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U.S. District Judge Paul Engelmayer of the Southern District of New York has struck down the Trump administration's "conscience rule" that would allow health care providers to refuse to perform procedures based on religious or moral objections.

The lawsuit was led by New York Attorney General Letitia James, who termed the measure a "refusal of care rule."

"Health care is a basic right that should never be subject to political games," James said. "Once again, the courts have blocked the Trump administration from implementing a discriminatory rule that would only hurt Americans."

Engelmayer wrote that the U.S. Department of Health and Human Services' proposed "conscience" provisions "principally, although not exclusively, address objections to abortion, sterilization, and assisted suicide, in addition to counseling and referrals related to these services."

HHS' May announcement said it would protect providers, individuals and entities from "having to provide, participate in, pay for, provide coverage of, or refer for, services such as abortion, sterilization, or assisted suicide." It also governed participation in advance directives.

The rule, which was scheduled to go into effect Nov. 22, was vacated as unconstitutional and adopted in violation of the Administrative Procedure Act.

The rule was rejected for, among other things, usurping the congressional spending power.

Engelmayer, in his 147-page opinion, also found that HHS lacked substantive rule-making authority to issue three of the five proposed "conscience" provisions and contradicted two other federal statutes—Title VII of the 1997 Balanced Budget Act, which governs employee-employer relations, and the Emergency Medical Treatment and Labor Act.

In promulgating the rule, Engelmayer reasoned, HHS exceeded its authority, since Congress never delegated authority to the executive branch to withhold funds on what plaintiffs argued was a "seemingly limitless" scale. He focused on one provision of the rule that would give HHS the discretion to bar all funding to a hospital for violations of a conscience provision.

That rule, he said, "aggrandizes the Executive Branch at Congress's expense. Such an encroachment is inconsistent with the separation of powers."

The decision handed a win to plaintiffs challenging the "conscience rule" in three consolidated actions: a coalition of 19 states, the District of Columbia and three municipal governments; the national Planned Parenthood Federation and its New England regional branch; and another coalition of health care providers.

The case drew 10 amicus briefs from 40 parties, Engelmayer observed.

"The refusal of care rule was an unlawful attempt to allow health care providers to openly discriminate and refuse to provide necessary health care to patients based on providers' 'religious beliefs or moral objections.'" James said in a statement after the ruling was handed down.

Engelmayer disagreed with one argument from challengers: that the rule facially violated the establishment clause of the First Amendment as an "excessive accommodation" to one set of religious beliefs.

He said the rule did not exclusively privilege religious beliefs.

"Like the conscience provisions it purports to construe, the rule equally accommodates all conscience-based objections to covered health care services and research activities," Engelmayer wrote. "That is so whether the individual objector's qualms derive from a religious or a secular moral conviction."

A request for comment to the U.S. Department of Health and Human Services was not immediately returned Thursday.

The case was captioned State of New York v. U.S. Department of Health and Human Services.

Among the plaintiffs were the states of Connecticut, New Jersey, Pennsylvania, Delaware, Maryland and Virginia.

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