WASHINGTON — A federal court on Friday blocked Trump administration rules that made it easier for employers to deny insurance coverage of contraceptives for women.
Judge Wendy Beetlestone of U.S. District Court in Philadelphia issued a preliminary injunction, saying the rules contradicted the text of the Affordable Care Act by allowing many employers to opt out of providing contraceptive coverage if they had religious or moral objections.
In the lawsuit, filed by the state of Pennsylvania, the judge said the rules would cause irreparable harm because tens of thousands of women would lose contraceptive coverage.
The Affordable Care Act contains no statutory language allowing federal agencies to create such “sweeping exemptions” to the law’s requirements to cover preventive services, Beetlestone declared.
The Trump administration rules reversed a policy of the Obama administration that generally required employers and insurers to provide women with coverage for contraceptives without copayments, deductibles or other costs.
“A simple hypothetical illustrates the insidious effect of the moral exemption rule," Beetlestone wrote. “It would allow an employer with a sincerely held moral conviction that women do not have a place in the workplace to simply stop providing contraceptive coverage.”
It is, she said, difficult to imagine a rule that “intrudes more into the lives of women.”
The lawsuit was filed by the Pennsylvania attorney general, Josh Shapiro, a Democrat.
In her opinion, Beetlestone said Pennsylvania was likely to succeed in its challenge to the birth control rules. In issuing the rules, she said, the Trump administration did not follow “proper procedure.” Federal officials, she said, flouted the Administrative Procedure Act, which generally requires agencies to seek public comment before adopting regulations that have the force of law.
For its part, the Trump administration said the contraceptive coverage mandate imposed a “substantial burden” on the exercise of religion by certain employers. The new rules, relaxing the mandate, fulfilled a campaign pledge by President Donald Trump, who said employers should not be “bullied by the federal government because of their religious beliefs.”
Lauren Ehrsam, a Justice Department spokeswoman, said: “We disagree with the court’s ruling and are evaluating next steps. This administration is committed to defending the religious liberty of all Americans, and we look forward to doing so in court.”
But Shapiro said the court ruling Friday was a victory for millions of women.
“Donald Trump broke the law to undermine women’s health, and women here in Pennsylvania stood up and proved that in court,” Shapiro said. “Together we’ve won a nationwide halt to these rules.”
The court order is a first step in what could be lengthy litigation. It “maintains the status quo pending the outcome of a trial on the merits” of the state’s claims, Beetlestone said. Similar claims have been made in lawsuits filed by women’s rights groups; female students and employees; and several other states, including California, Massachusetts and New York.
President Barack Obama signed the Affordable Care Act in March 2010. One section of the law requires coverage of preventive health services and screenings for women. In August 2011, the Obama administration required employers and insurers to provide women with coverage at no cost for all methods of contraception approved by the Food and Drug Administration.
Beetlestone said Pennsylvania had standing to sue the Trump administration because women denied coverage under the new rules were likely to “seek state-funded sources of contraceptive care,” generating additional costs for the state.
Federal officials estimated that at least 31,700 women could lose contraceptive coverage under the new rules, the judge said, and “there are reasons to believe the number is significantly higher.”
Moreover, Beetlestone said, the state has an interest in protecting the health of its citizens.
“The potential harm faced by Pennsylvanian women and across the nation is enormous and irreversible,” she wrote. As employers take advantage of the new rules, she said, “access to no-cost contraceptive services for many women will be severely curtailed.”
The Trump administration had argued that its interpretation of the Affordable Care Act was entitled to deference from the court. Beetlestone disagreed because, she said, the administration’s reading of the law “conflicts with the statute’s plain language.”
Administration officials suggested that the lawsuit was premature because Pennsylvania had not identified any individual who had lost contraceptive coverage.
But the judge said “there is no need to wait for the ax to fall,” particularly where “it is about to fall on tens of thousands of women.”
Beetlestone reviewed the convoluted history of the contraceptive coverage mandate, which was repeatedly revised by the Obama administration after dozens of legal challenges. She described scientific evidence on the effectiveness of various contraceptives in preventing unintended pregnancies.
And she examined what she called “the real-life consequences” of the Trump administration rules.
“Women,” Beetlestone said, “will likely forgo contraceptive services or seek out less expensive and less effective types of contraceptive services in the absence of no-cost insurance coverage.”
In October, the Trump administration issued two separate but similar rules on contraceptive coverage: one for religious objections and one for moral objections to the mandate.
A 1993 law, the Religious Freedom Restoration Act, says the government “shall not substantially burden a person’s exercise of religion” unless the burden is “the least restrictive means” to advance “a compelling governmental interest.”
The Trump administration acknowledged that the law “does not provide protection for nonreligious, moral conscientious objections” to contraceptives.
But, it said, “Congress has a consistent history of supporting conscience protections for moral convictions alongside protections for religious beliefs.”
Beetlestone said the rules vastly expanded the number of employers that could opt out of the contraceptive coverage requirement.
“They are,” she said, “the proverbial exception that swallows the rule.”