Judge blocks conscience protection rule for health workers

Modesto Morganelli
Novembre 8, 2019

A federal judge in NY overturned the Trump administration's conscience protection rule for health care workers on Wednesday.

In a 147-page decision, Judge Paul Engelmayer in Manhattan said that the "conscience" rule was unconstitutionally coercive because it permitted the US Department of Health and Human Services (HHS) hold back billions of dollars of federal funds for violations.

Thus, the judge warned, a hospital or clinic receptionist who schedules appointments, an elevator operator or an ambulance driver could refuse on moral or religious grounds to do their jobs.

DEADLINE UPDATE: Just minutes after this story was published, a federal judge in the Seattle case, Washington v. HHS, issued an opinion striking down the HHS Denial of Care Rule.

In May, HHS said the new rule would protect health care workers "from having to provide, participate in, pay for, provide coverage of, or refer for, services such as abortion, sterilization, or assisted suicide". "Health care is a basic right that should never be subject to political games", she said.

On the other hand, critics said that rule would deprive gay, transgender and other patients of the required healthcare, as providers might deem them less worthy of treatment.

The department could develop new rules but "must do so within the confines of the Administrative Procedures Act and the Constitution", he added. Of the 358 complaints HHS said it received starting in November 2016, shortly after Trump was elected, only 21 were "potentially related" to the rule, a number the judge said was "so small as to be asymptotic to zero".

The HHS rule was issued simply to give "enforcement tools" for conscience laws that were already in place, Roger Severino, director of the HHS Office for Civil Rights (OCR), said in a July statement.

The lawsuit was brought by the state of NY and more than 20 other states and cities. Judge Bastian ruled from the bench today in State of Washington v. Azar, agreeing with the ruling out of NY. The Denial of Care Rule, he noted, originated with an executive order from President Trump in May 2017.

Lambda Legal and co-counsel also argued that the rule is unconstitutional because it advances specific religious beliefs in violation of the First Amendment; violates patients' rights to privacy, liberty and equal dignity as guaranteed by the Fifth Amendment; and chills patients' speech and expression in violation of the First Amendment, all to the detriment of patients' health and well-being. Federal health care funding could be cut off if federal officials believed the state violated the rule. "HHS itself classifies the Rule as 'economically significant, ' meaning it will have an annual economic effect of more than $100 million". It required that federally-funded organizations be certified compliant with more than two dozen existing statutory conscience protections in health care. HHS estimates that it will cost around $1 billion to implement the Rule over its first five years, not including public health costs.... "It applies across the vast health care industry".

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