Federal Judge Overturns Trump-Backed ‘Conscience Rule’ for Health Workers

Federal Judge Overturns Trump-Backed ‘Conscience Rule’ for Health Workers

A federal judge in Manhattan on Wednesday overturned the Trump administration’s expanded “conscience” rule, which would have made it easier for the government to punish health care institutions or states and cities with the loss of federal funds if they did not allow workers to object to abortion and other medical procedures on religious or moral grounds.

The rule is part of a broader agenda by the Trump administration, which says it wants to expand protections for the civil rights of health care workers, even as critics say it has weakened civil rights protections for certain patients. President Trump announced the rule last May at a Rose Garden event for the National Day of Prayer.

The judge, in a 147-page opinion, said that the Department of Health and Human Services did not have the authority to impose major portions of the rule and that the agency’s “stated justification for undertaking rule making in the first place — a purported ‘significant increase’ in civilian complaints relating to the conscience provisions — was factually untrue.”

“Where H.H.S. claimed that the rule was justified by complaints made to it, the administrative record reflects a yawning evidentiary gap,” Judge Paul A. Engelmayer of United States District Court wrote.

The department did not immediately respond to a request for comment.

The case was brought by a number of cities and states and two reproductive rights groups that said they were concerned the rule would prevent vulnerable patients from obtaining needed care. The case was one of a series of lawsuits filed around the country objecting to the policy.

The rule built on existing civil rights protections for religious health care workers, by pulling together 25 separate laws — including some pertaining to abortion and end-of-life care — into one framework. The rule would have allowed medical providers to refuse care if it conflicted with their religious or moral convictions, and would have allowed them to decline to refer patients to another provider with no such objections. Hospitals that compelled their workers to perform such work despite objections would have been subject to penalties, including a loss of all federal funding.

The conscience rule, if eventually allowed to proceed, could have widespread impact. A wave of hospital mergers means that one in six hospital patients in the United States is now treated in a Catholic facility.

In addition to the rule overturned by the court on Wednesday, the administration has previously also substantially revised rules established by the Obama administration that required insurers and health care providers to care for patients who are transgender or have a history of abortion. The Trump administration proposal would eliminate such protections, leaving decisions about whether and how to treat such patients in the hands of individual medical providers and insurance companies.

Both rules originated in the Office for Civil Rights within the Health and Human Services Department, an office that has been expanded under President Trump to add a conscience and religious freedom division. Roger Severino, its director, has made expanding conscience protections for religious health care workers a priority. Mr. Trump, who sees conservative Christians as an essential part of his support as he seeks re-election, has sought to expand the office’s funding.


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