Religious health care providers win injunction on ACA rules

Aug 12, 2021, 10:52 PM | Updated: Aug 13, 2021, 12:33 pm

A federal judge has issued a permanent injunction on behalf of religious health care providers who feared the Biden administration would interpret the Affordable Care Act as requiring them to perform abortions or gender-transition treatment against their conscience.

The U.S. Department of Health and Human Services had argued that it doesn’t require religious providers to offer such procedures and has never brought or threatened any enforcement activity against a religious entity in such a case.

But U.S. District Court Judge Reed O’Connor interpreted HHS regulations as forcing the plaintiffs — a Catholic hospital system in the Midwest and a Christian medical association — to choose between their beliefs and their livelihood, resulting in “irreparable injury.”

The decision underscores a continued dispute between conservative religious health care providers and HHS over an issue that has generated a patchwork of rulings that will likely have to be sorted out by appellate courts.

O’Connor, whose court is in the Northern District of Texas, issued the injunction based on his earlier ruling that found HHS in violation of the Religious Freedom Restoration Act, which requires deference to religion barring a “compelling government interest.”

The injunction benefits only the plaintiffs — Franciscan Alliance, a Catholic hospital network in Indiana and Illinois, and the Christian Medical & Dental Associations and their 19,000 members nationwide — though O’Connor voided the disputed portions of the law in the earlier ruling.

Another federal judge issued a similar decision in favor of a Catholic health system in North Dakota in January. The Biden administration is appealing it.

The plaintiffs in the Texas court sued in 2016 over Affordable Care Act-related rules issued by HHS that year under the Obama administration. Those rules — applying to most medical providers by virtue of their participating in federally funded programs — barred discrimination based on factors including sex, interpreted as including gender identity, and pregnancy status, such as “termination of pregnancy.”

An HHS analysis at the time said health care institutions that, for example, perform hysterectomies for medical purposes would need to provide them to transgender men, though the rules said separately that federal protections for religious freedom and conscience would supersede any requirements. The analysis also noted that the ACA and other federal laws protected medical providers from having to provide abortions.

O’Connor in 2019 voided the parts of the rules barring discrimination based on gender identity and termination of pregnancy.

The Trump administration strengthened religious exemptions in 2020 and eliminated protections for gender identity — although other federal courts temporarily blocked that change. It was also soon followed by a Supreme Court ruling that interpreted the federal ban on sex discrimination as also prohibiting discrimination based on gender identity.

This May, HHS said it would interpret its rules according to that Supreme Court ruling but would also abide by previous court rulings such as that of O’Connor. The judge, in ordering the permanent injunction this week, said that was a contradiction.

Attorney Luke Goodrich, who represented the plaintiffs on behalf of Becket, a legal organization focused on religious liberty, applauded the decision.

“Everyone is better off when these doctors and hospitals can continue to provide top-notch medical care” without violating their consciences, he said.

But Omar Gonzalez-Pagan, senior attorney and health care strategist at Lambda Legal, which focuses on LGBTQ rights, said “the court and the plaintiffs were fabricating a controversy” when there “has been no threat of enforcement against the plaintiffs.”

He noted there are conflicting federal court decisions on defining sex discrimination in the ACA rules, and “at some point and time there will be a consensus among the courts or the Supreme Court may have to intervene.”

Lindsey Kaley, staff attorney with the American Civil Liberties Union’s Center for Liberty, said the ruling limits federal enforcement but “does not change the fact that transgender people who have been turned away from health care can continue to pursue litigation.” The ACLU’s Texas branch intervened on behalf of HHS.

“Gender-affirming care is life-saving care, and doctors agree that it is medically necessary for many transgender people,” Kaley said.

___

Associated Press religion coverage receives support from the Lilly Endowment through The Conversation U.S. The AP is solely responsible for this content.

Copyright © The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

AP

(AP Photo/Paula Bronstein, File)...
Associated Press

Inslee touts new housing program for Spokane’s homeless

Washington Gov. Jay Inslee was in Spokane Monday to preview the opening of a new housing project for homeless people, calling the Catalyst Project a step toward ending the state’s homelessness crisis.
9 hours ago
Associated Press

Italian firefighters find 12th victim of Nov. 26 landslide

MILAN (AP) — After 11 days of digging, search teams on Tuesday recovered the final victim from the debris of an enormous landslide on the Italian resort island of Ischia, bringing the final death toll to 12. The Naples prefect identified the victim as 31-year-old Maria Teresa Arcamone, whose body was found in an area […]
1 day ago
Associated Press

Vandalism at Missouri elementary school includes a swastika

SPRINGFIELD, Mo. (AP) — Police in Springfield, Missouri, are investigating after a swastika was sprayed on an elementary school during a vandalism spree. The vandalism at York Elementary School, which is under construction, was found on Saturday morning, police spokeswoman Cris Waters said. Stephen Hall, spokesman for Springfield Public Schools, said the district immediately replaced […]
1 day ago
FILE - Prada group president and Ceo Patrizio Bertelli and Luxottica Ceo Andrea Guerra smile during...
Associated Press

Prada charts line of business succession, tapping new CEO

MILAN (AP) — The Prada fashion house began charting a line of succession on its business side, announcing Tuesday that it is tapping a former LVMH executive as its next CEO and confirming that Miuccia Prada will continue in her creative roles. Andrea Guerra is set to be confirmed by the board next month as […]
1 day ago
FILE - A 2019 Jeep Compass is seen on display at the 2019 Pittsburgh International Auto Show in Pit...
Associated Press

US opens probe into Jeep Compass SUV engines shutting down

DETROIT (AP) — U.S. safety regulators are investigating complaints that the engines on some small Jeeps can shut down while being driven. The probe by the National Highway Traffic Safety Administration covers about 229,000 Jeep Compass SUVs from the 2019 and 2020 model years. Documents posted Tuesday by the agency say it has 15 complaints […]
1 day ago
FILE - Ramesh "Sunny" Balwani, right, the former lover and business partner of Theranos CEO Elizabe...
Associated Press

Holmes’ former partner faces sentencing in Theranos case

A former Theranos executive learns Wednesday whether he will be punished as severely as his former lover and business partner for peddling the company’s bogus blood-testing technology that duped investors and endangered patients. The sentencing for Ramesh “Sunny” Balwani, who was convicted in July of fraud and conspiracy, comes less than three weeks after Elizabeth […]
1 day ago

Sponsored Articles

Comcast Ready for Business Fund...
Ilona Lohrey | President and CEO, GSBA

GSBA is closing the disparity gap with Ready for Business Fund

GSBA, Comcast, and other partners are working to address disparities in access to financial resources with the Ready for Business fund.
SHIBA WA...

Medicare open enrollment is here and SHIBA can help!

The SHIBA program – part of the Office of the Insurance Commissioner – is ready to help with your Medicare open enrollment decisions.
Lake Washington Windows...

Choosing Best Windows for Your Home

Lake Washington Windows and Doors is a local window dealer offering the exclusive Leak Armor installation.
Anacortes Christmas Tree...

Come one, come all! Food, Drink, and Coastal Christmas – Anacortes has it all!

Come celebrate Anacortes’ 11th annual Bier on the Pier! Bier on the Pier takes place on October 7th and 8th and features local ciders, food trucks and live music - not to mention the beautiful views of the Guemes Channel and backdrop of downtown Anacortes.
Swedish Cyberknife Treatment...

The revolutionary treatment of Swedish CyberKnife provides better quality of life for majority of patients

There are a wide variety of treatments options available for men with prostate cancer. One of the most technologically advanced treatment options in the Pacific Northwest is Stereotactic Body Radiation Therapy using the CyberKnife platform at Swedish Medical Center.
Work at Zum Services...

Seattle Public Schools announces three-year contract with Zum

Seattle Public Schools just announced a three-year contract with a brand-new company to the Pacific Northwest to assist with their student transportation: Zum.
Religious health care providers win injunction on ACA rules