A judge tells federal agencies they can't enforce anti-trans bias policies against Catholic groups
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The judge rejected a request from an order of nuns, two Catholic homes and the Catholic Benefits Association, which represents employers, to impose similar bans on each agency covering abortion and fertility treatments Catholic organizations consider immoral. He said those claims were 'underdeveloped' and not ready for court review.
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But he concluded that allowing the two agencies to enforce policies on gender-affirming care or health coverage for it would restrict employers' and health care providers' ability to live out their religious beliefs, violating a 1992 federal law meant to provide broad protections for religious freedoms. The HHS rule had a provision allowing the agency to make case-by-case exceptions based on religious beliefs, but Welte said that would be insufficient.
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'The case-by-case exemption procedure leaves religious organizations unable to predict their legal exposure without furthering any compelling antidiscrimination interests,' wrote Welte, who is based in Fargo.
The two agencies did not immediately respond to email messages seeking comment Thursday.
The Catholic Benefits Association serves more than 9,000 employers and about 164,000 employees enrolled in member health plans, according to its website.
The group, founded in 2013, says it 'advocates for and litigates in defense of our members' First Amendment rights to provide employee benefits and a work environment that is consistent with the Catholic faith.' The First Amendment to the U.S. Constitution protects religious freedoms.
Association General Counsel Martin Nussbaum welcomed the ruling, saying the organization's members 'want to do the right thing in their health plan and in their medical services that they provide for those medical providers, and this gives them protection to doing that.'
And he said the judge's ruling suggests there are no mandates from the federal government on abortion or fertility treatments, so there is 'no need to provide protection.'
The U.S. Supreme Court ruled in 2020 that the Civil Rights Act's protections against discrimination based on sex also cover anti-LGBTQ+ bias in employment. The landmark 1964 act doesn't have specific provisions dealing with bias based on sexual orientation or gender identity.
But courts also have intervened to limit how far the federal government can go in combating anti-LGBTQ+ discrimination when religious organizations or employers with religious beliefs against LGBTQ+ rights are involved.
Both the HHS rule and the EEOC's policy on sex discrimination have their roots in efforts by President Barack Obama to protect LGBTQ+ rights in 2016, in his last year in office.
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When President Donald Trump began his second term in January, he issued an order saying the federal government would not recognize transgender people's gender identities. In April, two employees said the EEOC was classifying all new gender identity-related discrimination cases as its lowest priority, essentially putting them on indefinite hold.
The 2024 HHS rule also covered bias based on 'pregnancy or related conditions," and the Catholic health care providers argued that they might face losing federal funds if they refused to perform abortions, in line with Catholic opposition to abortion. But HHS said the rule wouldn't have forced them to perform abortions or provide health coverage for abortions — only that it couldn't refuse to care for someone because they'd had one, according to Welte.
Hanna reported from Topeka, Kansas.
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Despite removing the section on diversity, SSM Health has maintained its equal opportunity section. Froedtert did the opposite, by maintaining its webpages on diversity, equity and inclusion, but removing its equal opportunity policy document from the pages. The equal opportunity document, which can still be found online but was removed from the DEI website, specifically outlines Froedtert's commitment and policy to maintain equitable and nondiscriminatory recruitment, hiring and human resources practices. The document outlines two policies specifically: 'FH is committed to its affirmative action policies and practices in employment programs to achieve a balanced workforce' and 'FH will provide equal opportunity to all individuals, regardless of their race, creed, color, religion, sex, age, national origin, disability, military and veteran status, sexual orientation, gender identity, marital status or any other characteristics protected by state or federal law.' 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In 2018, Aurora merged with Advocate Health, a system with more than 26 hospitals throughout the Midwest. Advocate Aurora Health later merged with Atrium Health in 2022, creating the third largest nonprofit in the nation. Earlier this year, Aurora removed an entire page on diversity, equity and inclusion. The page now redirects to Advocate's page titled 'Access & Opportunity.' That change cut statements such as: 'Our diversity, equity and inclusion strategy is anchored by our purpose to help people live well and to deliver safe, consistent, and equitable health outcomes and experiences for the patients and communities we serve.' A spokesperson for Aurora Health Care said the organization will continue to 'deliver compassionate, high-quality, consistent care for all those we serve.' 'As our newly combined purpose and commitments state, we lift everyone up by ensuring access and opportunity for all,' the spokesperson said. 'To provide our patients and communities clear and consistent information that explains our programs, policies and services, we are making various changes to our websites.' Ascension, one of the largest nonprofit hospital systems in the nation, took down the entire page on diversity, equity and inclusion. The health care system currently operates at over 165 locations in Milwaukee, Racine, Appleton and Fox Valley. The system still has modules on 'Identifying & Addressing Barriers to Health' and 'Ensuring Health Equity.' Ascension did not respond to a request for a comment. UW Health removed its page on diversity, equity and inclusion, replacing it with a page titled 'social impact in belonging.' In doing so, UW Health removed 'anti-racism' from its entire website. It used to be one of the main themes. UW Health removed the anti-racism modules titled 'Being a leader in anti-racism' and 'anti-racism funding,' and now in their place are modules called 'Being a social impact leader' and 'Community giving.' Chief Social Impact Officer Shiva Bidar-Sielaff and CEO Alan Kaplan addressed the changes in a video, stating social impact and belonging align with their mission, values and strategies as a health care organization. 'At UW Health, social impact refers to the effects health care policies, practices and interventions have on the well-being of individuals and communities, improving health outcomes, access to care and quality of life,' Bidar-Sielaff said. 'Belonging is the understanding that you are valued and respected for who you are as an individual.' UW Health reported receiving $315 million in federal funding, totaling over half of the $622 million in grant funds — federal and non-federal — awarded to the School of Medicine and Public Health. That total is 37% of all grant funding awarded to UW-Madison. Despite claims by health care centers that missions remain the same, advocacy groups in Wisconsin are raising concerns regarding the impact these changes could have on communities in Wisconsin. Chris Allen, president and CEO of Diverse & Resilient — an advocacy group focused on health inequities for LGBTQ+ people in Wisconsin — said these quiet language shifts are significant. 'They send a message that commitments to addressing disparities may be weakening, even if that's not the stated intention,' Allen said. William Parke Sutherland, government affairs director at Kids Forward, a statewide policy center that advocates for low-income and minority families, said many health care partners feel pressured to preserve funding sources. In Wisconsin, maternal mortality rates are 2.5 times higher for Black women than white women. Maternal morbidities — or serious birth complications — were the highest among Black women and people enrolled in BadgerCare, the state's largest Medicaid program. From 2020 to 2022 there were 7.8 stillbirth deaths per 1,000 births among Black babies, compared with 4.5 among white babies. Disparities in maternal and infant mortality rates could be attributed to stress caused by poverty, lack of access to quality care, or systemic racism, according to health care researchers. If a mother is stressed over a long period of time, that can cause elevated levels of stress hormones, which could increase premature births or low birth weights for infants. For Black women, midwives have been found to reduce the disparities they otherwise may experience during pregnancy, reducing the risk of maternal mortality or morbidity. Access to midwives is currently covered by Medicaid, so losing federal funding could harm these services. Regardless of language, 'Wisconsin's racial disparities in health access and outcomes aren't going away on their own,' Sutherland said in an email. Removing language that acknowledges DEI efforts will not reduce the health care disparities felt by Wisconsin residents, Sutherland said. Federal funding cuts could also hurt rural families in Wisconsin, specifically those who rely on Medicaid for their health care needs. 'We cannot begin to address these challenges if we're not willing to acknowledge them,' Sutherland said. 'A colorblind approach has not helped in the past.' This article first appeared on Wisconsin Watch and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
