On August 23, 2016, a Catholic hospital system, Catholic medical group, Christian medical association, and five states filed a lawsuit challenging the Department of Health and Human Services' (HHS) regulations implementing section 1557, the nondiscrimination provision of the Affordable Care Act (ACA).
The complaint runs to 79 pages and pleads 20 causes of action (legal claims). It alleges that the regulation violates the federal Administrative Procedures Act; constitutional and statutory provisions protecting religious liberty, freedom of expression and association, due process, and equal protection; and the rights of the plaintiff states guaranteed by Constitution's spending clause and Tenth Amendment
Section 1557 applies various antidiscrimination laws to entities receiving assistance under the ACA. These antidiscrimination provisions include Title IX of the Education Amendments of 1972, which prohibits discrimination based on sex. In accordance with judicial cases interpreting sex discrimination law, the HHS regulations prohibit discrimination based on sexual stereotyping, including discrimination based on gender identity.
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