Attorney General Becerra Leads Multistate Amicus Brief Supporting Challenge to Trump Administration’s Healthcare Refusal Rule

The Rule would open the door to discrimination in healthcare and threaten the timely delivery of lifesaving care

SACRAMENTO – California Attorney General Xavier Becerra today led a multistate coalition in filing an amicus brief in the U.S. Court of Appeals for the Second Circuit supporting a multistate challenge led by New York, opposing the Trump Administration’s illegal Healthcare Refusal Rule. The Healthcare Refusal Rule jeopardizes the health and safety of state residents by creating a broad exemption that would allow anyone remotely involved in a healthcare transaction to deny care based on their religious or moral beliefs. This exemption would open the door to discrimination, particularly against women and LGBTQ individuals, and endanger the timely delivery of critical lifesaving care. In the brief, the coalition urges the Court of Appeals to uphold the district court ruling, which found the Rule to be unlawful.

“Once again, the Trump Administration is attempting to jeopardize Americans’ healthcare – this time by making it easier for health services to be denied on a whim,” said Attorney General Becerra. “California has laws that protect access to care for all Californians, while creating a framework for those who object to such care. But this new rule goes far beyond, dangerously and unlawfully throwing open the doors to discrimination. The rule would go so far as to allow an EMT worker to leave a woman to bleed out by the side of the road. In California, we will fight to protect everyone’s right to access timely, lifesaving care from reproductive care to emergency services.”     

In the brief, the attorneys general argue that the Amici States have already tailored their laws and regulations to balance the need to protect access to healthcare while respecting providers’ right to lodge “conscience” objections, in accordance with numerous existing federal conscience provisions Congress has enacted. However, the Healthcare Refusal Rule issued by the Trump Administration’s U.S. Department of Health and Human Services (HHS) goes far beyond existing provisions, creating a broad exemption that risks access to care. The new rule would allow anyone remotely involved in a healthcare transaction – from front desk staff to emergency personnel to private entities – to object not just for religious reasons, but for “moral, ethical, or other” reasons as well.

The coalition argues that the Rule would compromise patient access to care, and encourage discrimination against vulnerable patient populations, including women, people of color, LGBTQ individuals, and rural and low-income communities. In the New York district court, HHS’ counsel even conceded that the Rule would permit an ambulance driver to cease driving in the middle of Central Park “en route to hospital…upon learning that the patient sought emergency care for ectopic pregnancy,” and that an employer’s failure to accommodate that ambulance driver could “result in a loss of federal funding.”  These harsh outcomes not only conflict with federal law, but would greatly undermine Amici States’ longstanding efforts to ensure access to emergency care in their own states.

In addition to impeding access to basic healthcare, including reproductive and emergency care, the Rule has substantial material costs. It threatens hundreds of billions of dollars in federal funding for healthcare programs and services using unlawful, draconian penalties for non-compliance. For Amici States alone, the Rule puts at risk some $100 billion in federal funds. The Rule, quite simply, puts a “gun to the head” of Amici States, and many others.

In the brief, the coalition asserts that the district court correctly concluded that HHS’s new conscience regulation exceeds the agency’s authority, is arbitrary and capricious, and contrary to federal law and the United States Constitution. The amici urge the Court of Appeals to uphold the district court’s ruling.  

Attorney General Becerra has fought against the Trump Administration’s Healthcare Refusal Rule at every turn. On May 21, 2019, he filed a lawsuit in the U.S. District Court for the Northern District of California, challenging the rule. On September 12, 2019, he filed a motion for summary judgment, to swiftly resolve the case and stop the rule from taking effect in California. On November 19, 2019, the district court granted California’s motion, finding the Rule illegal.

In filing the brief, Attorney General Becerra is joined by the attorneys general of North Carolina, Maine, and Washington.

A copy of the brief is available here.