Santa Clara County, San Francisco, the state of California and an array of medical groups asked a federal judge on Thursday to strike down an expanded version of a measure known as the religious refusal rule.
The rule announced by the administration of President Donald Trump in June would allow health care institutions and many types of workers to refuse services on religious grounds and would deny federal health, welfare and education funds to state and local governments that don't comply.
U.S. District Judge William Alsup will hold a hearing on the request in San Francisco on Oct. 30. He will also hear a competing motion by the U.S. Justice Department for dismissal of the state and local governments' lawsuits.
The rule was originally due to take effect on July 22, but after the lawsuits were filed, the Health and Human Services Department agreed to delay implementation until Nov. 22.
The local opponents claim the rule illegally goes far beyond conscience protections previously granted by Congress to doctors and certain other personnel and would allow "virtually anyone involved in the provision of health care to refuse to provide vital services and information to patients."
Front office staff and call operators would be among those who could refuse to help, with no exception for emergencies, and patients who would be harmed include women seeking contraceptive care and abortions and lesbian, gay, bisexual, and transgender people, the lawsuits claim.
"Far from preventing discrimination, the rule perpetuates widespread discrimination against populations that have historically faced obstacles to obtaining care," the local governments say.
Justice Department lawyers representing the Health and Human Services Department argued in their brief last month that the rule is consistent with the protections in laws enacted by Congress.
Those laws and the new rule "simply ensure that the targeted federal funds are not used to disadvantage individuals or entities on the basis of objections to certain health care activities, some of which may be rooted in religion," the federal attorneys wrote.
Alsup is presiding over three similar lawsuits filed by the state, San Francisco and Santa Clara County together with a coalition of medical and civil rights groups. At his request, they filed a joint brief supporting their motions for summary judgment.
The state could risk losing $77.6 billion and San Francisco and Santa Clara County each $1 billion in federal funding, according to the brief.