County of Santa Clara v. HHS

(Revised 9.21.21) This lawsuit challenges the “Denial of Care” rule first issued by the U.S. Department of Health and Human Services in 2019, which changed a component of the implementation of the Affordable Care Act in a way that would harm health care access for women, LGBTQ people, and immigrants. The new regulation would invite health care workers – doctors, nurses, EMTs, administrators and clerical staff – to deny medical treatment and services to patients because of personal religious or moral beliefs. Health care facilities that do not comply risk losing federal funding.  Because of this, health care facilities may do away with reproductive and LGBTQ services altogether, leaving millions without access to critical health care.

Plaintiff(s): Trust Women Seattle, Hartford GYN, Whitman-Walker Health, Bradbury-Sullivan LGBT Community Center, Los Angeles LGBT Center, Center on Halsted, Mazzoni Center, GLMA, Association of Gay and Lesbian Psychiatrists, Medical Students for Choice

Center Attorney(s): Genevieve Scott

Co-Counsel/Cooperating Attorneys: Jamie A. Gliksberg at LAMBDA Legal Defense and Education Fund, Lee H. Rubin at Mayer Brown LLP, Richard B. Katskee at Americans United for Separation of Church and State, James R. Williams, Greta S. Hansen, Laura S. Trice, Mary E. Hanna-Weir, Susan P. Greenberg, and H. Luke Edward Office of the County Counsel, County of Santa Clara

Summary: We filed our complaint in federal district court on May 28, 2019.  The lawsuit argues that the Denial of Care rule is unconstitutional because it advances specific religious beliefs (in violation of the First amendment); violates the patients rights to privacy, liberty and equal dignity as guaranteed by the Fifth Amendment. It could also lead to many LGBTQ patients not fully disclosing their identity and medical history for fear of discrimination, resulting in improper or incomplete care.  The lawsuit also asserts that HHS violated the federal Administrative Procedure Act in creating the rule by arbitrarily and capriciously failing to consider the impact on patients.

In June 2019, the federal government agreed to delay the effective date of the new rule until at least November 22.  Following a hearing in October, the district court granted a permanent injunction on November 19, vacating the rule in its entirety.  The federal government filed an appeal with the U.S. Court of Appeals for the Ninth Circuit. The case has since been stayed as the new presidential administration reviews the rule.