Regulatory NewsBREAK: OCR Rescinds Prior Civil Rights Guidance

Topic(s):

Legislation & Regulation

On January 23, 2026, the U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) issued three notices:
- Rescission of Guidance to Nation’s Retail Pharmacies: Obligations under Federal Civil Rights Laws to Ensure Nondiscriminatory Access to Health Care at Pharmacies (Pharmacy Notice),
- Rescission of Guidance on Nondiscrimination Protections under the Church Amendments (Nondiscrimination Notice), and
- Rescission of Office for Civil Rights Documents under Executive Order 14192 (Additional Documents Notice).
In the Pharmacy Notice, OCR rescinds its 2023 “Guidance to Nation’s Retail Pharmacies: Obligations under Federal Civil Rights Laws to Ensure Nondiscriminatory Access to Health Care at Pharmacies” (Prior Pharmacy Guidance), which had revised the 2022 Guidance titled “Guidance to Nation’s Retail Pharmacies: Obligations under Federal Civil Rights Laws to Ensure Access to Comprehensive Reproductive Health Care Services” (2022 Guidance).
- OCR interprets the Prior Pharmacy Guidance as requiring pharmacies to stock and fill prescriptions for drugs such as methotrexate and misoprostol, even if the pharmacist objects due to their potential abortion-related uses.
In the Nondiscrimination Notice, OCR rescinds its 2021 “Guidance on Nondiscrimination Protections under the Church Amendments” (Prior Nondiscrimination Guidance).
- The Prior Nondiscrimination Guidance addresses the federal conscience statute known as the Church Amendments, 42 USC 300a-7(c)(1). That statute, which is still in effect, prohibits discrimination against a health care provider who has performed or assisted in a lawful sterilization or abortion procedure.
- The Prior Nondiscrimination Guidance relied on Planned Parenthood v. Casey and related precedents, which were overturned or undermined by Dobbs v. Jackson Women’s Health Organization (2022).
In the Additional Documents Notice, OCR rescinds several letters and guidance documents, including:
- A 2021 OCR letter about the University of Vermont Medical Center, which reinterpreted the Church Amendments with a Title VII “undue hardship” analysis. OCR says this no longer reflects the Department’s view and conflicts with the Amendments' plain text.
- Three 2021 letters to Michigan, Texas, and South Carolina withdrawing religious exemptions under Religious Freedom Restoration Act (RFRA) in foster care. OCR rejected their factual assumptions and legal basis, noting regulatory changes undermined their rationale.
- 2021 guidance on equitable COVID-19 vaccine administration due to the end of the public health emergency and the rescission of the related executive order.
- A 2021 letter withdrawing a violation notice against California under the Weldon Amendment, Pub. Law No. 118-47, 138 Stat. 460, 703 (Mar. 23, 2024), for mandating insurance coverage of abortion. OCR said that the legal interpretations no longer reflect the Department’s position.
OCR noted that these actions are part of a deregulatory effort to align agency guidance with statutes and cut unnecessary compliance burdens.
The rescissions take effect upon publication.