Court hears arguments in ‘Denial of Care Rule’ lawsuit

The U.S. District Court for the Northern District of California heard arguments Wednesday in a case, with plaintiffs that include two local LGBTQ organizations, challenging a proposed Trump administration rule that would allow health care professionals to refuse services on the ground of personal religious or moral beliefs.

Allentown’s Bradbury-Sullivan LGBT Community Center and the Mazzoni Center join other groups across the country, including Whitman-Walker Health in Washington, D.C, Hartford GYN in Connecticut, Los Angeles LGBT Center and Trust Women Seattle, in challenging what has been dubbed the “Denial of Care Rule” by the legislation’s opponents. Attorneys from Americans United for Separation of Church and State, the Center for Reproductive Rights, and Lambda Legal, alongside the County of Santa Clara and pro bono counsel Mayer Brown LLP, argued Wednesday that the restrictions are unlawful and should be blocked from taking effect Nov. 22.

The legal team told the court that the U.S. Department of Health and Human Services has stepped outside the bounds of its authority and failed to consider how the rule could harm patients and the country’s health care system. The federal legislation would greenlight any health care worker, including doctors, nurses, EMTs, administrators, janitors and clerical staff, to deny medical treatment, information and services to patients based on personal views. 

The lawyers also argued the rule is unconstitutional, advancing religious beliefs that violate patient rights to free speech, privacy, liberty and equal dignity.

“We can’t risk not being able to find doctors who will care for us, we can’t risk not being able to access PrEP or HIV treatment, we can’t risk not being able to have providers who will provide care for transgender people in our communities,” said Adrian Shanker, executive director of Bradbury-Sullivan LGBT Community Center. “These issues are just too serious; they’re too specific to our basic livelihood. We’re hopeful that the court sees that.”

The lawsuit, County of Santa Clara v. HHS, was filed May 28, days after the federal department issued the rule. The legislation was originally supposed to be implemented July 22 but was pushed back following the 183-page lawsuit. 

“The Rule specifically invites refusals to provide care to women seeking reproductive healthcare and transgender and gender-nonconforming patients seeking gender-affirming care, adversely affecting the healthcare entities that provide reproductive healthcare services and that serve the lesbian, gay, bisexual, and transgender (“LGBT”) community,” the suit states. “The Rule stigmatizes and shames these patients, depriving them of their constitutionally protected rights of access to healthcare and their dignity and autonomy in seeking medically necessary healthcare central to their self-determination.” 

Wednesday’s County of Santa Clara v. HHS arguments coincided with those for two other challenges to the “Denial of Care Rule” brought by the City and County of San Francisco and the State of California.

Jamie Gliksberg, Lamba Legal senior attorney, said Wednesday morning she was confident the court would “strike the Rule in its entirety so that it never takes effect.”

“Health care available to LGBT people should be no different than what is available to other populations in the United States. Accessing health care services is already a fraught experience for LGBT folks, who historically have encountered discrimination in multiple contexts, from EMTs and ambulances to basic reproductive health care,” Gliksberg told PGN, adding,”A ruling from the court halting implementation of this Denial of Care Rule will hopefully send a clear message that no one should be denied critical and often life-saving health care services on the basis of the religious or moral beliefs of the healthcare providers upon whom we all rely upon in our most vulnerable times of need.”

Alecia Manley, chief operating officer and interim co-leader at Mazzoni Center, told PGN the Philly-based LGBTQ nonprofit signed on as a plaintiff because the “Denial of Care Rule” undermines the goals of Mazzoni Center, which was founded 40 years ago to provide services to folks who were denied care, or feared being denied care, because of health providers’ moral objections.

“The Denial of Care Rules undermines Mazzoni Center’s mission by encouraging providers to shame, judge, or discriminate against patients, and by threatening penalties against [those] who discourage providers from doing so,” Manley said. “This rule empowers health care workers to feel that they have a government-sponsored license to deny care to patients. Denying care to someone in their time of need because of their sex, sexual orientation, race, gender identity, religion or reproductive health needs and history is dangerous and humiliating. It is also against civil rights laws, the Constitution and medical ethical requirements.”

 

A ruling had not yet been made in County of Santa Clara v. HHS at press time. 

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