State files to block federal ‘conscience rule’ on health care

May 29, 2019 GMT

Washington state is suing the Trump administration again, this time over a proposed change in federal rules that would allow doctors and other medical personnel to refuse a patient’s requested treatment based on religious or moral grounds.

Attorney General Bob Ferguson filed the lawsuit in the U.S. District Court for Eastern Washington, saying the new “conscience” rule announced by the Department of Health and Human Services is “an open license to discriminate.”

He filed the case in Spokane, he said in a news release, because rural communities, like those in Eastern Washington, have fewer health care providers and are more likely to be harmed by the new rule.


President Donald Trump described the change on May 2 during the National Day of Prayer ceremony as “new protections of conscience rights for physicians, pharmacists, nurses, teachers, students and faith-based charities.” The department announced the final rule May 21.

Washington has a long tradition of respecting its citizens’ religious beliefs, Ferguson said in the lawsuit. But it has laws that balance those beliefs so that no one’s views are imposed unwillingly on someone else.

“Washington’s laws require that no health care provider’s conscience-based refusal results in the denial of timely access to information and services required by prevailing medical and ethical standards,” the lawsuit says.

The rule is so broad that it extends that right of refusal to insurers and employers, the suit contends.

Among the possible examples of the rule the lawsuit lists are:

A rape victim could be refused emergency contraception.

A pregnant woman whose baby has developed a fatal condition could be refused counseling about certain options like abortion.

A doctor who objects to the state’s Death with Dignity Act could refuse to transfer the records of a patient suffering from a terminal illness to a doctor who doesn’t object to the law.

A health care provider with a religious objection could refuse to help a gay or transgender individual seeking health care.

States that don’t comply with the rule could risk the loss of federal health care funding, which in Washington is more than $10 billion per year, the lawsuit says. In setting up the rule, the department violated the Administrative Procedures Act by failing to follow existing federal laws and interfering with decisions on federal spending that are up to Congress, it contends.


The lawsuit asks the federal court to declare the conscience rule unconstitutional, block it with a permanent injunction and pay Washington’s costs for bringing the lawsuit.

Ferguson has repeatedly challenged the Trump administration’s efforts to change federal rules, filing a total of 38 lawsuits since 2017. The state has won on 12 cases that cannot be appealed and received favorable rulings on another 10 that are under appeal, or could still be appealed by the administration. The state hasn’t lost any of the other cases, which are in different phases of litigation.