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Court Blocks Trump Administration Restrictions on Birth Control

Women are guaranteed access to free birth control under the Affordable Care Act, but President Trump has sought to allow employers to deny insurance coverage of contraceptives on religious or moral grounds.Credit...Rich Pedroncelli/Associated Press

WASHINGTON — A federal court issued a nationwide injunction on Monday that prevents the Trump administration from interfering with women’s access to free birth control guaranteed under the Affordable Care Act.

The decision, by Judge Wendy Beetlestone of the Federal District Court in Philadelphia, extends a losing streak for President Trump, who has repeatedly been set back in his efforts to allow employers to deny insurance coverage of contraceptives to which the employers object on religious or moral grounds.

The rules were scheduled to take effect on Monday. The states of Pennsylvania and New Jersey challenged the rules before Judge Beetlestone, saying they would have to shoulder much of the burden of providing contraceptives to women who lost coverage under the Trump administration’s rules.

“The states’ harm is not merely speculative; it is actual and imminent,” Judge Beetlestone wrote. “The final rules estimate that at least 70,500 women will lose coverage.”

The Trump administration argued that the states had not identified anyone who had lost coverage under the rules. Judge Beetlestone replied: “There is no need to wait for the ax to fall before an injunction is appropriate, particularly where defendants have estimated that it is about to fall on thousands of women — and, as a corollary, on the states.”

Judge Beetlestone said the final rules were likely to have harsh consequences: “numerous citizens losing contraceptive coverage, resulting in significant, direct and proprietary harm to the states in the form of increased use of state-funded contraceptive services, as well as increased costs associated with unintended pregnancies.”

Her decision was issued less than 24 hours after Judge Haywood S. Gilliam Jr. of the Federal District Court in Oakland, Calif., granted a request by 13 states and the District of Columbia to block the rules in their jurisdictions.

“Women who lose their entitlement to cost-free contraceptives are less likely to use an effective method, or any method at all — resulting in unintended pregnancies,” Judge Gilliam said. Moreover, he said, many of the women are likely to “turn to state programs to obtain no-cost contraceptives, at significant cost to the states.”

Josh Shapiro, the attorney general of Pennsylvania, who filed the lawsuit there, welcomed the decision by Judge Beetlestone.

“Today’s ruling is a victory for the health and economic independence of women in Pennsylvania and across America,” Mr. Shapiro, a Democrat, said. “Women need contraception for their health because contraception is medicine, pure and simple.”

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Josh Shapiro, the attorney general of Pennsylvania, who filed a lawsuit to block the Trump administration’s restrictions, called the ruling “a victory for the health and economic independence of women.”Credit...Matt Rourke/Associated Press

The attorney general of California, Xavier Becerra, also a Democrat, said: “The law couldn’t be clearer. Employers have no business interfering in women’s health care decisions.”

President Barack Obama signed the Affordable Care Act in March 2010. One section of the law requires coverage of preventive health services and screenings for women. In August 2011, the Obama administration required employers and insurers to provide women with coverage at no cost for all methods of contraception approved by the Food and Drug Administration.

For its part, the Trump administration said the contraceptive coverage mandate imposed a “substantial burden” on the exercise of religion by certain employers. The new rules, relaxing the mandate, fulfilled a campaign pledge by Mr. Trump, who said employers should not be “bullied by the federal government because of their religious beliefs.”

Alex M. Azar II, the secretary of health and human services, was a defendant in both cases. Caitlin Oakley, a spokeswoman for Mr. Azar, reiterated the administration’s position after the court decisions.

“No American should be forced to violate his or her own conscience in order to abide by the laws and regulations governing our health care system,” Ms. Oakley said on Monday. “The final rules affirm the Trump administration’s commitment to upholding the freedoms afforded all Americans under our Constitution.”

The administration said employers who had moral objections to certain forms of birth control should also be exempt from the contraceptive coverage mandate.

Congress and the courts have long recognized the importance of respecting moral convictions as well as religious beliefs, the Trump administration said, and as an example it cited the exemption from military service available to certain “conscientious objectors.”

Moreover, it said an early version of the First Amendment, proposed by James Madison, protected not only freedom of religion, but also “the full and equal rights of conscience.”

The rulings issued in Pennsylvania and California were preliminary injunctions. The judges in both cases said the states were likely to succeed on the merits of their claims and to suffer irreparable harm in the absence of a court order.

Mark L. Rienzi, the president of the Becket Fund for Religious Liberty, said Monday that his organization would appeal the court decisions on behalf of its client the Little Sisters of the Poor, an order of Roman Catholic nuns who object to the contraceptive coverage mandate.

“We never wanted this fight, and we regret that after a long legal battle, it is still not over,” Mother Loraine Marie Maguire of the Little Sisters said. “We pray that we can once again devote our lives to our ministry of serving the elderly poor as we have for over 175 years.”

A version of this article appears in print on  , Section A, Page 16 of the New York edition with the headline: Court Blocks Attempt to Restrict Access to Birth Control. Order Reprints | Today’s Paper | Subscribe

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