Legal challenges filed to Trump's 'conscience' rule that allows healthcare workers to refuse care for religious reasons

Medical justice
Lawsuits allege a new federal rule would reduce access to healthcare, particularly for women, LGBTQ individuals and other vulnerable populations. (Getty/yavdat)

Two lawsuits were filed Tuesday suing the Trump administration to overturn a conscience rights rule that protects healthcare workers who object to procedures such as abortion for religious or moral reasons.

A coalition of 23 states and municipalities filed a lawsuit (PDF) to challenge a final rule issued by the Department of Health and Human Services (HHS) that allows healthcare clinicians to decline to provide services that conflict with their moral or religious beliefs. The lawsuit was filed in a Manhattan federal court and asks a judge to declare the rule unconstitutional and in excess of HHS’ statutory jurisdiction.

The final rule, dubbed by its opponents as the “healthcare refusal rule,” is scheduled to take effect in July.

A separate lawsuit (PDF) was filed in San Francisco federal court, brought by the state of California. Attorney General Xavier Becerra, who filed the lawsuit, argued that the new rule is unlawful and reckless.

The city of San Francisco was the first to take legal action seeking to invalidate the final rule, issued by HHS’ Office for Civil Rights (OCR) on May 2, immediately filing a lawsuit.

In New York, Attorney General Letitia James led the coalition filing the lawsuit which it said expands the ability of businesses and individuals to refuse to provide necessary healthcare on the basis of their religious beliefs or moral convictions.

RELATED: HHS issues new rule with 'conscience' protections for healthcare workers

“Once again, the Trump Administration is putting politics over the health and safety of Americans,” James said in a statement. “The federal government is giving healthcare providers free license to openly discriminate and refuse care to patients—a gross misinterpretation of religious freedom that will have devastating consequences on communities throughout the country. When the health of our residents is at stake, and the safety of vulnerable populations hang in the balance, we cannot rest until this ‘health care refusal’ rule is stopped.” 

James said the rule drastically expands the number of providers eligible to make such refusals, ranging from ambulance drivers to emergency room doctors to receptionists to customer service representatives at insurance companies. 

In addition to New York, the lawsuit was filed by the city of New York, Colorado, Connecticut, Delaware, the District of Columbia, Hawaii, Illinois, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, Wisconsin, the city of Chicago and Cook County, Illinois.  

The suit filed Tuesday in California says the final rule creates a broad exemption that permits any individual, entity or provider—from doctors to front office staff—to deny patients basic healthcare, including reproductive and emergency care, not just on the basis of federally protected conscience allowances but also on the basis of “ethical or other reasons.” The lawsuit says the rule encourages discrimination against vulnerable patients, including women and LGBTQ individuals.

RELATED: New 'conscience' rule: Proponents say it protects healthcare workers' rights, opponents fear 'free pass' for discrimination

“The Trump Administration should be expanding access to care, not opening the door to limitless denials of care for vulnerable patients and communities,” Becerra said in a statement. “This notion of licensing the discriminate refusal of care to patients smacks of a century-old, bigoted mindset. This is 2019, not 1920. California won’t backslide.” 

In a Twitter post, the California Medical Association supported the lawsuit. “This action by the Trump administration could lead to discrimination that is prohibited under both federal and California law, adversely impact patient access to comprehensive care and inappropriately insert politics into the patient-physician relationship,” the physicians’ group said.

HHS has said the rule change is needed to protect the religious freedom of employees who may object to some healthcare procedures. Roger Severino, director of HHS’ OCR, which will enforce the rule, says it does not create any new laws but provides enforcement tools for 25 laws passed by Congress that are already on the books.

The controversial rule is intended to protect individuals and healthcare entities from discrimination on the basis of their exercise of conscience in HHS-funded programs. The rule will protect providers, individuals and other healthcare entities from having to provide, participate in, pay for, provide coverage of or refer for services such as abortion, sterilization or assisted suicide. It also includes conscience protections with respect to advance directives, OCR said.