AG Joins Lawsuit to Defend State’s Federal Healthcare Funding

Lilo H. Stainton | May 22, 2019 | Health Care
Trying to fend off Trump administration’s new rule that would let providers decline to perform abortions, other services on moral or religious grounds

Credit: Office of Attorney General/Tim Larsen
Attorney General Gurbir Grewal
New Jersey officials are concerned that as much as $12 billion in annual federal funding could be at risk if the Trump administration institutes a rule that would let healthcare providers decline to provide abortions and other services that conflict with their moral or religious views.

State Attorney General Gurbir S. Grewal joined the attorneys general of New York, Pennsylvania and nearly two dozen other states to challenge the rule and its attendant regulations which are scheduled to take effect in late July, in a lawsuit filed Tuesday. The complaint alleges that the rule is unconstitutional in that it allows doctors and other clinicians to discriminate against patients, potentially undermining care for scores of vulnerable patients.

According to Grewal, the rule enables the U.S. Department of Health and Human Services to terminate all of its federal funding to New Jersey — a total of $11.8 billion last year — if the state fails to comply with the new requirements, which permit providers far more freedom in whom they would treat and for what. The plaintiffs called it an overreach to protect religious values at the expense of care for gay or transgender patients, or the availability of some services like abortion and vaccinations.

“This refusal-of-care rule represents an unprecedented and unlawful overreach by the federal government, and we’re proud to stand against it,” Grewal said. “New Jersey will not be strong-armed into accepting a federal rule that is unconstitutional, morally wrong and potentially harmful to some of our most vulnerable populations.”

Under Gov. Phil Murphy, New Jersey officials have focused on expanding healthcare services for underserved populations, including LGBTQ patients, and addressing racial disparities in health outcomes, particularly maternal and infant mortality. Grewal has joined a number of multi-state lawsuits to battle Trump administration policies that seek to reduce funding for women’s healthcare services or curb benefits tied to the federal Affordable Care Act.

‘Potentially cruel’

In the charges filed Tuesday in Manhattan’s federal court, New Jersey joined neighbors from New England and the mid-Atlantic region and states as far away as Hawaii in challenging the legitimacy of the new rule.
They claim the rule unlawfully expands nearly 30 provisions of existing laws in ways that are dangerous to patients or “potentially cruel.” They suggest it would affect statutes that restrict federally funded entities from retaliating against individuals that do not want to participate in certain protocols, such as physician-assisted suicide or sterilization, for religious, moral or personal reasons. (Federal law already prevents public funding from being used for abortion, they add.)

In addition, the rule would compel states and local governments, which benefit from the federal dollars, to permit individual providers to discriminate against citizens, based on the provider’s personal views, they said. It also gives the federal government the right to withhold or deny states any amount of funding if it determines any providers felt they were unable to uphold their moral or religious beliefs, even if it meant denying care to others.

“This change to put providers above patients comes at a dangerous price: it will undermine the Plaintiffs’ ability to administer their health care systems and deliver patient care effectively and efficiently,” the complaint states.

“The Final Rule would permit a wide swath of employees — from receptionists to nurses to doctors to pharmacists to anesthesiologists — to refuse to assist that patient in real time, and without any advance notice, no matter the intense medical risk to the patient,” it notes.

In the complaint, the plaintiffs also note that the impact could be particularly harsh on black and brown communities, which rely more heavily on publicly subsidized programs than their white neighbors. “And women and LGBTQI individuals who are already stigmatized in obtaining access to health care will be further hindered in obtaining the lawful medical services they need,” it adds.

In addition, Grewal said the rule conflicts with state laws regarding emergency care, which require certain treatment and prohibit clinicians from abandoning their medical duties. “Our state already has a framework of laws that carefully balance respect for religious freedom with the rights of patients to access health care,” he added. “This rule could leave us unable to enforce those laws, and we don’t intend to let that happen.”