District court rules against Trump's religious conscience rule and Little Sisters of the Poor

PHILADELPHIA — A federal district court in Philadelphia on Wednesday ruled against a Trump administration religious conscience rule, siding with Pennsylvania and New Jersey. Those states have insisted for years that the Little Sisters of the Poor, a group of Catholic nuns who care for the elderly, must include abortion and contraceptives in their health care plans for employees.

The Supreme Court issued two different rulings favoring the Little Sisters and other religious groups who want a religious exemption from the federal government's contraceptive mandate, but neither of those Supreme Court decisions closed the door on additional challenges.

The mandate was installed under the Affordable Care Act, when the Department of Health and Human Services required employers in their insurance plans to provide women's "preventive care," which includes some contraceptives and medication that can cause an abortion.

The original mandate provided some exemptions but did not offer exemptions to religious organizations like Little Sisters.

Little Sisters challenged the Affordable Care Act's regulations and brought the case to the Supreme Court in 2016. The court ruled that the federal government should arrive at an approach that would accommodate religious exercise while still ensuring women are covered by health plans and receive access to contraceptive care.

Shortly after taking office the first time, President Donald Trump asked HHS to devise new rules that promoted "free speech and religious liberty." HHS considered conscience-based objection to care and issued new rules, which allowed providers to refuse certain services if they cite a religious objection.

The new rules were issued in 2017, and several state governments then sued. Lower circuit courts placed injunctions on the rule change, and the issue again made its way to the Supreme Court in 2020. The court ruled that the Trump administration's rules were valid and could stand, giving a religious exemption over the issue.

The judge in Wednesday's ruling said the Trump administration's amendments to the rule allowed for "more entities to take advantage of the exemption or accommodation." The judge's decision means the Trump administration rule is "vacated" in full.

Mark Rienzi, the president of Becket, a religious liberty organization and lead attorney for the Little Sisters, said the effort by Pennsylvania and New Jersey is out of control.

"It's bad enough that the district court issued a nationwide ruling invalidating federal religious conscience rules. But even worse is that the district court simply ducked the glaring constitutional issues in this case, after waiting five years and not even holding a hearing," Rienzi said in a statement. "It is absurd to think the Little Sisters might need yet another trip to the Supreme Court to end what has now been more than a dozen years of litigation over the same issue."

The Little Sisters said they will be appealing Wednesday's ruling in the coming weeks.

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