Montana Gov. Gianforte signed HB 303 letting providers refuse gender-affirming care and abortion on moral grounds

On May 3, 2023, Montana Gov. Greg Gianforte signed House Bill 303, the "Medical Ethics and Diversity Act," into law, allowing medical practitioners, health care institutions, and health care payers to decline to participate in or pay for medical services on "ethical, moral, or religious" grounds. The law provides no corresponding right for a patient to actually obtain a service when a provider, facility, or insurer objects.

Sponsored by Rep. Amy Regier, R-Kalispell, the bill passed the Republican-majority House 65-35 largely along party lines before clearing the Senate and reaching the governor. Regier described it as a "preservation and protection for medical conscience" for practitioners and institutions objecting to specific "lifestyle and elective procedures," and in floor debate identified abortion, gender-affirming care, physician aid in dying, and marijuana or opioid prescribing among the practices a provider could refuse. Opponents and LGBTQ+ advocates warned that, because the law guarantees no patient a means to obtain a refused service, it opens the door to denial of gender-affirming and other care to transgender patients specifically.