Washington, DC – Yesterday, Representatives Julia Brownley (CA-26), Barbara Lee (CA-13), Diana DeGette (CO-1), Jerrold Nadler (NY-10), and Chris Pappas (NH-1) led over 150 members of the U.S. House of Representatives and U.S. Senate in submitting a Congressional amicus brief challenging the Trump administration’s refusal of care rule. The rule, currently under consideration in the 2nd and 9th Circuit, encourages discrimination and turns away more patients, particularly women, LGBTQ+ people, and other marginalized communities, who will suffer from delays or denials in accessing health care.

The amicus brief argues that the refusal of care rule would impermissibly alter the scope of refusal statutes, overriding Congress’s intent in enacting them, and that it also stands contrary to other statutes, including Title VII of the Civil Rights Act and the Emergency Medical Treatment and Labor Act (EMTALA). It also reaffirms that Congress, not HHS, is responsible for balancing competing public policy concerns.

“This rule is yet another example of the Trump Administration’s continuous attacks on the healthcare of Americans, particularly vulnerable populations, including women and LGBTQ+ individuals,” said Congresswoman Julia Brownley. “Patients’ health should always come first instead of being dictated by the personal beliefs of those who took an oath to care for them. It’s time for the courts to overturn this rule and call it what it is – discrimination.”

“The Refusal of Care Rule is yet another attempt by the Trump Administration to marginalize people who are already vulnerable to discrimination in health care, including women, LGBTQ+ individuals,  people with disabilities, and people living with HIV,” said Congresswoman Barbara Lee. “This rule could result in more patients turned away for essential care, including abortion, miscarriages, and infertility. It could also allow institutions to refuse LGBTQ+ patients, who already face significant barriers in receiving care. I joined Rep. Brownley in 2018 calling on the administration to reverse its Refusal of Care Rule and I’ve introduced the Put Patients First Act with Rep. Pappas to safeguard health care for all. We must continue to take a stand against this administration’s cruel and discriminatory attacks on reproductive health.”

“No one should be denied the health care they need because of who they are, who they love, or because they’ve previously had an abortion. This Trump administration rule is yet another egregious attack on the LGBTQ+ community, people of color and the millions of Americans who’ve exercised their constitutionally-protected right to reproductive care,” said Congresswoman Diana DeGette.

“HHS’s impermissible rule would allow health care workers to refuse to provide services based on personal religious beliefs, including refusing to provide reproductive care or to treat LGBTQ patients,” said House Judiciary Chair Jerrold Nadler. “This rule clearly exceeds HHS’s authority, conflicts with other statutes, and would result in significant harm to millions of Americans by opening the door to discrimination in the provision of health care services.  I hope the court will uphold the lower court decision and strike this cruel and indefensible rule down.”

“The care patients receive should be predicated on their medical needs and not the personally-held beliefs of providers or administrators,” said Congressman Chris Pappas. “While religious exemption laws already exist, the Trump Administration’s Refusal of Care puts patients at risk by illegally expanding those laws. I am joining my colleagues on this Amicus brief in order to ensure a provider’s personal or religious beliefs do not compromise patient care. We must protect individuals from potential discrimination, especially women, LGBTQ+, and marginalized communities who are most at risk.”


In the spring of 2018, the Trump Administration issued a proposed rule entitled, “Protecting Statutory Conscience Rights in Health Care; Delegations of Authority,” which drastically broadened the reach of refusal of care laws. In response, more than 100 Democrats sent a letter to then-Secretary Azar objecting to the rule. The refusal of care rule was finalized in May 2019 and could empower virtually anyone involved in patient care to deny medical care and information to any patient based on personal beliefs.

The rule was challenged by more than 20 states, D.C., and several other cities and localities, as well as several health clinics and providers. This led to the rule being struck down in several district courts across the country, and their appeals have been consolidated into cases in the 9th Circuit and 2nd Circuit.

In addition to Representatives Brownley, Lee, DeGette, Nadler, and Pappas, the amicus brief is also signed by Reps. A. Adams; P. Aguilar; N. Barragán; K. Bass; A. Bera; D. Beyer Jr.; E. Blumenauer; L. Rochester; S. Bonamici; T. Cárdenas; A. Carson; E. Case; S. Casten; K. Castor; J. Chu; D. Cicilline; K. Clark; Y. Clarke; W. Clay; S. Cohen; G. Connolly; J. Cooper; A. Craig; J. Crow; S. Davids; D. Davis; S. Davis; P. DeFazio; R. DeLauro; S. DelBene; M. DeSaulnier; T. Deutch; D. Dingell; E. Engel; V. Escobar; A. Eshoo; A. Espaillat; L. Fletcher; B. Foster; L. Frankel; M. Fudge; R. Gallego; J. García; S. Garcia; J. Gomez; R. Grijalva; D. Haaland; A. Hastings; J. Hayes; D. Heck; B. Higgins; J. Huffman; P. Jayapal; W. Keating; J. Kennedy, III; R. Khanna; D. Kildee; D. Kilmer; R. Kind; A. McLane Kuster; J. Larson; B. Lawrence; A. Lawson; A. Levin; M. Levin; T. Lieu; Z. Lofgren; A. Lowenthal; N. Lowey; S. Lynch; T. Malinowski; C. Maloney; S. Maloney; B. McCollum; A. McEachin; J. McGovern; J. McNerney; G. Meeks; G. Meng; G. Moore; J. Morelle; D. Mucarsel-Powell; G. Napolitano; E. Holmes Norton; I. Omar; J. Panetta; E. Perlmutter; S. Peters; D. Phillips; C. Pingree; M. Pocan; K. Porter; A. Pressley; D. Price; M. Quigley; J. Raskin; K. Rice; L. Roybal-Allard; B. Rush; T. Ryan; L. Sánchez; J. Sarbanes; M. Scanlon; J. Schakowsky; A. Schiff; B. Schneider; K. Schrier; D. Scott; J. Serrano; D. Shalala; B. Sherman; A. Smith; D. Soto; J. Speier; E. Swalwell; M. Takano; B. Thompson; D. Titus; P. Tonko; N. Torres; N. Velázquez; D. Schultz; M. Waters; B. Coleman; P. Welch; J. Wexton; S. Wild; J. Yarmuth and Senators R. Wyden; D. Feinstein; S. Whitehouse; J. Merkley; T. Baldwin; S. Brown; C. Booker; R. Blumenthal; K. Harris; K. Gillibrand; B. Cardin; J. Shaheen; A. King; E. Markey; M. Hirono; J. Reed; E. Warren; C. Masto; M. Bennet; R. Menendez; T. Duckworth; T. Smith; J. Rosen; C. Van Hollen; A. Klobuchar.


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