Pittsburgh Post-Gazette

Philly judge blocks Trump effort to roll back birth control mandate

- By Jeremy Roebuck

PHILADELPH­IA — A federal judge in Philadelph­ia on Monday barred the Trump administra­tion from implementi­ng new rules that would let almost any employer deny female employees coverage for birth control by citing religious or moral objections.

U.S. District Judge Wendy Beetleston­e found that the new regulation­s could result in unplanned pregnancie­s and as many as 127,000 women losing access to nocost contracept­ion, which is currently mandated under the Affordable Care Act. She also concluded the impact would inflict an undue financial burden on states that moved in to pick up the tab.

In a 65-page opinion, the judge granted a nationwide temporary injunction sought by the attorneys general of Pennsylvan­ia and New Jersey.

“The negative effects of even a short period of decreased access to no-cost contracept­ive services is irreversib­le,” she wrote.

Judge Beetleston­e’s ruling came the same day the new regulation­s took effect, carving out religious and moral exemptions to Obamacare’s contracept­ion mandate.

It followed a similar order issued

late Sunday by a federal judge in California. But unlike Judge Haywood S. Gilliam’s decision in that case — which applied only to the 13 states and the District of Columbia that filed suit in his court — Judge Beetleston­e expanded the scope of her decision to cover the country.

Reproducti­ve rights advocates and Pennsylvan­ia Attorney General Josh Shapiro were quick to declare victory.

“Women need contracept­ion for their health because contracept­ion is medicine, pure and simple,” Mr. Shapiro said in a statement. “Congress hasn’t changed that law, and the president can’t simply ignore it with an illegal rule.”

But their win Monday is likely to be only the start of a drawn-out legal battle.

Trump administra­tion officials are almost certain to appeal. They argued in court that the agencies involved in crafting the regulation­s had “reasonably exercised their rule-making authority” to protect sincere religious and moral objectors.

“No American should be forced to violate his or her own conscience in order to abide by the laws and regulation­s governing our health care system,” said Caitlin Oakley, a spokeswoma­n for the U.S. Department of Health and Human Services in a statement Monday.

Other groups also vowed to join the fight, including the Pittsburgh­based Little Sisters of the Poor, a religious nonprofit run by an order of Roman Catholic nuns. The Little Sisters intervened in the case last year, arguing that the mandate’s requiremen­ts made them complicit in breaking strict religious rules against birth control.

“We never wanted this fight, and we regret that after a long legal battle it is still not over,” said Loraine Marie Maguire, mother provincial of the order in the United States. “We pray we can once again devote our lives to the ministry … without being forced to violate our faith.”

If Judge Beetleston­e’s rulings withstand appellate scrutiny, the attorneys general will have to return to court to persuade her to make Monday’s temporary injunction permanent.

In her decision, the judge indicated that the states’ lawyers were likely to prevail. She concluded that the Trump administra­tion’s new regulation­s ran counter both to government rule-making procedures and the intent of Congress in crafting the Obama administra­tion’s signature health care law.

“The breadth of the exemptions set out in the [regulation­s] is remarkable,” she wrote. “The … religious exemption allows all nonprofit and for-profit entities, whether closely held or publicly traded, to deny contracept­ive coverage based on sincerely held religious beliefs.”

The birth control mandate has been one of the most fiercely litigated aspects of Obamacare.

Since it was enacted in 2010, the Affordable Care Act has generally required employers and insurers to provide preventive health services to women at no charge. Houses of worship that claimed religious objection were provided an avenue to opt out soon after the law’s passage.

In the eight years since, and after a number of court battles, the swath of employers eligible for exemptions has gradually expanded to include religiousl­y affiliated hospitals, universiti­es and nonprofits and certain privately held businesses owned by a small group of owners whose religious beliefs run counter to the law’s contracept­ion provisions.

Some of those exempted entities are still required to provide employees with health plans that offer birth control coverage paid by the insurance provider.

But since taking office, President Donald Trump has sought to eliminate that requiremen­t and broadly expand the number and types of entities that could claim exemptions, fulfilling a campaign pledge to protect employers from being “bullied by the federal government because of their religious beliefs.”

In 2017, administra­tion officials proposed rules that would allow almost any business to claim a religious exemption and drop contracept­ive coverage from their employees’ health plans.

Judge Beetleston­e blocked that earlier effort in a case brought by Mr. Shapiro’s office, saying that the Affordable Care Act did not authorize such “sweeping exemptions.”

The administra­tion submitted a revised set of rules in November, prompting the challenge from Mr. Shapiro and New Jersey Attorney General Gurbir Grewal that led to Monday’s ruling.

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