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June 14, 2019

Planned Parenthood, ACLU sue Trump admin over 'conscience' rule

Daily Briefing

    Advocacy groups on Tuesday filed lawsuits against HHS to block a Trump administration rule intended to enforce protections for health care professionals who have moral or religious objections to providing certain medical care, including abortion care and medically assisted death.

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    The two lawsuits come a few weeks after a coalition of civil rights organizations and a group of nearly two dozen states and localities each filed their own lawsuits to block the conscience protection rule. The civil rights organizations argue that the final rule is unconstitutional and exceeds HHS's statutory authority, while the local governments argued the final rule could jeopardize patients' access to care.   

    Final rule details

    The 440-page final rule, which HHS proposed in January 2018, is designed to help HHS' Office for Civil Rights (OCR) enforce 25 existing statutory protections intended to ensure entities and individuals are not forced to participate in medical procedures that violate their consciences.

    For instance, the final rule will allow doctors, nurses, and other health care workers, including schedulers, to decline to be involved in medical procedures that violate their moral or religious beliefs. Specifically, the final rule will protect such workers if they refuse to provide, participate in, pay for, or offer a referral for services that violate their moral or religious beliefs.

    Under the final rule, health care workers will be able to file complaints with OCR if they believe they have experienced discrimination because they declined to participate in specific medical procedures. OCR said it will enforce the statutory protections in the same manner it enforces other civil rights requirements, such as those prohibiting discrimination on the basis of national origin or the basis of race.

    The final rule is scheduled to take effect July 22.

    The latest lawsuit

    Advocacy groups on Tuesday filed two lawsuits in Manhattan federal court to block the rule.  Both lawsuits ask a federal judge in the Southern District of New York to declare the rule "arbitrary and capricious" and block it from taking effect as scheduled.

    One lawsuit was filed by the Planned Parenthood Federation of America and Planned Parenthood of Northern New England, while the other was filed by the American Civil Liberties Union (ACLU) and the New York Civil Liberties Union on behalf of the National Family Planning and Reproductive Health Association and Public Health Solutions.  

    Broadly, the lawsuits argue that enforcing the rule would encourage discrimination against women, racial minorities, low-income individuals, and people who are gay, bisexual, transgender, or queer by reducing access to legal health are procedures, Reuters reports.

    The ACLU in its lawsuit says that the rule should be declared unconstitutional because it "encourages and authorizes discrimination by unlawfully granting a wide swatch of institutions and individuals broad new rights to refuse to provide health care services."  

    Further, the lawsuit says the new rule will create "a virtually absolute obligation to accommodate employee objections" to a range of health care services, including abortion care, "regardless of impact." This means, the groups argue, that health care workers could "refuse to do core aspects of their job and yet stay in their role." For instance, ACLU in a release noted a hospital receptionist could refuse to schedule an appointment for a patient seeking gender-affirming care.

    In addition, the groups argue that the rule could lead to high costs for health care providers who could lose federal funding if they refuse to comply with the new rule, Reuters reports.


    HHS said it would defend the rule against the slew of recent lawsuits.

    Roger Severino, director of OCR, on Tuesday defended the need for the rule, saying it "gives life and enforcement tools" to the 25 existing federal laws that protect conscience and religious rights.

    However, Leana Wen, president of Planned Parenthood said the rule violates patients' trust, which "is the cornerstone of the physician-patient relationship." She added, "No one should have to worry if they will get the right care or information because of their providers' personal beliefs" (Weixel, The Hill, 6/11; Rappleye, Becker's Hospital Review, 6/12; Stempel, Reuters, 6/11; Klasfeld, Courthouse News Service, 6/11; American Civil Liberties Union release, 6/11).

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