Judge vacates Obamacare rule forcing doctors to perform sex change surgeries

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A judge in Texas has struck down an Obama-era federal regulation that would have required healthcare providers and insurers to perform gender-transition procedures and abortions even if they go against their medical judgment or violate religious convictions.

U.S. District Court Judge Reed O’Connor, an appointee of President George W. Bush, vacated a 2016 Obamacare mandate that critics feared could have forced faith-based doctors out of work if they refused to perform gender-transition procedures or abortions on patients referred to them.

This was the second time that O’Connor ruled against the regulation, with the first coming in January 2017 when he issued a nationwide preliminary injunction against Section 1557 of the Affordable Care Act on the basis that it violated the Administrative Procedures Act.

The Obama-era rule incorporated a broadened interpretation of federal anti-discrimination law that bars discrimination in healthcare on the basis of “gender identity and termination of pregnancy.”

Because the Trump administration proposed a new rule this year with a more narrow interpretation of anti-discrimination law to supplant the Obama-era regulation, the American Civil Liberties Union and River City Gender Alliance are acting as putative intervenors in the case.

The intervenors reject the Trump administration’s proposed rule and argue that the government has a compelling interest to ensure that individuals have “nondiscriminatory access to health care and health coverage.”

On Tuesday, O’Connor maintained his opinion that the rule violates the APA but also ruled that the regulation violates the Religious Freedom Restoration Act.

“Accordingly, the Court holds that the Rule, which expressly prohibits religious exemptions, substantially burdens Private Plaintiffs’ religious exercise in violation of RFRA,” O’Connor’s opinion reads.

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The plaintiffs in the case —Christian healthcare providers in five states that are members of the Franciscan Alliance, Christian Medical & Dental Associations and Specialty Physicians of Illinois — are represented by the religious freedom nonprofit legal group Becket Fund for Religious Liberty.

“Once again, Defendants have failed to address Private Plaintiffs’ RFRA claim,” O’Connor wrote.

“However, RFRA’s text and this Court’s binding precedent make clear that Putative Intervenors cannot carry Defendants’ burden; the ‘[g]overnment may substantially burden a person’s exercise of religion only if it demonstrates that application of the burden to the person’ satisfies strict scrutiny.”

Rather than issuing a permanent injunction, O’Connor remanded the regulation "for further consideration” as the current administration has already proposed an alternate rule and regularly vows to protect the religious freedom rights of its social conservative Christian base.

Luke Goodrich, vice president and senior counsel at Becket, praised O’Connor’s decision.

“It is critically important that doctors are able to continue serving patients in keeping with their consciences and their professional medical judgment, especially when it comes to the personal health choices of families and children,” Goodrich said in a statement. “Doctors cannot do their jobs if government bureaucrats are trying to force them to perform potentially harmful procedures that violate their medical and moral judgment.”

The ruling was also praised by the pro-life student organization Students for Life of America.

“Federal Judge Reed O'Connor was right to end Obamacare's forced funding of abortion in the name of ending discrimination,” a tweet from the organization reads.

“Pregnancy is not a disease. Real healthcare affirms life.”

O’Connor is active with the conservative legal organization Federalist Society, which advocates for an originalist interpretation of the U.S. Constitution. He has taken on a number of healthcare and LGBT-related cases in the last several years.

He ruled last December that the Affordable Care Act’s individual mandate was unconstitutional.

In 2016, he blocked a 2016 Obama administration guidance advising public schools to allow students to access bathrooms and locker rooms in accordance with their gender identities, something critics felt would jeopardize the privacy rights of children.

In 2015, O’Connor temporarily blocked regulations that would have allowed the Family and Medical Leave Act benefits to extend to same-sex couples.

“Today marks a major victory for compassion, conscience, and sound medical judgment,” Goodrich stressed. “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.”

Becket is also fighting for the religious freedom rights of doctors in the case of New York v. HHS, which is a lawsuit filed by several states, including New York, against the Trump administration’s May 2019 Conscience Rule.

Becket filed a motion to intervene in the case on behalf of Christian OB-GYN Regina Frost, a member of the Christian Medical & Dental Associations.