This fact sheet was written by Kimya Forouzan. It was edited by Ian Lague.

Under a patchwork of federal and state laws, health care providers and institutions in the United States may refuse to offer health care services to which they have religious, moral or ethical objections. Most US states have enacted some type of care refusal law, although they vary in scope and limitations. In the realm of sexual and reproductive health, these laws are often specific to abortion, contraception, sterilization or gender-affirming care. However, some states also maintain statutes that permit refusal for any form of health care.

States with refusal laws vary in the type of health care providers allowed to opt out of offering care—some states specifically list the categories of providers, while some extend refusal provisions to all clinicians. Additionally, some states limit the types of medical institutions that are permitted to refuse care. While this table covers state statutes related to care refusals, state professional organizations also commonly issue guidelines on such refusals.

In addition to refusal laws, several states also have laws inspired by the federal Religious Freedom and Restoration Act (RFRA). The federal RFRA law creates a higher standard for government actions which substantially burden the exercise of religion, and has been used by clinicians and institutions to defend their refusals to provide or participate in certain kinds of sexual and reproductive health care. Since its passage, several states have also enacted state-level RFRA laws.