U.S. can't punish Christian hospitals for refusing to do abortions, gender surgery
(Reuters) - The U.S. government cannot require several Christian medical groups and providers to perform abortions or gender transition surgeries under the Affordable Care Act, a federal appeals court has ruled.
A unanimous panel of the 5th U.S. Circuit Court of Appeals on Friday upheld a lower court's permanent order shielding Christian Medical and Dental Associations and Specialty Physicians of Illinois, along with Catholic hospital system Franciscan Alliance Inc, from any enforcement action under the ACA's anti-discrimination provision, known as Section 1557, for refusing to perform the procedures, which they say would violate their religious freedom.
Circuit Judge Don Willett, joined by Circuit Judges Jennifer Elrod and Kurt Engelhardt, rejected the government's argument that the case should be dismissed as moot because the original rule challenged by the providers had been overturned. Willett wrote that the providers still faced harm because the U.S. Department of Health and Human Services (HHS) had "repeatedly refused to disavow enforcement" against them.
"In its brief on appeal, HHS simply says it 'has not to date evaluated' whether it will enforce Section 1557 against Franciscan Alliance — in other words, it concedes that it may," he wrote.
Joe Davis of The Becket Fund for Religious Liberty, a lawyer for the plaintiffs, called the ruling "a major victory for conscience rights and compassionate medical care in America."
HHS did not immediately respond to a request for comment.
The Christian groups had sued in Wichita Falls, Texas federal court to challenge an HHS rule issued in 2016 during Democratic President Barack Obama's administration. The rule interpreted Section 1557 to prohibit healthcare providers that receive federal funding or participate in ACA exchanges from discriminating on the basis of "gender identity" or "termination of pregnancy."
U.S. District Judge Reed O'Connor vacated parts of the rule in 2019, but declined to enter an injunction. In 2020, under Trump, HHS rescinded the rule.
The plaintiffs nonetheless appealed to the 5th Circuit to ask for an injunction. That court remanded the case for further consideration to O'Connor, who then entered a broad injunction against enforcing 1557 against the plaintiffs to require gender transition care or abortion.
HHS, in turn, appealed that injunction, leading to Friday's ruling.
The agency on July 25 proposed a new rule enforcing Section 1557 that would adopt similar language to the rescinded 2016 rule. While the proposed rule contains a religious exemption, the groups in the lawsuit have said it does not go far enough.
The case is Franciscan Alliance Inc v. Becerra, 5th U.S. Circuit Court of Appeals, No. 21-11174.
For the plaintiffs: Luke Goodrich and Joseph Davis of The Becket Fund for Religious Liberty
For the government: McKaye Neumeister of the U.S. Department of Justice Civil Division