House Speaker Nancy Pelosi said that expanded permissions for health care providers to deny care based on religious or moral objections could be “downright deadly” for women and LGBTQ people.

Pelosi said the new rule grants “an open license to discriminate against Americans who already face serious, systemic discrimination” in a statement Thursday night.

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A final “conscience” rule unveiled by the Trump administration Thursday would expand the scope of moral and religious protections for workers and health care institutions that refuse medical services, such as abortion or reproductive health care to transgender people.

The regulation also grants the administration a more powerful toolbox to investigate non-compliance with the rule, refer cases to the U.S. Department of Justice and cut off federal spending to providers. President Donald Trump announced the regulation at a Rose Garden speech on Thursday in a ceremony timed to coincide with the National Day of Prayer.

“The final rule fulfills President Trump’s promise to promote and protect the fundamental and unalienable rights of conscience and religious liberty,” the U.S. Department of Health and Human Services said in a statement.

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But Pelosi lambasted the rule as “greenlighting open discrimination in health care against LGTBQ Americans” and “directly threatening the well-being of millions.”

“Since Day One, this Administration has waged a cruel campaign of intolerance and discrimination targeting the civil rights of our most vulnerable communities. House Democrats fully, flatly reject these attacks on LGBTQ Americans and on the rights of all Americans to get the health care they need and will fight these hateful actions,” Pelosi said.

Pelosi’s statement echoes the concerns of advocates at the Transgender Law Center and the American Civil Liberties Union.