WASHINGTON -- The Department of Health and Human Services (HHS) is delaying until at least late November implementation of its "conscience protection" rule allowing healthcare providers to decline treatment and services to certain groups of people based on religious and moral beliefs, pending the outcome of several lawsuits over the regulation.
HHS said Friday in a that it agreed to the delay "because it is the most efficient way to adjudicate the Final Rule on the merits" -- the rule was originally planned to be implemented on July 22.
The agency said it was not conceding that the plaintiffs are "likely to succeed on the merits," or are likely to "suffer irreparable harm" in the absence of a stay, or that an injunction is in the public interest, according to the filing for in the U.S. District Court for the Northern District of California.
The lawsuit was filed by the city and county of San Francisco on May 2 -- the same day that HHS issued the final rule. The plaintiffs allege that if the city refuses to comply with the rule -- which would allow providers to, for example, refuse to provide care to gay or transgender patients -- "it risks losing nearly $1 billion in federal funds that support critical health care services and other vital functions."
"While the City supports the legitimate conscience rights of individual health care professionals, the exercise of these rights must be balanced against the fundamental obligations of the medical profession and the right of all patients to receive quality health care," the lawsuit says.
Roger Severino, head of HHS's Office for Civil Rights, said on the day the final rule was issued that it does not add any new laws; it merely strengthens enforcement of rules already on the books to protect providers' religious beliefs, Severino said in a conference call with reporters. Those rules include:
- The , which bars federal agencies from making grants to entities that discriminate against healthcare providers who don't provide abortions
- The , which prohibits the federal government from discriminating in grants or loans on the basis of whether the entity is willing to perform sterilizations or abortions
- The , which says the federal government and state governments can't discriminate against entities that refuse to undergo training in how to perform abortions, or to provide such training
HHS dismissed the idea that the new rule, which also will apply to those objecting to contraception and assisted suicide, will decrease access to care in already underserved communities, noting that it doesn't expand current anti-discrimination or conscience laws already on the books. (The department's assertions have been disputed by many, however, including House Democrats during a hearing last week.)
San Francisco's lawsuit is one of several pending over the rule. Another group of plaintiffs that includes Americans United for Separation of Church and State and the Center for Reproductive Rights, has in California, as has .
San Francisco City Attorney Dennis Herrera hailed the delay as a victory for the city. "Faced with the law, the Trump administration blinked," he . "We have won this battle -- and it was an important one -- but the fight is not over. The Trump administration is trying to systematically limit access to critical medical care for women, the LGBTQ community, and other vulnerable patients. We're not going to let that happen. We will continue to stand up for what's right. Hospitals are no place to put personal beliefs above patient care. Refusing treatment to vulnerable patients should not leave anyone with a clear conscience."
Other reactions to the implementation delay, which will run until at least Nov. 22, varied. "The HHS Conscience Rule is essential to protecting the First Amendment rights of all healthcare workers," Donna Harrison, MD, executive director of the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG), said in an email responding to a request for comment.
"Those who oppose the HHS Conscience Rule demonstrate their clear intention to squeeze out of the medical profession any doctor who still abides by the Hippocratic oath, and to squelch any opposition to forcing doctors to kill human beings at the beginning and end of life. AAPLOG strongly supports the HHS Conscience Rule as critically important to the rights of all Americans, including medical professionals."
"The delay is certainly good news because it means that this rule isn't going to take effect and that the harms are not going to happen now," Santa Clara County Counsel James Williams, who is part of another lawsuit against the rule, . "But it's just an interim step, and we're going to be pressing forward very vigorously with getting a decision and summary judgment to vacate the rule."