December 11, 2003
Introduced by Senators Bill Hardiman - (primary) Tony
Stamas, Wayne Kuipers, Jim Barcia, Jason Allen, Mike Bishop, Cameron Brown
Referred to the Committee on Health Policy. See
Bill Analysis: Committee Summary
A bill to amend 1956 PA 218, entitled "The insurance code of 1956," (MCL
500.100 to 500.8302) by adding section 3406r.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 3406r. (1) Notwithstanding any other provision of law, a health
maintenance organization and a health insurer may refuse to offer or provide
a health care benefit that violates an ethical, moral, or religious
principle reflected in its articles of incorporation, bylaws, or an adopted
(2) A health maintenance organization and a health insurer shall not
refuse to offer or provide a health care benefit under subsection (1) if the
benefit is specifically covered under the contract, policy, or certificate.
(3) A health maintenance organization and a health insurer's refusal to
offer or provide a health care benefit under subsection (1) shall not be a
basis for 1 or more of the following:
(a) Civil, criminal, or administrative liability.
(b) Eligibility discrimination against the health
maintenance organization or health insurer in providing a contract, policy,
or certificate where offering or providing the health care benefit is not
expressly required as a condition of eligibility.
Senate Bills 894, 895, and 896 (as introduced 12-11-03)
Sponsor: Senator Tony Stamas (S.B. 894)
Senator Bill Hardiman (S.B. 895 & 896)
Committee: Health Policy
Date Completed: 9-21-04
Senate Bill 894 would create a new act to allow a health facility to
assert a conscientious objection to providing or participating in health
care services under certain circumstances.
Senate Bills 895 and 896 would amend the Nonprofit Health Care
Corporation Reform Act and the Insurance Code, respectively, to allow Blue
Cross and Blue Shield of Michigan (BCBSM), or a health maintenance
organization (HMO) or health insurer, to assert a conscientious objection to
providing a health care benefit.
The bills are described below in further detail.
Senate Bill 894
The bill would allow a health facility to refuse to provide or
participate in a health care service that violated an ethical, moral, or religious principle reflected in
its articles of incorporation or bylaws, or an adopted mission statement.
A health facility could not assert a conscientious objection if the
objection excluded an entire health profession, or if the objection were to a health care service the
facility routinely provided or participated in and was based on a disagreement with a member of
a health profession employed by, under contract to, or granted privileges by the
health facility regarding the medical appropriateness of a health care service for a
specific patient, if the patient had consented to the provision of the health care service.
A health facility would have to give notice of an objection to providing
a health care service through written public notice or personally at the time an individual sought
to obtain that health care service from the health facility.
A health facility's conscientious objection could not be a basis for
civil, criminal, or administrative liability; or eligibility discrimination against the facility
in a grant, contract, or program, if providing or participating in the health care service were not
required expressly as a condition of eligibility.
Under the bill, "health facility" would mean a health facility or agency
as defined in Section 20106 of the Public Health Code, a private physician office, or a public or
private institution, teaching institution, pharmacy, corporation, partnership, or sole
proprietorship that provides Page 2 of 2 Bill Analysis @ www.senate.michigan.gov/sfa sb894-896/0304
a health care service to an individual. (Under Section 20106 of the Public
Health Code, "health facility or agency" means an ambulance operation, aircraft transport
operation, nontransport prehospital life support operation, or medical first response
service; a clinical laboratory; a county medical care facility; a freestanding surgical
outpatient facility; an HMO; a home for the aged; a hospital; a nursing home; any of these
facilities located in a university, college, or other educational institution; a hospice; or a
hospice residence.) The bill would define "health care service" as the provision or withdrawal
of, or research or experimentation involving, a medical treatment, procedure, device,
medication, drug, or other substance intended to affect an individual's physical or mental
Senate Bills 895 & 896
Senate Bills 895 and 896 would allow BCBSM, or an HMO or a health
insurer, respectively, to refuse to offer or provide a health care benefit that violated an
ethical, moral, or religious principle reflected in its articles of incorporation or bylaws, or an
adopted mission statement. An HMO, a health insurer, and BCBSM could not refuse to offer or
provide a health care benefit that specifically was covered under the contract,
policy, or certificate.
A refusal by BCBSM, an HMO, or a health insurer to offer or provide a
health care benefit could not be a basis for civil, criminal, or administrative liability; or
eligibility discrimination against the entity in providing a contract, policy, or certificate if
offering or providing the health care benefit were not expressly required as a condition of
Proposed MCL 550.1409a (S.B. 895)
Proposed MCL 500.3406r (S.B. 896)
Legislative Analyst: Julie Koval
The fiscal impact of these bills is indeterminate. One could argue that
if a Medicaid client were denied a form of treatment or procedure, either the cost of that
treatment or procedure would be saved, or the denial or delay of that treatment or
procedure could lead to greater costs down the road.
Fiscal Analyst: Steve Angelotti