On January 18, the Trump administration’s Department of Health and Human Services announced the creation of a “conscience and religious freedom” division. They followed that up on January 19 with proposed regulations that could expand religious exemption laws in new and very damaging ways. In short, Trump wants to allow health care workers to refuse to perform any service that they have a moral or religious objection to. As with much of the other policy coming out of this administration, women, LGBTQ people, and people of color would be disproportionately harmed.

Patients’ needs should dictate patient care—not a provider’s religious beliefs. We’ve already seen how abandoning this approach can have dire consequences. In 2010, a woman who was miscarrying an 18-week pregnancy went to a Catholic hospital in Michigan for care. She was refused care for religious reasons three different times, while in pain, bleeding, and with a serious infection, before the hospital finally admitted her. A 2016 study found that Catholic hospitals are inconsistent in their care for women due to existing religious refusal laws and that women often experience treatment delays with severe consequences.

LGBTQ people, particularly transgender individuals, are also vulnerable under the proposed HHS rule. It is possible that medical personnel could refuse transition-related care—meaning that transgender patients could face yet another barrier to accessing medically necessary hormones and gender-confirmation surgeries. A 2015 survey found that more than 800 transgender people also reported being denied care that was unrelated to their gender identity. Harmful and biased attitudes that medical professionals may have toward them can be traumatizing and prevent gender and sexual minorities from actively seeking care when they need it.

Women of color are significantly more likely than white women to get medical treatment at religiously-affiliated hospitals, meaning that this illegal proposed rule could also have a racial impact. Since women of color already receive subpar care in comparison to white women, particularly in the area of reproductive health, the potential consequences of this rule are chilling. Black mothers die in childbirth at three times the rate of white mothers, a tragic result of a medical system that has significant disparities in how Black and Latinx patients are treated compared to white patients.

The proposed rule is also written very broadly, meaning it could interfere in other aspects of patient care if other staff like translators also refuse to serve patients, which could heighten disparities in health care for non-English-speaking patients. A patient’s inability to speak English should not prevent them from having access to the health care they need.

The Religious Right, which has long lobbied for stronger exemption laws and has no problem turning its back on vulnerable Americans, may be pleased with this policy change, but it comes at a significant cost for many people seeking health care.