This suit consolidates a number of challenges to a rule from the Federal Department of Health and Human Services (HHS) that allows healthcare providers to refuse medical treatment or services that conflict with their religious or moral beliefs. Based on an 2017 executive order by President Trump and a memorandum from then Attorney General Jeff Sessions, the rule promoted an expansive reading of religious discrimination law that could allow any entity involved with a medical procedure to object to the procedure on religious grounds. It also set up a comprehensive enforcement regime for compliance. This rule would have had a particular impact on abortion access and transgender procedures, especially in low-income communities.
The two main sets of plaintiffs are State governments, represented by their attorney generals, and a number of health-related nonprofit organizations, including Planned Parenthood. The Government plaintiffs filed their complaint on May 21, 2019, and private plaintiffs filed two separate challenges on June 11, 2019, and June 14, 2019, before the three suits were consolidated. Plaintiffs alleged that the rule misinterpreted long-standing congressional statutes cabining the right to refuse to provide medical treatment and violated various sections of the Administrative Procedure Act. Plaintiffs contended that the rule conflicted with the establishment clause of the First Amendment by impermissibly promoting religious beliefs, with the Fifth Amendment on account of the rule’s vagueness and violation of plaintiff’s right to privacy, with the Spending Clause of the Constitution, with the Separation of Powers doctrine. Plaintiffs sought preliminary and permanent injunctive relief, attorneys' fees, and for the rule to be vacated.
On August 2, 2019, the court (District Judge Paul A. Engelmayer) wrote an opinion allowing the intervention of the Christian Medical and Dental Association to argue in favor of the rule. However, on November 6, 2019, after ten amicus briefs, the court granted summary judgment in favor of plaintiffs, vacating the rule in full. The court found that the rule exceeded the scope of the so-called “conscience provisions,” congressional statutes that addressed moral and religious objections to abortion and other procedures. Much of the legislation around the healthcare industry over the past 40 years has contained these provisions so that healthcare entities will not be discriminated against for failing to assist in abortions and other procedures.
The court found HHS, as an administrative agency, impermissibly expanded the scope of these provisions in violation of the Administrative Procedure Act. The court also held that the regulatory scheme enacted by HHS also exceeded the agency’s legal authority. The holding went on to conclude that HHS’s rule conflicted with the traditional Title VII framework on discrimination and was arbitrary and capricious in violation of the Administrative Protective Act. Finally, the court held that the rule was unconstitutional in violation of the Separation of Powers and the Spending Clause of the Constitution. 414 F.Supp.3d 475.
Summary judgment was granted and the court vacated HHS’s rule, which is now up on appeal in the Second Circuit.
Dan Toubman - 02/23/2020
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