Court Rules for Catholic Health System’s Effort to Deny Care to Transgender Patients

In a recent ruling that continues a prolonged legal battle between the U.S. federal government and Catholic interest groups, a court has blocked a mandate for Catholic hospitals that receive federal funding to perform abortions and gender affirming surgeries.

The injunction will benefit plaintiffs Franciscan Health, a Catholic hospital network in Indiana and Illinois formerly known as Franciscan Alliance, and the Christian Medical and Dental Associations, who have a combined total of 19,000 members nationwide. An initial lawsuit on the issues involved was filed in 2016 “over Affordable Care Act-related rules issued by [the Department of Health and Human Services] that year under the Obama administration,” reported Crux. Since then, a legal tug-of-war has ensued.

Health Affairs provides a legal analysis of the meaning of the recent developments:

“On August 9, Judge O’Connor reversed his prior decision and newly agreed that the religious plaintiffs were entitled to a permanent injunction to prevent HHS from interpreting or enforcing Section 1557 (the statute) and implementing regulations in a way that would require the plaintiffs to perform or provide insurance coverage for services related to gender transition or abortion. As a result, HHS cannot enforce this interpretation of Section 1557 by withholding federal funds or otherwise fining, penalizing, investigating, or taking other enforcement actions against these specific religious plaintiffs in Franciscan Alliance (or their associated health plans, insurers, or third-party administrators).”

In the Crux report, civil rights attorneys weighed in on the decision:

“[Omar] Gonzalez-Pagan, senior attorney and health care strategist at Lambda Legal, which focuses on LGBTQ rights, said ‘the court and the plaintiffs were fabricating a controversy’ when there ‘has been no threat of enforcement against the plaintiffs.’”

“He noted there are conflicting federal court decisions on defining sex discrimination in the ACA rules, and ‘at some point and time there will be a consensus among the courts or the Supreme Court may have to intervene.’

“Lindsey Kaley, staff attorney with the American Civil Liberties Union’s Center for Liberty, said the ruling limits federal enforcement but ‘does not change the fact that transgender people who have been turned away from health care can continue to pursue litigation.’ The ACLU’s Texas branch intervened on behalf of HHS.”

As Gonzalez-Pagan and Kaley note, this legal battle is likely far from over, as trans people will continue to pursue justice and courts appear to be without consensus. Kaley goes on to say that “gender-affirming care is life-saving care, and doctors agree that it is medically necessary for many transgender people.” In the continued struggle over the meaning of religious liberty, it is at least worth wondering why a pro-life church is spending millions of dollars in legal battles to protect the right to refuse life-saving surgeries.

Read more on the history of this lawsuit detailed in Bondings 2.0 here and a narrative on harm caused to transgender patients denied surgery here.

–Barbara Anne Kozee, August 20, 2021

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