Health Law

Multistate suit challenges federal ‘conscience’ rule over health care refusals on religious grounds

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Doctor and patient

The state of New York is leading a coalition of 23 state and local governments in a lawsuit challenging a federal “conscience” rule that expands the ability of businesses and individuals to refuse to provide medical services on religious or moral grounds.

The lawsuit, filed Tuesday, says the final rule, set to take effect in July, is “an unprecedented and unlawful expansion” of nearly 30 federal statutory provisions. The final rule, issued by the U.S. Department of Health and Human Services, would cut off federal funds to institutions unless they allow workers to refuse to provide care based on conscience grounds. The Washington Post, BuzzFeed News and Bloomberg have coverage; a press release is here.

The rule authorizes the federal government to withhold money from governments that fail to comply, undermining their ability to run their health care facilities, according to the suit, filed in federal court in Manhattan.

The suit gives some examples of how the rule would affect care. Health care institutions would be prevented from asking an applicant for a nursing job whether they had religious objections to administering a measles vaccine. In addition, a “wide swath of employees” would be allowed to refuse to assist patients, without any advance notice, the suit says.

Under the rule, people eligible to refuse treatment include ambulance drivers, emergency room doctors, receptionists and customer service representatives at insurance companies, according to the New York attorney general’s press release.

The suit claims that the final rule exceeds statutory authority; is arbitrary and capricious in violation of the Administrative Procedure Act; is unconstitutionally vague; and is a violation of the spending clause, the establishment clause and the constitutional separation of powers.

California’s attorney general filed a separate suit Tuesday that also seeks to block the rule. The federal rule allows a health care provider to deny service “on the basis of a hunch or prejudice, without any supporting evidence, without notifying a supervisor of the denial of service, and without providing notice or alternative options and/or referrals to patients in need,” according to the suit, filed in federal court for the Northern District of California.

The city of San Francisco also sued earlier this month.

Plaintiffs in the multistate suit are the city and state of New York; Colorado; Connecticut; Delaware; Hawaii; Illinois; Maryland; Massachusetts; Michigan; Minnesota; Nevada; New Jersey; New Mexico; Oregon; Pennsylvania; Rhode Island; Vermont; Virginia; Wisconsin; the District of Columbia; the city of Chicago; and Cook County, Illinois.

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