Arkansas Gov. Sanders signed Act 970, letting providers and insurers refuse gender-transition and other care on conscience grounds

On April 21, 2025, Arkansas Gov. Sarah Huckabee Sanders signed SB444 into law as Act 970 of 2025. The measure amends the state's 2021 Medical Ethics and Diversity Act, which established conscience-based refusal rights for medical practitioners and institutions, and broadens those rights in two significant ways. It extends the right to decline to participate in a health care service to health care payers — insurers — alongside practitioners and institutions, and it protects declining to take part in gender-transition procedures, abortion, assisted suicide, or "any healthcare service that violates his, her, or its conscience."

The law further permits religious health care institutions to make employment, staffing, contracting, and admitting-privilege decisions consistent with their religious beliefs, and bars state licensing boards from sanctioning practitioners for First Amendment-protected speech absent clear and convincing evidence that the speech directly caused physical harm. By grounding the refusal of care in the conscience or religious belief of the provider or insurer, the statute privileges those beliefs over a patient's access to treatment, and by naming gender-transition procedures among the services that may be refused, it marks out transgender patients in particular as subject to denial.

The measure was enacted in the same 2025 legislative session as a broader wave of state conscience-refusal and anti-LGBTQ health measures. It is recorded here as its own originating enactment; the 2021 Medical Ethics and Diversity Act it amends is not itself in the archive.