Demonstrators outside Supreme Court , the day of arguments in the case Zubik v. Burwell

A federal appeals court has upheld a nationwide injunction that blocked the Trump administration from enacting certain religious and moral exceptions to the Affordable Care Act that have been widely seen as a means to roll back the mandate for covering birth control medications.

A unanimous three-judge panel of the U.S. Court of Appeals for the Third Circuit ruled July 12 to uphold a decision from January that barred the federal government from enforcing a version of the ACA that allowed for greatly expanded exceptions to the requirement that companies help cover the cost of contraceptives.

The ruling is a win for Pennsylvania and New Jersey, which are seeking to halt the proposed changes that, the states argued, would have resulted in the states picking up the bill for thousands of women whose coverage, the states contend, would be dropped as a result of the changes.

Led by Judge Patty Shwartz, the panel determined that, since the states were likely to succeed with their arguments, a nationwide injunction was appropriate to halt any harm the states or women may suffer.

“Because the current accommodation does not substantially burden employers' religious exercise and the exemption is not necessary to protect a legally-cognizable interest, the states' financial injury outweighs any purported injury to religious exercise,” Shwartz said. “Moreover, the public interest favors minimizing harm to third-parties by ensuring that women who may lose ACA guaranteed contraceptive coverage are able to maintain access to the preventive care to which they are entitled under the ACA and [Health Resources and Services Administration]'s comprehensive guidelines while final adjudication of the rules is pending.”

In a statement to the press, Pennsylvania Attorney General Josh Shapiro called the ruling a “big win.”

“Contraception is medicine—pure and simple. Today's decision by the Third Circuit Court of Appeals to uphold my office's nationwide injunction is a win for the women of this nation,” Shapiro said. “This is a huge victory for women's rights and the rule of law—two things the Trump administration has disregarded from day one. Pennsylvania women can be confident I will continue to fight for their right to health coverage and contraceptive care.”

New Jersey Attorney General Gurbir Grewal offered similar sentiments.

“The rules that we just defeated would deny basic health care to tens of thousands of women across the country,” Grewal said. “We will keep fighting for equal and affordable health care for people in New Jersey and across the country, and are proud to have Pennsylvania Attorney General Josh Shapiro as a partner in that fight.”

In a press statement, a spokeswoman for the U.S. Department of Justice said, “We are disappointed by this decision. Religious organizations should not be forced to violate their mission and deeply-held beliefs. The Department of Justice continues to vigorously defend religious liberty.”

Along with arguments about the alleged harm, much of Shwartz's 56-page decision focused on allegations that the government did not follow the proper notice and comment rule-making process.

The Trump administration had argued it had been able to circumvent the usual comment period in part because of the religious harm those objecting to the mandate might face. The Third Circuit, however, said objectors could still litigate individual accommodations regarding the contraceptive mandate, and that the changes the Trump administration sought were “such a dramatic overhaul” of the rules, they needed to go through the normal process.

The panel also looked into the lower court's decision to impose a nationwide injunction in the matter. Nationwide injunctions, which bar a given practice from coast to coast, have come under increasing scrutiny recently, with some critics saying the rulings affect those beyond the district court's jurisdictions and others contending that the wide-ranging rulings stymie a rigorous development of the law, since only one judge, or one circuit, can weigh the issue.

The Third Circuit panel, however said the nationwide injunction U.S. District Judge Wendy Beetlestone of the Eastern District of Pennsylvania issued in January was appropriate given how so many people work, or attend schools, in states where they do not live.

“An injunction geographically limited to the states alone will not protect them from financial harm, as some share of their residents who work out-of-state will lose contraceptive coverage originally provided through employers in non-enjoined states who will exempt themselves,” Shwartz said. “In light of the impact of these interstate activities, the district court did not abuse its discretion in concluding that a nationwide injunction was necessary to afford the states complete relief.”

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Court upholds injunction barring Trump admin's exceptions to birth control mandate

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