Religious Freedom Moves to the Center of Federal Health Policy

A recent report found that one area where religious discrimination shows up most is vaccines.

The Trump administration is putting religious freedom at the center of federal health policy.

Last week, the Department of Health and Human Services announced a reorganization of its Office for Civil Rights, putting conscience and religious freedom protections at the top of its agenda.

The announcement came two days after President Trump’s Religious Liberty Commission released a new report that repeatedly names abortion, vaccines, and the medical mutilation of minors as flashpoints for religious freedom.

Under the reorganized HHS office, federal agencies, state and local governments, healthcare providers, and health plans must now prioritize “protecting the free exercise of religion and conscience and the right to be free from coercion in HHS-conducted or funded programs.”

An HHS official said the new structure is about protecting conscience rights, addressing race-based discrimination in a color-blind manner, combating both antisemitism and anti-Christian bias, and restoring biological truth.

A Startling Pattern

The changes follow a recent report from the Religious Liberty Commission, which found widespread violations of religious freedom in healthcare. The Commission collected hundreds of written testimonies from families who say they were punished for their faith.

One area where religious discrimination shows up most is vaccines. The Commission found that schools excluding unvaccinated religious children are not necessarily enforcing 100 percent vaccination. The same schools let in students with medical exemptions, and even students with no medical records at all. Meanwhile, several states quietly wiped out religious exemptions for schoolchildren while leaving comparable secular exemptions in place.

The Supreme Court has not ruled directly on religious exemptions to school vaccine mandates. But in Mahmoud v. Taylor, the Court decided that states cannot condition access to public education on parents sacrificing their religious beliefs.

The Costine Family: Seven Years and Counting

For Nancy Costine and her husband, Roman Catholic faith shapes nearly every decision they make, including how they’ve raised their two daughters. Like many religious families, they clashed with the standard vaccine schedule. After their first daughter, Isabelle, was born, Nancy started researching vaccine development and found manufacturing practices — including the use of certain animal and human cell lines — that conflicted with her family’s beliefs.

For more than 50 years, New York’s public schools honored religious exemptions to vaccination requirements. That ended in 2019, the same year Isabelle turned seven, when the state repealed the exemption outright. Nancy and her husband were left with an impossible choice: violate their faith, or pull their daughters out of the schools they’d grown up in.

The fallout went well beyond lost classroom time. Nancy told the Commission that lawmakers “questioned the sincerity of our beliefs and disparaged our children,” even calling the family’s convictions “utter garbage.”

Isabelle testified that children with religious exemptions were compared to “criminals bringing weapons into school.” Meanwhile, the same schools kept admitting students with medical exemptions and no medical records on file — proof, the family said, that the policy was never really about vaccination rates.

With no other option, Nancy started homeschooling her daughters. Despite her efforts, both girls felt cut off from friends and teachers. Eventually the family enrolled the girls in a private religious school across state lines, a decision that upended their finances.

“We drive three hours every day to give them the opportunity to go to school,” Nancy said. Their district wouldn’t provide bus service, so the family absorbed steep transportation costs on top of tuition they never budgeted for. Nancy could no longer work full time, giving up more than a third of the household’s income and any real shot at career advancement. “The amount of money and salary, retirement, and benefits that have been lost due to the religious exemption repeal will never be recovered,” she said. “The relentless worry has negatively affected my health.”

Their daughters, banned from school grounds, were also shut out of school camps and sports, even as the family kept paying local school taxes. “Families should not be forced to sacrifice education, employment, privacy, financial stability, and the peaceful enjoyment of life in order to maintain religious convictions as they raise their children,” Nancy said.

Seven years later, the Costines still haven’t been let back into New York’s public schools.

Karen Amigon: A Single Mother’s Choice

Karen Amigon is a single mother raising her seven-year-old daughter in Los Angeles. She’d like to send her daughter to public school. She can’t. As she told the Commission, her daughter “is not allowed to attend school because of our family’s sincere religious beliefs regarding medical decisions.”

Karen’s objection to certain vaccines is rooted in faith. That wouldn’t always have cost her daughter a public education. But in 2015, California scrapped the religious exemption to its school vaccine requirements, mandating the full vaccine schedule for every student, public or private, with no exceptions for faith..

Now homeschooling is her only option. She’s found real blessings in the extra time with her daughter, but also real strain. Working full time as a single mother while teaching her daughter at home has meant nights spent, in her words, “quietly praying and wondering how we would make it financially.”

The emotional weight is its own burden. “Many mornings, my daughter sees the children with their backpacks walking to school,” Karen said. “Sometimes she watches them and asks me why she cannot go to school like the other children.” She added: “How do you explain to a child that something as simple and ordinary as going to school is not available to her because her mother followed her conscience and her faith when making healthcare decisions for her child?”

Dr. Aaron Kheriaty: From the Operating Room to the University

For Dr. Aaron Kheriaty, questions of conscience in medicine didn’t start with COVID-19. They started years earlier, in a hospital operating room, when he was a medical student on a labor-and-delivery rotation.

A patient in labor had agreed to an additional sterilization procedure. Kheriaty asked for an exemption. “I informed the resident physician that while I was willing to assist on the cesarean section, I would need to step out of the operating room and not help with the tubal ligation as a matter of conscience,” he told the Commission.

The resident’s reaction was immediate and hostile. “How dare you impose your views on the patient?” she asked, according to Kheriaty. “I replied that I was imposing nothing on anyone,” he said.

He was pulled from the case, faced retaliation for the rest of the rotation, and carried negative evaluations into his residency applications. He didn’t even know at the time that federal law protected his right to decline. “These laws were actually in place when I went to medical school, but I had no understanding of them,” he said. “I was never advised of my rights even after they were violated.”

Years later, the same fight resurfaced in a different form. As director of the Medical Ethics program at the University of California, Kheriaty grew alarmed by the university’s proposed COVID-19 vaccine mandate. He published an op-ed in The Wall Street Journal calling the mandate unethical — then challenged it in federal court when the university adopted it anyway.

The university’s response came fast. “They placed me on what they called investigatory leave, then a month later on unpaid suspension. Then a month after that, they fired me,” he told the Commission. He’d spent more than a decade at the university and won multiple teaching awards along the way.