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Nos. 19- 4254(L), 20-31, 20-32, 20-41 Case 19-4254, Document 166; 20-31, Document 80; 20-32, Document 79; 20-41, Document 112, 04/27/2020 Nos. 19- 4254(L), 20-31, 20-32, 20-41 IN THE UNITED STATES COURT OF APPEALS FOR THE SECOND CIRCUIT STATE OF NEW YORK; CITY OF NEW YORK; STATE OF COLORADO; STATE OF CONNECTICUT; STATE OF DELAWARE; DISTRICT OF COLUMBIA; STATE OF HAWAII; STATE OF ILLINOIS; STATE OF MARYLAND; COMMONWEALTH OF MASSACHUSETTS; STATE OF MICHIGAN; STATE OF MINNESOTA; STATE OF NEVADA; STATE OF NEW JERSEY; STATE OF NEW MEXICO; STATE OF OREGON; COMMONWEALTH OF PENNSYLVANIA; STATE OF RHODE ISLAND; STATE OF VERMONT; COMMONWEALTH OF VIRGINIA; STATE OF WISCONSIN; CITY OF CHICAGO; AND COOK COUNTY, ILLINOIS, Plaintiffs-Appellees, (Caption continued on inside cover) On Appeal from the United States District Court for the Southern District of New York JOINT APPENDIX VOLUME VIII OF X Of Counsel: JOSEPH H. HUNT Assistant Attorney General ROBERT P. CHARROW MICHAEL S. RAAB General Counsel LOWELL V. STURGILL JR. SARAH CARROLL SEAN R. KEVENEY LEIF OVERVOLD Deputy General Counsel Attorneys, Appellate Staff U.S. Department of Health & Human Services Civil Division, Room 7226 U.S. Department of Justice 950 Pennsylvania Avenue NW Washington, DC 20530 (202) 532-4631 Counsel for Defendants-Appellants and Consolidated- Defendants-Appellants PLANNED PARENTHOOD FEDERATION OF AMERICA, INC.; PLANNED PARENTHOOD OF NORTHERN NEW ENGLAND, INC.; NATIONAL FAMILY PLANNING AND REPRODUCTIVE HEALTH ASSOCIATION; AND PUBLIC HEALTH SOLUTIONS, INC. Consolidated-Plaintiffs-Appellees, v. UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES; ALEX M. AZAR, II, in his official capacity as Secretary of the United States Department of Health and Human Service; AND UNITED STATES OF AMERICA, Defendants-Appellants, DR. REGINA FROST AND CHRISTIAN MEDICAL AND DENTAL ASSOCIATIONS, Intervenors-Defendants-Appellants, ROGER T. SEVERINO, in his official capacity as Director, Office for Civil Rights, United States Department of Health and Human Services; AND OFFICE FOR CIVIL RIGHTS, UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES, Consolidated-Defendants-Appellants. TABLE OF CONTENTS Page Colangelo Declaration, Exs. 110-131 Nat’l Women’s Law Ctr. Comment, Ex. 110 (ECF No. 180-44) ................. JA 1965 Calif. Med. Ass’n Comment, Ex. 111 (ECF No. 180-45) .............................. JA 1982 GLMA: Health Professionals Advancing LGBT Equality Comment, Ex. 112 (ECF No. 180-46) ............................................................................. JA 1992 Planned Parenthood Fed’n of Am. Comment, Ex. 113 (ECF No. 180-47) ............................................................................. JA 2001 Ctr. for Reprod. Rights Comment, Ex. 114 (ECF No. 180-48).................... JA 2023 Medicare Rights Ctr. Comment, Ex. 115 (ECF No. 180-49) ........................ JA 2052 Inst. for Policy Integrity Comment, Ex. 116 (ECF No. 180-50) .................. JA 2060 Lambda Legal Comment, Ex. 117 (ECF No. 180-51) ................................... JA 2070 Christian Med. Ass’n, Summary of Online Survey of Faith-Based Med. Prof’ls, Ex. 118 (ECF No. 180-52) ............................................................................. JA 2091 Closure Letter, Compl. 11-122388, Ex. 119 (ECF No. 180-53) ................... JA 2097 Closure Letter & PIMS Record, Compl. 17-259696, Ex. 120 (ECF No. 180-54) ............................................................................. JA 2100 Compl. 18-293704, Ex. 121 (ECF No. 180-55) ............................................... JA 2104 Compl. 18-293773, Ex. 122 (ECF No. 180-56) ............................................... JA 2114 Compl. 18-294058, Ex. 123 (ECF No. 180-57) ............................................... JA 2124 Compl. 18-294456, Ex. 124 (ECF No. 180-58) ............................................... JA 2136 Compl. 18-296732, Ex. 125 (ECF No. 180-59) ............................................... JA 2146 Compl. 18-297792, Ex. 126 (ECF No. 180-60) ............................................... JA 2151 Compl. 18-298614, Ex. 127 (ECF No. 180-61) ............................................... JA 2161 Compl. 18-298848, Ex. 128 (ECF No. 180-62) ............................................... JA 2182 Compl. 18-304776, Ex. 129 (ECF No. 180-63) ............................................... JA 2192 Compl. 18-306427, Ex. 130 (ECF No. 180-64) ............................................... JA 2236 Compl. 18-316861, Ex. 131 (ECF No. 180-65) ............................................... JA 2249 Case 1:19-cv-04676-PAE Document 180-44 Filed 09/05/19 Page 1 of 17 ([KLELW JA 1965 Case 1:19-cv-04676-PAE Document 180-44 Filed 09/05/19 Page 2 of 17 tz NA T I ONA L ~ rJi w o M E N• s LAW CE NTER EXUPANDING TH£ POSSIBIL ITIES March 27, 201s Oftice for Civil Rights Department of Health and Human Services Hubert H. Humphrey Bui lding, Room 509f' 200 llldependence Avenue, SW Washington, D.C. 2020 I Submilled F:leclro11icallv Altention: Comments in Res ponse to Department or Health and Human Services, Office. for Civil Rights, Conscience NPRM, RlN 0945-ZA03 Dear Secretary Azar, The National Women's Law Center ("the Center~) is writing to comment on the Department of Health and Human Services' ("the Departrnem" ) and the Office for Civil Rights' ("OCR") proposed rule "Protecting Stamtory Rights in Healtl1 Care" ("Proposed Rule").1 Since 1972, the Center has worked to protect and advance the progress of women and their families in core aspects of their Uives, including income security, employment. education, and reproductive rights alld health, with an emphasis on the needs of low-income women and d1ose who face multiple and intersecting forms of discrimination. To that en<I, the Center has long worked to en<I sex discriminati on and to ensure all people have equal access to the full range of health care. including abortio n and birth control, regardless of income, age, race, sex, sexual orientation, gender identity, ethnicity, geographic location, or type of insurance coverage. Despite the Dep.artment's claims, the Proposed Rule is unnecessary. It is also illegal. The Proposed Rule ruttempts to create new rights for individuals and entities to refuse to provide patient care by expandi ng existing, hannful religious exemption laws in ways that exceed and conflict wirb both the plai n language of the statutes and Congressional i111en1. The Proposed Ruic also asserts authority over od1er federal laws, attempting to create new refusals 10 provide care. In creating these new rights and expanding its reach, the Proposed Rule conflicts with federal law thereby fostering confusion and chaos. The Proposed Rule emboldens discrimination By making it easier for institutions and individuals to refuse to provide comprehensive heal th care, the Proposed Rule endange:rs the health and liv~ of women and lesbian, gay, l)isexual, !ransgender, and queer (" LQBTQ") people across the country. While the Center's comments focus in particular on the harm 10 women and access to reproductive health care, it is clear that the Proposed Rule will undermine the provision of health care and exacerbate health disparities for many patient populations, as other commentators w ill discuss. And yet the Department fails to take this ham1 imo accow1t. Coouary 1 Protccling Statutory Conscicnoo Rights in HcalLl1 Care: Dclc,g:uions of AuLl10ri1y. 83 Fed. Reg. 3880 (proposed Jan.26.2018) (to be codified at 45 C.F.R. pl. 88) [hcrciml\cr Rule]. V.1th r.he law on yo,1r sidt,, grear things Ofl? poss.ible. ll Oupotit Cirdc ~ Suite 800 ~ WJ~h,ngton. DC 20036 ~ 202.S885180 t 202.588.5185 F,oc II wwwnwlc.org HHS Conscience Rule-000149141 JA 1966 Case 1:19-cv-04676-PAE Document 180-44 Filed 09/05/19 Page 3 of 17 to the Department's claims, the Proposed Rule harms rather than helps the provider-patient relationship and burdens providers who want to provide comprehensive care. For all of these reasons, explained in more detail below, the Center is strongly opposed to the Proposed Rule and calls on the Department and OCR to withdraw the Proposed Rule in its entirety. I. Despite the Department's Claims, the Proposed Rule is Unnecessary, Emboldens Discrimination in Health Care, and Goes Far Beyond the 2008 Rule. The Department claims that the Proposed Rule is necessary to protect individuals and health care providers from "discrimination, coercion, and intolerance."2 But there is no need to address the so-called discrimination the Department purports to protect against. There are already ample religious exemptions in federal law, including in Title VII, 3 the Americans with Disabilities Act, 4 and the "ministerial exception" courts have read into the U.S. Constitution. 5 In addition, there are already a number of existing federal religious exemption laws that unfortunately allow individuals and entities to opt of providing critical health care services, in particular abortion and sterilization. 6 The Proposed Rule claims that more authority and enforcement of the religious exemption laws is needed, but the Notice of Proposed Rulemaking cites only forty-four complaints in ten years, which OCR is capable of handling without additional resources or authority.7 Moreover, OCR already has authority to investigate complaints and, where appropriate, either collect funds wrongfully given while the entity was not in compliance or terminate funding altogether, and already educates providers about their rights under these laws. 8 The reality is that the Department is seeking not to enforce existing laws but to expand them
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