The federal government is ratcheting up its support for a so-called “conscience rule” that would allow healthcare workers to deny specific care if it conflicts with their religious or moral beliefs. 

Skilled nursing and other long-term care facilities that accept federal funding would be among providers affected by the rule.

The Trump administration has filed a notice of appeal in the U.S. District Court for the Southern District of New York, where a judge vacated the proposed rule in early November.

The U.S. District Court for the Eastern District of Washington and the District Court for the Northern District of California also vacated the rule late last year. Allowing those lower court rulings to stand would force workers to provide care even if it caused a personal conflict.

The New York case will now head to the U.S. Court of Appeals for the Second Circuit, where officials with the Department of Health and Human Services hope to clear the way for implementation.

The final rule, which was set to take effect in November,  referred to federal protections for abortion, assisted suicide, compulsory healthcare, specific programs for hearing screening, occupational illness testing, vaccination and mental health treatment as well as “certain requirements under Medicare and Medicaid that may burden their exercise of their religious beliefs regarding medical treatment.”

Elder advocacy group SAGE has noted the rule might make it easier to discriminate against LGBTQ patients.

In the New York case, U.S. District Judge Paul A. Engelmayer called the rule unconstitutional and said HHS exceeded its authority and “acted arbitrarily and capriciously” in publishing it. 

“HHS’s stated justification for undertaking rulemaking in the first place — a purported ‘significant increase’ in civilian complaints relating to the Conscience Provisions — was factually untrue,” he noted.