Any health care worker could refuse to provide treatment that violates his or her conscience under a bill pending in the state Senate.

It's a measure critics say could limit patient access to a host of services, such as abortion, contraceptives or care for transgender individuals.

Insurance companies also could refuse to pay in such cases under Senate Bill 90, sponsored by Sen. Stephen Meredith, R-Leitchfield.

Meredith said it is aimed solely at providing protection for health care workers under pressure to provide certain treatments or medication they oppose in a rapidly changing climate of medical advances.

"This is not intended to deny health care to anyone," Meredith, a retired hospital CEO, told the Senate Judiciary Committee at a Thursday hearing.

"We are advancing at warp speed," he said. "God only knows what the future looks like for life and death experiences."

Opponents, including Planned Parenthood, the state Fairness Campaign, the Kentucky Mental Health Coalition and the Kentucky Association of Sexual Assault Programs, argued it could curtail care for health services ranging from abortion and psychological counseling to treatment for rape victims.

"I think it's a bad bill, and its going to put discrimination into the statutes," said Sheila Schuster, a psychologist and executive director of the mental health group.

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Several health providers spoke in favor of the bill, including Dr. Steven House, a Glasgow physician who said doctors "should not be forced to participate in treatments that conflict with their morals, religion or their beliefs."

Dr. Lewis Hicks, a retired obstetrician and gynecologist, said he's still troubled by an abortion he assisted in as a young medical resident as part of cancer surgery on a pregnant woman. Hicks said he believed he had to assist despite "my conscience screaming at me."

But critics said the bill is so broadly written that anyone at any health care facility, including the receptionist at the front desk or the janitor cleaning the building, could object to allowing services for someone.

The bill allows "any person who may be or is asked to participate in a health care service" to refuse without fear of reprisal from the employer or civil liability. It also allows insurance companies that object to certain services to refuse payment.

Individuals may base objection on "religious, moral, ethical or philosophical beliefs or principles." Health insurance companies may refuse to pay based on "governing documents," according to the bill.

SB 90 also allows the individual to sue if they have been injured through disciplinary action, such as being fired or demoted over a refusal to provide a health care service.

And it includes students, such as medical residents or those studying nursing or psychology.

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SB 90 passed the Senate committee over objections of several members, including Sen. Robin Webb, a Grayson Democrat who said the language was so broad, almost anyone could refuse care for any service.

"I'm a hunter," she said. "What if I fall out of my tree stand and get somebody from PETA (People for the Ethical Treatment of Animals) that has a conscience objection to treating me?"

While Webb acknowledged some might find that example "laughable," it would be possible under SB 90.

Others who spoke against SB 90 raised more immediate concerns.

Sara Hall, with Planned Parenthood of Indiana and Kentucky, said the bill would allow a hospital receptionist who objects to ending pregnancies to turn away someone experiencing a miscarriage.

A pharmacist could refuse to dispense birth control medication, and an insurance company employee could refuse to process payments for vaccinations based on individual beliefs, she said.

Jeremy McFarland, of Louisville, a transgender man, said he experienced great difficulty finding a therapist as a teenager in Southern Kentucky when he began having suicidal thoughts. Later, when he began his transition, a local pharmacist stopped filling his prescriptions, he said.

"I remember feeling so ashamed," he said. "When you're denied health care, you're being denied your dignity."

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Laela Kashan, a staff lawyer with the Kentucky Association of Sexual Assault Programs, said her organization sees potential problems in treatment for rape victims.

Some Kentucky hospitals in the past have turned away such patients, saying they are not equipped to perform examinations for sexual assaults even though they are not supposed to do so under state law

"This happens already," said Kashan, who said her organization is working with hospitals to improve access in such cases.

Chris Hartman, with the Fairness Campaign, which advocates for LGBTQ rights, said Kentucky law already included protections for people based on religious beliefs and for health providers who don't wish to assist in abortion care.

"SB 90 would allow any person — any person — working in a health care setting to deny service or refuse to perform their job for any reason without repercussion," he said.

The bill now goes to the Senate for further action.

Reach Deborah Yetter at dyetter@courier-journal.com or 502-582-4228. Find her on Twitter at @d_yetter. Support strong local journalism by subscribing today: www.courier-journal.com/subscribe.