom to choose whether to provide certain services – and they’re often willing to fight for it. 

“Religion in health care is pretty interesting,” Pete Serrano, Silent Majority Foundation (SMF) director and general counsel, said. 

SMF, a Pasco-based organization which advocates for constitutional rights in Washington, has several lawsuits in support of both private and public employees who have been penalized for standing on their religious beliefs. 

“Even those private employers who have a theological or a religious foundation still let go of people for their exercise of their religious beliefs,” Serrano said. 

However, those from a non-religious background, such as American Atheists, often advocate for greater separation between religion and health care. 

“The religious beliefs of others should never interfere with a person’s ability to access essential health care,” the American Atheists report read.