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Analysis

Federal Judge Vacates 'Conscience Rule'

By John Commins  
   November 06, 2019

Trump administration's healthcare agenda delivered another setback in court.

A federal judge in Manhattan on Wednesday vacated "in its entirety" the Trump administration's so-called "conscience rule" that would have allowed clinicians to refuse to provide medical services, namely abortions, on moral or religions grounds.

In a 147-page ruling that consolidated three separate lawsuits challenging the law, U.S. District Judge Paul Engelmayer said that federal law already acknowledges the conscience rights of clinicians, and "accommodate(s) religious and moral objections to health care services provided by recipients of federal funds."  

"The Court's decision today leaves HHS at liberty to consider and promulgate rules governing these provisions," said Engelmayer, an Obama administration appointee in 2011. "In the future, however, the agency must do so within the confines of the APA and the Constitution."

An HHS officials said they're reviewing the opinion.

Alexis McGill Johnson, Acting President and CEO, Planned Parenthood Federation of America – a plaintiff in one of the suits – cheered the ruling.

"Today, the Trump administration was blocked from providing legal cover for discrimination," she said. "As the federal district court made clear, the administration acted outside its authority and made false claims to try to justify this rule. This rule put patients' needs last and threatened their ability to access potentially lifesaving healthcare."  

"No one should have to worry they will be denied the medical care they need simply because of their health care provider's religious, moral, or personal beliefs," she said.  

U.S. Senator Ben Sasse (R-NE) called the ruling "absurd mush," and urged the Trump administration to "defend basic conscience rights all the way to the Supreme Court."

"The point of the First Amendment – especially the free exercise of religion – is to protect the conscience rights of Americans," he said. "In this country, government doesn’t get to tell you that your faith is fine on Sunday at church but not Monday at work.

The ruling was the latest setback for the Trump administration, which has seen its various attempts at healthcare reform – from Medicaid work requirements to hospital outpatient reimbursement cuts -- rebuffed by federal judges across the nation.

Last week, Health and Human Services Secretary Alex Azar announced that the government would forge ahead with site-neutral cuts under its outpatient prospective payment system, even though a federal court in September vacated the policy.

Azar said HHS would also push forward a 22.5% payment rate cuts for some drugs under the 340B program, even though that policy was vacated by a federal court in May.    

The Trump administration's final rule that would require hospitals to disclose payer-specific negotiated rates is also expected to see legal challenges from payers and providers when it's unveiled.  

“As the federal district court made clear, the administration acted outside its authority and made false claims to try to justify this rule. ”

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.


KEY TAKEAWAYS

District Judge Paul Engelmayer said that federal law already acknowledges the conscience rights of clinicians.

Englemayer said HHS is free to 'promulgate rules' but 'must do so within the confines of the APA and the Constitution.'

The Trump administration has not said if it will appeal the ruling.


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