Fighting Discrimination

A Trump-era rule invited religious meddling in health care. Here’s how AU helped get rid of it.

  A Trump-era rule invited religious meddling in health care. Here’s how AU helped get rid of it.

The Biden administration’s recent decision to mostly rescind the dangerous parts of the Trump-era “Denial of Care Rule” didn’t get as much attention as it deserved. It’s actually kind of a big deal – and Americans United played a huge role in its demise.

Here’s a look at what went on behind the scenes: The Denial of Care Rule, which was issued in May 2019 by the U.S. Department of Health and Human Services under former President Donald Trump, invited any health care worker to deny medical care to patients because of the worker’s personal religious or moral beliefs.

AU knew right away that this was a big problem. The rule, an unprecedented intrusion of religion into Americans’ personal medical decisions, threatened to punish health care facilities by pulling essential federal funding unless they granted employees carte blanche to deny services. It was yet another attempt by the Trump administration to curry favor with his Christian Nationalist base.

AU swings into action

After the rule was proposed, AU quickly swung into action. AU’s Policy Department submitted comments opposing the proposed rule, pointing out that it exceeded the government’s authority, threatened the health and well-being of patients, violated church-state separation and conflicted with existing laws.

AU and allied groups engaged our supporters to comment as well. In the end, we delivered over 200,000 comments at a rally in front of HHS.

When the Trump administration prepared to finalize the rule anyway, Americans United’s Legal Department began laying the groundwork to challenge it in court. We worked with the Center for Reproductive Rights, and Lambda Legal, as well as the law departments of the City and County of Santa Clara, California, and the City of Baltimore, which would serve as plaintiffs.

At the same time, the Policy team briefed congressional committees that have oversight authority over the rule.

Challenging the rule in court

Eventually, AU and its partners filed two lawsuits on behalf of a wide variety of health care providers, organizations and government entities challenging the rule. The lawsuits argued that the Trump administration exceeded its authority and arbitrarily and capriciously failed to consider the rule’s potential harm to patients and the health care system, in violation of the federal Administrative Procedure Act.

We also argued that the rule was unconstitutional because it favored specific religious beliefs in violation of the First Amendment; violated patients’ rights to privacy, liberty and equal dignity as guaranteed by the Fifth Amendment; and chilled patients’ speech and expression in violation of the First Amendment, all to the detriment of patients’ health and well-being.

In conjunction with the lawsuits our Communications Department created a series of graphics and videos to drive home the many marginalized and vulnerable populations the rule would harm. We held press briefings and created live “from the courthouse” videos. All this was designed to get the word out and inform and engage our network of supporters on the issue.

The rule failed to take effect

Partners also filed similar lawsuits in New York and Washington. In one of our cases and some of the related cases, three federal district courts invalidated the Trump administration’s Denial of Care Rule and prevented it from taking effect.

Joe Biden’s election in 2020 dramatically shifted the landscape. Americans United included repeal of the rule on a 10-point list of recommendations for the Biden administration. In 2022, the administration did just that and proposed rescinding the unlawful and dangerous aspects of the Trump rule. We submitted comments supporting the Biden administration proposal.

And on Jan. 9, the Biden administration finalized the repeal. The American people are in a much better and safer place because of that.

Congress needs to hear from you!

Urge your legislators to co-sponsor the Do No Harm Act today.

The Do No Harm Act will help ensure that our laws are a shield to protect religious freedom and not used as a sword to harm others by undermining civil rights laws and denying access to health care.

Act Now