HHS has now posted more than 12,000 public comments on its request for information (RFI) to loosen the standards for exemptions to regulations for religious and faith-based groups after initially only posting 80 which most back the administration’s efforts.

POLITICO reported Dec. 18 that HHS was hand-picking the comments it released. Of the 80 that were initially posted, 71 were in favor of easing requirements for healthcare organizations with religious affiliation, attacking policies from the Obama administration on abortion and treating transgender patients. Several of the comments repeated phrases suggested by the Christian Medical and Dental Associations, which told members to say they’ve “experienced pressure from government laws, regulations, policies or communications to alter your faith-based views.”

Opponents of the proposal used the same tactic, with thousands of identical comments being submitted criticizing HHS for “looking for ways to make it easier for entities to let religion dictate patient care.”

“It is not the case that faith-based entities are facing barriers to participating in HHS programs,” these comments said. “What some faith-based entities have identified as barriers are simply non-discrimination requirements, as well as laws and programs conditions that require the delivery of essential and medically necessary health care services. The non-discrimination requirements, laws, and program conditions are not barriers, but rather fundamental legal requirements from which there can be no ‘accommodation.’”

Other commenters used different form letters, such as one referencing the Constitution’s separation of church and state and saying organizations want additional or easier exemptions from HHS regulations are “seeking special treatment.” Supporters of the National Council of Jewish Women also submitte their own standardized responses, saying existing religious exemptions offered by HHS are “too expansive” and there are no barriers HHS needs to remove to accommodate faith-based organizations participating in HHS programs.

“HHS rules and regulations should serve as a shield to protect religious freedom, not a sword that allows harm to those seeking government services,” these letters read.

Few healthcare organizations or associations responded to the RFI. The American Academy of Nursing (AAN) was among them, arguing HHS is focusing on the wrong problem, collecting comments on limited discrimination against faith-based organizations while ignoring larger discrimination against patients, especially women and LGBTQ individuals, and healthcare providers who choose to work on services like abortion or contraception.

“HHS proposed regulations cite no evidence that further protections are needed and we note that additional provisions to shield these providers from delivering evidence-based, quality medical and health-related services that meet the standard of care would be unnecessary and restrictive,” AAN CEO Cheryl Sullivan wrote. “All healthcare provision should be guided by clear, robust and consistent standards that are monitored and updated to reflect the best evidence and recommendations available.”