Judge Blocks Trump’s Attempt to Roll Back Birth Control Mandate

A federal judge on Sunday granted a request by more than a dozen states to temporarily block the Trump administration from putting into effect new rules that would make it easier for employers to deny women health insurance coverage for contraceptives.

Contraception is covered by the Affordable Care Act as a preventive health service, something employers and insurers are generally required to provide at no charge. But the Trump administration developed rules to allow employers to opt out of the mandate if they had religious or moral objections.

A version of those rules was stymied by the courts in 2017, so the administration issued a new set of rules in November, which had been scheduled to take effect on Monday.

However, the judge, Haywood S. Gilliam Jr. of the United States District Court in Oakland, Calif., granted a request by 13 states and the District of Columbia for a preliminary injunction, writing that the new rules “are nearly identical to” the ones that he had previously blocked.

The plaintiffs, he wrote, had done enough to bolster their claim that the religious exemption and the moral exemption sought by the Trump administration were “not in accordance with” the Affordable Care Act.

After Judge Gilliam blocked the initial rules, the Trump administration appealed. Last month the United States Court of Appeals for the Ninth Circuit upheld the District Court’s ruling but limited the injunction’s scope.

With that ruling in mind, Judge Gilliam made clear that the preliminary injunction he granted on Sunday bars enforcement in only the states that sued.

“The Court fully recognizes that limiting the scope of this injunction to the plaintiff states means that women in other states are at risk of losing access to cost-free contraceptives when the final rules take effect,” he wrote in Sunday’s order.

States had also argued they would suffer economic harm as a result of the rules because they would have had to provide contraceptive coverage or pay for medical treatment and social services for more women with unintended pregnancies.

Judge Gilliam agreed, writing they had “shown that they are likely to suffer irreparable harm as a result of this violation, that the balance of hardships tips sharply in their favor, and that the public interest favors granting the injunction.”

In a statement, Xavier Becerra, the attorney general of California, which is listed as the lead plaintiff in the case, said: “The law couldn’t be clearer — employers have no business interfering in women’s health care decisions.”

“Today’s court ruling stops another attempt by the Trump administration to trample on women’s access to basic reproductive care,” he said. “It’s 2019, yet the Trump administration is still trying to roll back women’s rights. Our coalition will continue to fight to ensure women have access to the reproductive health care they are guaranteed under the law.”

Mr. Becerra’s office suggested in its statement that access to cost-free birth control for “millions of women and their families” was at stake. A regulatory impact analysis of the administration’s new rules estimated that “no more than 126,400 women of childbearing age” would have been affected, court documents said.

The Department of Health and Human Services, which is listed as the lead defendant in the case, did not immediately respond to a request for comment. But in court documents opposing the request for an injunction, lawyers for the Justice Department argued that the agencies involved “reasonably exercised their rule-making authority to protect a narrow class of sincere religious and moral objectors from being forced to facilitate practices that conflict with their beliefs.”

As part of the Affordable Care Act, the Obama administration said preventive health services included all methods of contraception approved for women by the Food and Drug Administration.

But under rules issued in October 2017, the Trump administration expanded exemptions from the contraceptive coverage mandate, allowing employers to opt out if they had religious or moral objections. The moves were meant to help President Trump carry out a promise he made about not allowing “people of faith to be targeted, bullied or silenced anymore.”

The Trump administration’s revised rules, published in November 2018, said that employers could obtain an exemption if they objected to some or all forms of contraception based on their “sincerely held religious beliefs” or moral convictions. Those rules also emphasized that female employees could obtain contraceptives at family-planning clinics as an alternative to seeking them through health insurance.

Last month, the five states that opposed the initial rules — California, Delaware, Maryland, New York and Virginia — filed a second complaint over the revised rules, which was joined by Connecticut, Hawaii, Illinois, Minnesota, North Carolina, Rhode Island, Vermont, Washington State and the District of Columbia.

Because of the injunction Judge Gilliam ordered on Sunday, none of those states will need to comply with the Trump administration’s expanded exemptions until the case is resolved.