Minnesota Attorney General Keith Ellison has joined a coalition of 23 states and local governments in filing a lawsuit against a Trump Administration rule that would compel Minnesota to, “grant to individual health providers the categorical right to deny lawful and medically necessary treatment, services, and information to patients, based on the provider’s own personal views.”
The federal lawsuit, filed in the Southern District of New York, seeks to prevent a Final Rule issued by the Trump Administration’s Department of Health and Human Services (HHS) from going into effect. The suit follows a comment letter that Minnesota and a coalition of states submitted in March 2018, when the rule was first proposed, urging that the rule be withdrawn.
“No one should be able to deny anyone else legal, medically-necessary care based solely on their own personal beliefs. No one,” Ellison said. “It’s a fundamental betrayal of everyone’s right to live with dignity, safety, and respect. The Trump Administration wants to take that right away from Minnesotans. I’m stepping in to protect Minnesotans when the federal government won’t.”
Under the rule, HHS would have sole discretion to determine whether a state has complied with the mandate to allow discrimination. If HHS were to determine that Minnesota or any of the many agencies and nonprofits that the state contracts with to deliver healthcare services had not allowed businesses or providers to discriminate solely on the basis of their personal beliefs, the federal government could terminate funding that supports Minnesotans’ health. This could include Medicaid, the Children’s Health Insurance Program, HIV/AIDS and STD treatment and prevention, and substance-abuse and mental-health treatment, among many others.
Ellison said the consequences of the rule would fall particularly hard on women, people of color, low-income people and LGBTQ patients, who already confront discrimination and other restrictions in obtaining affordable, high-quality health care.
The lawsuit Ellison joined alleges the Final Rule, which will take effect in July 2019, would undermine the delivery of healthcare by giving a wide range of healthcare institutions and individuals a right to refuse care, based on the provider’s own personal views. The rule expands the number of providers eligible to make such refusals, ranging from ambulance drivers and emergency-room doctors to receptionists and customer-service representatives at insurance companies. Ellison contends the rule makes this right absolute and categorical, and no matter what reasonable steps a health provider or employer makes to accommodate the views of an objecting individual, if that individual rejects a proposed accommodation, a provider or employer is left with no recourse.
For example, under the rule, Ellison said a hospital could not inquire, prior to hiring a nurse, if he or she objected to administering a measles vaccination – even if this was a core duty of the job in the middle of an outbreak of the disease or an emergency room doctor could refuse to assist a woman who arrived with a ruptured ectopic pregnancy, even if the woman’s life was in jeopardy. The lawsuit filed contends the rule would also allow businesses, including employers, to object to providing insurance coverage for procedures they consider objectionable, and allow individual health care personnel to object to informing patients about their medical options or referring them to providers of those options.
The lawsuit argues this expansion of refusal rights, and the “draconian threat,” as Ellison put it, of termination of federal funds, violates the federal Administrative Procedures Act and the Spending Clause and separation of powers principles in the U.S. Constitution.
A copy of the complaint is available on the website of New York Attorney General Letitia James.
Attorney General Ellison is joined in filing the lawsuit with the original plaintiff, New York, and the states of Colorado, Connecticut, Delaware, the District of Columbia, Hawaii, Illinois, Maryland, Massachusetts, Michigan, Nevada, New Jersey, New Mexico, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, Wisconsin, the City of New York, the City of Chicago and Cook County, Illinois.