In these consolidated cases, a coalition of entities affiliated with the Catholic Church and the State of North Dakota challenge the implementation of Section 1557 of the Patient Protection and Affordable Care Act (“ACA”), a statute that prohibits certain forms of discrimination in healthcare. The Plaintiffs contend that the Department of Health and Human Services (“HHS”) and, derivatively, the Equal Employment Opportunity Commission (“EEOC”) interpret Section 1557 and related antidiscrimination laws in a way that compels them to perform and provide insurance coverage for gender transitions and abortions. (source)

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On June 15, 2020, the Supreme Court decided Bostock—just three days after HHS finalized the 2020 Rule.5 The Court held that firing an employee for being homosexual or transgender constitutes sex discrimination under Title VII because such a decision “necessarily and intentionally discriminates against that individual in part because of sex.” Bostock, 140 S. Ct. at 1744. In so holding, the Court assumed that “sex” referred “only to biological distinctions between male and female.” Id. at 1739. Even with that assumption, the Court deemed it “impossible to discriminate against a person for being homosexual or transgender without discriminating against that individual based on sex.” Id. at 1741.

Bostock arrived with caveats, however. The Court warned that its decision did not “prejudge” any “other federal or state laws that prohibit sex discrimination.” Id. at 1753. Indeed, a dissent from Justice Alito went so far as to identify Section 1557 as having the potential to “emerge as an intense battleground under the Court’s holding.” Id. at 1781 (Alito, J., dissenting). And the Court separately expressed continued commitment to safeguarding employers’ religious convictions. Id. at 1753-54 (majority opinion). Referencing the RFRA by name, the Court categorized it as “a kind of super statute” that “might supersede Title VII’s commands in appropriate cases.” Id. at 1754. (source)

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The Court HEREBY ORDERS that Defendant EEOC is STAYED from enforcing its position that Title VII bars discrimination on the basis of gender identity against the Catholic Benefits Association and its members and the Catholic Medical Association and its members pending Defendants’ requested remand and stay, and until this Court rules on the CBA’s pending motion for a temporary restraining order. (source)

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The Court has reviewed the record, the parties’ filings, and the relevant legal authority. For the reasons above, the Defendants’ motion to dismiss for lack of jurisdiction…is GRANTED IN PART and DENIED IN PART. The abortion-related claims, the APA claims, and the claims challenging Title IX and other unidentified federal laws are hereby DISMISSED WITHOUT PREJUDICE. The Plaintiffs’ motions for partial summary judgment and injunctive relief (Doc. Nos. 96, 98) are GRANTED as to the RFRA claims challenging the interpretations of Section 1557 and Title VII that require the Catholic Plaintiffs to perform and provide insurance coverage for gender-transition procedures and DENIED in all other respects.

The Court DECLARES that HHS’s interpretation of Section 1557 that requires the Catholic Plaintiffs to perform and provide insurance coverage for gender-transition procedures violates their sincerely held religious beliefs without satisfying strict scrutiny under the RFRA. Accordingly, the Court PERMANENTLY ENJOINS AND RESTRAINS HHS, Secretary Azar, their divisions, bureaus, agents, officers, commissioners, employees, and anyone acting in concert or participation with them, including their successors in office, from interpreting or enforcing Section 1557 of the ACA, 42 U.S.C. § 18116(a), or any implementing regulations thereto against the Catholic Plaintiffs in a manner that would require them to perform or provide insurance coverage for gender-transition procedures, including by denying federal financial assistance because of their failure to perform or provide insurance coverage for such procedures or by otherwise pursuing, charging, or assessing any penalties, fines, assessments, investigations, or other enforcement actions.

The Court further DECLARES that the EEOC’s interpretation of Title VII that requires the CBA and its members to provide insurance coverage for gender-transition procedures violates their sincerely held religious beliefs without satisfying strict scrutiny under the RFRA. Accordingly, the Court PERMANENTLY ENJOINS AND RESTRAINS the EEOC, Chair Dhillon, their divisions, bureaus, agents, officers, commissioners, employees, and anyone acting in concert or participation with them, including their successors in office, from interpreting or enforcing Title VII of the Civil Rights Act of 1964, 42 U.S.C. § 2000e et seq., or any implementing regulations thereto against the CBA and its members in a manner that would require them to provide insurance coverage for gender-transition procedures, including by denying federal financial assistance because of their failure to provide insurance coverage for such procedures or by otherwise pursuing, charging, or assessing any penalties, fines, assessments, investigations, or other enforcement actions.

Peter D. Welte, Chief District Judge in United States District Court, D. North Dakota, Eastern Division. Case: The Religious Sisters of Mercy, et al., Plaintiffs, v. Alex M. Azar II, Secretary of the United States Department of Health and Human Services, et al., Plaintiffs | Catholic Benefits Association, et al., v. Alex M. Azar II, Secretary of the United States Department of Health and Human Services, et al., Defendants. (January 19, 2021)

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