Two Judges Block Trump Administration Rules Against ACA Coverage of Contraceptives

On January 13, 2019, Judge Haywood Gilliam of the United States District Court for the Northern District of California issued a preliminary injunction to halt enforcement of the Trump administration’s two final rules on religious and moral objections to the Affordable Care Act’s (ACA’s) contraceptive mandate in the plaintiff states (DC, California, Connecticut, Delaware, Hawaii, Illinois, Maryland, Minnesota, New York, North Carolina, Rhode Island, Vermont, Virginia, and Washington). On January 14, 2019, Judge Wendy Beetlestone of the United States District Court for the Eastern District of Pennsylvania issued a nation-wide preliminary injunction against the final rules.

On November 7, 2018, the Departments of Health and Human Services, Labor, and Treasury released two final rules on religious and moral objections to the coverage of contraceptives under the ACA. “The Final Religious Exemption allows all non-profit and for-profit entities, whether closely held or publicly traded, to deny contraceptive coverage based on sincerely held religious beliefs. The Final Moral Exemption allows any non-profit or forprofit organization that is not publicly traded to deny contraceptive coverage for its employees for any sincerely held moral conviction.” (Judge Beetlestone’s Order, 34)

Judge Gilliam ruled that “Plaintiffs have shown that they are likely to succeed . . . on their claim that the Religious Exemption and the Moral Exemption are inconsistent with the Women’s Health Amendment, and thus violate the APA. Plaintiffs also have shown that they are likely to suffer irreparable harm as a result of this violation, that the balance of hardships tips sharply in their favor, and that the public interest favors granting the injunction.” Judge Beetlestone ruled similarly that “The Final Rules . . . exceed the scope of the Agencies’ authority under the ACA, and, further, cannot be justified under [the Religious Freedom Restoration Act of 1993].” Unlike Judge Gilliam, Judge Beetlestone issued a nation-wide injunction, stating that “given the harm to the States should the Final Rules be enforced— numerous citizens losing contraceptive coverage, resulting in ‘significant, direct and proprietary harm’ to the States in the form of increased use of state-funded contraceptive services, as well as increased costs associated with unintended pregnancies—a nation-wide injunction is required to ensure complete relief to the States.”

The Little Sisters of the Poor, a Roman Catholic religious institute for women, has appealed to the Ninth Circuit and the Third Circuit as defendant-intervenor in both cases.