U.S. District Judge Wendy Beetlestone (Photo: Greg Benson) U.S. District Judge Wendy Beetlestone (Photo: Greg Benson)

A federal judge in Pennsylvania temporarily blocked President Donald Trump’s effort to let companies with religious or moral objections to birth control opt out of U.S. Department of Health and Human Services (HHS) requirements that they offer free contraception in their employee health care plans.

U.S. District Judge Wendy Beetlestone in Philadelphia issued a nationwide injunction less than 24 hours after the final rules for the exemption, announced in December, were set to take effect. It follows a California judge’s more-limited order late Sunday that blocked the administration’s plan in 13 states and the District of Columbia.

(Related: Judge Blocks Trump Plan to Revoke Obama-Era Contraceptive Rule)

The decision, which may be appealed, is the latest outgrowth of the culture war triggered by Trump’s stated desire to extend “religious freedom” rights from churches to companies — a move that in 2017 triggered litigation backed by rights groups and Democratic-led states.

A broad injunction is warranted while the case proceeds to trial because the states’ interest in securing the health of women and keeping health care costs down outweighs any potential harm to the government, the Pennsylvania judge said in her ruling Monday.

“A preliminary injunction is unquestionably in the public interest because it maintains the status quo pending the outcome of this litigation,” wrote Beetlestone, who was nominated by former President Barack Obama.

The White House didn’t immediately respond to a request for comment.

Pennsylvania Attorney General Josh Shapiro and his New Jersey counterpart, Gurbir Grewal, who challenged exemption rules finalized in December, declared the decision a win for women.

“Women need contraception for their health because contraception is medicine, pure and simple,” Shapiro said in a statement.

The Affordable Care Act requires major medical plans to provide coverage for a basic package of preventive health services with no co-payments, deductibles or other patient cost-sharing costs.

Former HHS Secretary Kathleen Sebelius ruled in 2012, based on recommendations from a panel of experts, that the preventive services package should include coverage for contraceptive products and services.

The administration’s final rules seek to expand an earlier religious exemption so it applies to for-profit companies, whether private or publicly traded. They also grant a moral-objection exemption to companies “without any need for the objection to be grounded in a religious objection to contraception,” according to the ruling.

(Related: Feds Ask If Offering Birth Control-Only Plans Could Work)

Companies seeking to use the exemption wouldn’t be required to notify the government because doing so would make them complicit in contraceptives being provided by someone else.

“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,” Caitlin Oakley, a spokeswoman for the U.S. Department of Health & Human Services, said in an email after the California judge issued the first injunction on Sunday.

Beetlestone said in her 65-page opinion that a nationwide injunction, which Trump has previously condemned as unfair and used too often, is warranted in this case. An order limited to Pennsylvania and New Jersey would have an uneven impact on people who work for companies based in other states or students from out-of-state attending schools in Pennsylvania and New Jersey, she said.

The case is Pennsylvania v. Trump, 2:17-cv-04540, U.S. District Court, Eastern District of Pennsylvania (Philadelphia).

—With assistance from Alyza Sebenius.

— Read Religious Group Employers Required to Offer Contraceptive Coverageon ThinkAdvisor.

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