One year ago, millions of women around the country were readying their hand-drawn signs, hand warmers, and pink hats for what would be widely reported as the largest demonstration in U.S. history.

Driving these women — and more than a few of their allies — were the policy goals outlined by the Trump-Pence administration to control women’s bodies, go after immigrants and people of color, attack LGBTQ people, and take away health care.

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Over the last year, the administration has issued rules to eliminate the guarantee of birth control coverage, which more than 62 million women benefit from as well as expanded the global gag rule, an action that has been shown to increase maternal mortality and morbidity around the globe.

The administration has also eliminated protections for survivors of sexual violence; encouraged states to prevent patients from accessing care at Planned Parenthood health centers; and repeatedly attempted to unlawfully deny abortion access to young, undocumented women — whom the administration has detained.

That’s why the Department of Health and Human Services (HHS) announcements this week that it’d taken new, significant steps to block access to care for women, LGBTQ people, and other marginalized people was extremely disturbing — but not shocking.

It was clearly part of a concerted agenda. The Trump-Pence administration turned its national Office of Civil Rights (OCR), housed under HHS, whose mission it is to protect people throughout the country from discrimination, into an office that gives health care workers a license to discriminate.

First, on Thursday, the administration created a division within OCR — ironically — to ensure that patients can be denied access to basic health care and information based on health care workers’ personal beliefs.

They even went so far as to change OCR’s mission statement to make it clear that the administration’s priority is to permit discrimination against patients for a variety of reasons, including their gender identity, sexual orientation, or decision to access a safe, legal abortion.

Then, on Friday, the administration issued an expansive proposed rule that would allow providers and other health care workers to deny access to basic health care services, including — though certainly not limited to — transgender health services, abortion, and even birth control.

Women, people of color, and LGBTQ people already experience barriers to care. For example, in 2015, according to the U.S. Transgender Survey, 33 percent of respondents who sought health care in the last year experienced mistreatment because they were transgender — and nearly one-quarter avoided seeking health care when they needed it out of fear of discrimination.

Black women already receive disparate care compared to their white counterparts, and face a significant number of barriers to health care due to systemic racism and sexism. This new move by the administration means that black women’s lives could be at stake. Women like Tamesha Means, who was rushed to Mercy Health Partners in Muskegon, Michigan after her water broke at 18 weeks of pregnancy.

She was sent home twice in excruciating pain despite the fact that there was no chance that her pregnancy would succeed, and that continuing the pregnancy posed significant risks to her health. Due to its Catholic affiliation, the hospital said there was nothing it could do for Tamesha and neglected to tell Tamesha that terminating her pregnancy was an option and the safest course for her condition.

Medical groups have recognized the negative effects refusal laws can have on patients and have called for patient protections when religious refusals may compromise care. In fact, the American College of Obstetricians and Gynecologists (ACOG) has affirmed that providers should not be able to deny people care if it negatively affects a patient's health, if their decision is based on false information, or if it creates or reinforces racial or socioeconomic inequalities.

This is not about health care workers’ rights and this is certainly not about patients’ health care needs. This is about continuing to push the administration’s agenda. The Trump-Pence administration has just turned the agency in charge of protecting the health of all Americans into one that will devote its resources to deny essential, potentially life-saving care to people of all identities.

People have the right to be able to trust that health care providers will provide the best care possible, not worry that they may instead impose their private, religious beliefs on their patients.

Jamille Fields is a senior policy analyst at Planned Parenthood Federation of America.