Federal Judge Rules Obamacare Protections Violate Religious Freedom

WICHITA FALLS, Texas (CN) – A federal judge on Tuesday invalidated Obama-era protections for patients seeking transgender or abortion-related care, concluding they violate the religious rights of medical providers who object to performing such treatments.


The federal website where consumers can sign up for health insurance under the Affordable Care Act is shown on a computer screen in Washington on Nov. 1, 2018. (AP Photo/Susan Walsh)

U.S. District Judge Reed O’Connor granted motions for partial summary judgment against the federal government in Texas, concluding the protections violated religious medical providers’ rights under the Religious Freedom Restoration Act and are illegal under the Administrative Procedure Act.


According to the 25-page opinion, the rule’s “broadly states purpose, implemented through universal application of the rule, could arguably satisfy a categorical application of strict scrutiny, [but] it cannot satisfy RFRA’s ‘more focused’ inquiry.”

The judge said the U.S. Department of Health and Human Services failed to show its rule would “achieve a compelling governmental interest through the least restrictive means” in “substantially burden[ing]” plaintiffs’ religious rights.

“Accordingly, the court holds that the rule, which expressly prohibits religious exemptions, substantially burdens private plaintiffs’ religious exercise in violation of RFRA,” O’Connor wrote. 

Enacted in 2016, the rule requires federally-funded medical providers and insurers to treat and pay for patients regardless of their sex, gender identity or termination of pregnancy. Originally defended by the Obama administration, the regulation has been in limbo under President Donald Trump who has declined to defend it.

Critics claim the regulation forces doctors to perform abortions or gender-reassignment procedures against their will.

Five states and three physicians associations sued HHS in 2016, claiming the Affordable Care Act regulation violates the “medical judgment and conscience rights” of doctors. 

“On pain of significant financial liability, the regulation forces doctors to perform controversial and sometimes harmful medical procedures ostensibly designed to permanently change an individual’s sex – including the sex of children,” the complaint stated. “Under the new regulation, a doctor must perform these procedures even when they are contrary to the doctor’s medical judgment and could result in significant, long-term medical harm. Thus, the regulation represents a radical invasion of the federal bureaucracy into a doctor’s medical judgment.”

Lead plaintiff Texas argued that Congress has consistently defined the term “sex” for several decades and across several federal laws as meaning a patient’s biological sex at birth.

The other states joining Texas in the lawsuit include Wisconsin, Nebraska, Kentucky and Kansas. The physicians’ groups include the Franciscan Alliance, Specialty Physicians of Illinois and Christian Medical and Dental Associations.

HHS could not be reached for comment after office hours Tuesday.

Plaintiffs’ attorney Luke Goodrich, with Becket Law in Washington, D.C., said the ruling is a “major victory for compassion, conscience and sound medical judgment.”

“Our clients look forward to joyfully continuing to serve all patients, regardless of their sex or gender identity, and continuing to provide top-notch care to transgender patients for everything from cancer to the common cold,” Goodrich said.

Texas Attorney General Ken Paxton thanked the court for “recognizing that Washington’s pursuit of an ideological agenda must still be constrained by the rule of law.”

“HHS lacked the legal authority to re-write a number of federal laws that prevent sex discrimination and protect religious freedom, especially when it sought to do so by forcing doctors to perform – and American taxpayers to pay for – controversial medical procedures that are contrary to the religious and moral beliefs of millions across our nation,” Paxton said in a written statement Tuesday night.

O’Connor is the same federal judge who ruled for Texas in a separate lawsuit invalidating Obamacare as a whole in Dec. 2018. O’Connor concluded the ACA’s individual mandate is invalid due to the Republican-enacted Tax Cuts and Jobs Act of 2017 reducing the tax penalty to zero.

Texas successfully argued the U.S. Supreme Court’s upholding of Obamacare in 2015 concluded the mandate would be an unconstitutional exercise of federal power without the tax penalty.

O’Connor later issued a stay allowing the law to stand pending an appeal to the Fifth Circuit, citing “great uncertainty” for those seeking health care coverage.

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