Third Judge Voids Trump's Rule Allowing Discrimination in Health Care

A third federal judge has struck down the Trump administration's rule allowing health care providers to deny care that offends their religious beliefs -- including services to LGBTQ people.

"When a rule is so saturated with error, as here, there is no point in trying to sever the problematic provisions," U.S. District Judge William Alsup of the Northern District of California wrote in the ruling, issued Tuesday afternoon. "The whole rule must go."

The so-called conscience protection rule would allow health care providers to opt out of procedures to which they object on religious or moral grounds, even in cases of emergency or if their involvement in the procedures is tangential. Donald Trump's administration, though the U.S. Department of Health and Human Services, issued the rule in May, and it was originally set to go into effect this Friday, although a New York federal judge's ruling, released about two weeks ago, prevented that. A U.S. district judge in Washington State issued a similar ruling the following day.

Opponents of the rule, titled "Protecting Statutory Conscience Rights in Health Care," have said it is overly broad, granting refusal rights to workers who provide emergency services or those who are only tangentially involved in care, therefore endangering lifesaving health care for many patients, especially those from marginalized populations, and even encouraging such refusals. It could jeopardize the care of transgender people, of HIV-positive people, those taking PrEP, patients seeking abortion or contraception, and more. Clinics and hospitals that do not comply with the rule would stand to lose federal funding, as would state Medicaid and Children's Health Insurance programs.

Alsup's ruling came in a suit brought against HHS by Lambda Legal, Americans United for Separation of Church and State, the Center for Reproductive Rights, and the County of Santa Clara, Calif., along with several health care providers and LGBTQ community centers.

He noted that there are already federal laws accommodating health care providers' conscientious objection to certain procedures, with the first having been enacted after a court forced a religiously affiliated hospital to allow abortions to be performed there. The plaintiffs contended the new rule "expands these protections beyond what Congress intended and will hamstring the delivery of health care," he wrote.

"Under the new rule, to preview just one example, an ambulance driver would be free, on religious or moral grounds, to eject a patient en route to a hospital upon learning that the patient needed an emergency abortion," Alsup continued. "Such harsh treatment would be blessed by the new rule. One important question presented herein is the extent to which such scenarios conflict with the underlying statutes themselves. Although this order does not accept all of plaintiffs' criticisms, this order holds that the new rule conflicts with those statutes in a number of ways and upsets the balance drawn by Congress between protecting conscientious objections versus protecting the uninterrupted effective flow of health care to Americans."

The plaintiffs lauded Alsup's ruling. "That is now three judges in two weeks who have recognized the Denial of Care Rule for what it is, an egregious and unconstitutional attack on women, LGBT people and other vulnerable populations," Lambda Legal Senior Attorney Jamie Gliksberg said in a prepared statement. In his ruling, Judge Alsup was blistering in his assessment of the Denial of Care Rule, determining that the rule is 'saturated with error.' Judge Alsup joins Judge Stanley A. Bastian of the Eastern District of Washington and Judge Paul A. Engelmayer of the Southern District of New York in vacating this discriminatory and harmful rule, and in likely saving countless lives. The Denial of Care Rule targets some of our most marginalized and vulnerable communities and deserves to be relegated to the dustbin of history."

"One after another, three judges across the country have now made it crystal clear that it was unlawful for the Trump administration to misuse religious freedom to justify harming patients," added Rachel Laser, president and CEO of Americans United for Separation of Church and State. "These decisions, coupled with Congress's introduction of the Put Patients First Act, should send an emphatic message to President Trump that no patient should ever be discriminated against or denied health care based on who they are, who they love or what they believe."

This is not the Trump administration's last attack on services for marginalized populations, though. This month it announced plans to allow organizations receiving HHS grants for adoption and foster care placement, homeless shelters, HIV services, and more to discriminate against clients who offend their religious beliefs. The administration also wants to eliminate provisions of the Affordable Care Act that ban anti-transgender discrimination.