NEW YORK, May 21 (Reuters) ― Two dozen U.S. states and municipalities sued the Trump administration on Tuesday to stop it from enforcing a rule that would make it easier for doctors and nurses to avoid performing abortions on religious or moral grounds.

A lawsuit led by New York Attorney General Letitia James said the expanded “conscience” protections could undermine the ability of states and cities to provide effective healthcare without jeopardizing billions of dollars a year in federal aid.

It also said the rule would upset legislative efforts to accommodate workers’ beliefs while ensuring that hospitals, other businesses and staff treat patients effectively.

Sterilizations and assisted suicide are other procedures that might be impeded, according to a complaint filed by New York and 22 other states and municipalities in federal court in Manhattan. California filed a similar lawsuit in San Francisco.

“The federal government is giving health care providers free license to openly discriminate and refuse care to patients,” James said in a statement.

California joins almost two dozen states and cities suing over a federal rule allowing businesses and individuals to refuse healthcare services based on their religious beliefs or moral convictions. https://t.co/bDOYjcQL6Y — Los Angeles Times (@latimes) May 22, 2019

The rule is scheduled to take effect on July 22. It will be enforced by the U.S. Department of Health and Human Services.

Roger Severino, director of HHS’ Office for Civil Rights, said in a statement: “The rule gives life and enforcement tools to conscience protection laws that have been on the books for decades. HHS finalized the conscience rule after more than a year of careful consideration and after analyzing over 242,000 public comments. We will defend the rule vigorously.”

President Donald Trump, a Republican, has made expanding religious liberty a priority, and the proposed rule drew support from anti-abortion activists.

Critics, including some civil rights medical groups, have said the rule could deprive some patients, including gay and transgender people, of needed healthcare because they might be deemed less worthy of treatment.

The Manhattan lawsuit said the rule could even prevent hospitals from asking applicants for nursing jobs whether they opposed giving measles vaccinations, even during an outbreak.

So far in 2019, the worst U.S. measles outbreak in a quarter century has sickened 880 people, the U.S. Centers for Disease Control and Prevention said on Monday.

The plaintiffs in Tuesday’s lawsuits are led by Democrats or often lean Democratic.

They also include New York City, Chicago and Washington, D.C.; the states of Colorado, Connecticut, Delaware, Hawaii, Illinois, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia and Wisconsin; and Cook County, Illinois.

Hundreds of lawsuits by Democratic-leaning states and municipalities have targeted White House policies under Trump.

The cases are New York et al v. U.S. Department of Health and Human Services et al, U.S. District Court, Southern District of New York, No. 19-04676; and California v. Azar et al, U.S. District Court, Northern District of California, No. 19-02769.

(Reporting by Jonathan Stempel in New York; editing by Jonathan Oatis)