Appeals court affirms injunction against Biden HHS rule to force religious healthcare providers to perform gender transition services

 December 11, 2022

President Joe Biden's administration reinterpreted a discrimination provision within the Affordable Care Act to include gender identity and sought to force religious doctors and hospitals to provide gender transition surgeries and treatments regardless of their religious beliefs or conscientious objections.

A district court had previously issued a permanent injunction against that rule and now an appeals court panel has upheld that earlier ruling against the administration, the Daily Caller reported.

This ruling from the Eighth Circuit Court of Appeals comes just a few months after a similar decision by the Fifth Circuit Court of Appeals in a separate challenge to the same rule.

Permanent injunctions affirmed

At issue here, according to the 40-page ruling from an Eighth Circuit three-judge panel, is Section 1557 of the Affordable Care Act which prohibits healthcare providers who receive federal funds from engaging in discrimination based on sex, among other things.

The Obama administration sought to expand that in 2016 to include gender identity but was struck down by the courts, only for the reinterpretation to be revived by other separate court cases involving discrimination based on gender, which led the Biden administration to reimplement that new rule.

As a result, a coalition of Catholic healthcare providers led by the Religious Sisters of Mercy sued Health and Human Services Sec. Xavier Becerra and a district court in North Dakota sided with the providers and issued an injunction against the HHS rule that violated the First Amendment and Religious Freedom Restoration Act by forcing them to act against their beliefs.

Concurrent with that was a separate group of Catholic healthcare providers known as the Franciscan Alliance who initially sued HHS in 2016 over the original attempt to impose the same rule and similarly won an injunction in a Texas district court against the new version under the Biden administration. In August, a three-judge panel of the Fifth Circuit similarly affirmed the lower court's permanent injunction against the HHS rule in an 18-page ruling.

Given all of that from the two district courts, the Fifth Circuit, and more, the Eighth Circuit panel on Friday wrote, "We agree with these courts and therefore conclude that the district court correctly held that 'intrusion upon the Catholic Plaintiffs’ exercise of religion is sufficient to show irreparable harm.'"

"Common-sense ruling"

Becket Law, which specializes in religious liberty cases, represented the Catholic plaintiffs in both cases and celebrated the Eighth Circuit panel's ruling in a press release.

"The federal government has no business forcing doctors to violate their consciences or perform controversial procedures that could permanently harm their patients," Becket VP and senior counsel Luke Goodrich said in a statement. "This is a common-sense ruling that protects patients, aligns with best medical practice, and ensures doctors can follow their Hippocratic Oath to 'do no harm.'"

"Today’s victory sets an important precedent that religious healthcare professionals are free to practice medicine in accordance with their consciences and experienced professional judgment," he added. "The government’s attempt to force doctors to go against their consciences was bad for patients, bad for doctors, and bad for religious liberty."

Further appeal by Biden admin seems unlikely

The Daily Caller noted that the Biden administration was granted 45 days to request a rehearing by the full Eighth Circuit or 90 days to appeal the panel's decision to the Supreme Court, but Goodrich explained in a media call why he believed the administration would not do either.

"Number one, these rulings were on very solid grounds, very strong rulings. It’s kinda hard to even debate that these rulings are wrong," Goodrich said.

"But then, secondly, we already kinda had a test run on this from the Fifth Circuit ruling a few months ago on the Texas case, which affirmed the same type of injunction, the Biden Administration had the same type of opportunity to seek rehearing from the Fifth Circuit or appeal to the US Supreme Court but it declined to do both of those," he added. "It just let the deadlines pass without further appeal, and it just let that case become final."

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