The city of San Francisco has filed a lawsuit alleging that a new federal rule is unconstitutional. The rule greatly expands the types of cases in which a health-care worker or entity can decline, on religious grounds, to participate in providing a service.

In a filing in the U.S. District Court for Northern California, San Francisco City Attorney Dennis Herrera said the new regulations — announced Thursday by President Trump — are discriminatory and prioritize “providers’ religious beliefs over the health and lives of women, lesbian, gay, bisexual, or transgender people, and other medically and socially vulnerable populations.”

If San Francisco does not comply, the complaint states, it could lose $1 billion in federal funding that support critical services.

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The rule is a hallmark project for the Office of Civil Rights at the Department of Health and Human Services. OCR director Roger Severino said Thursday in a conference call with reporters that the new rule is necessary because, while there are numerous religion and conscience exemption statutes on the books, they have not been as strongly enforced as other civil rights laws.

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In previous administrations, the OCR was known for increasing access to care by taking a lead in ending segregation in health-care facilities and taking on insurers who discriminated against people with HIV. In recent years, as more medical records have gone online, it has invested resources into ensuring the privacy and security of medical information. Under Trump, who was elected on a wave of support from social conservatives, however, the focus has been more on protecting people’s expressions of religion.

Herrera said in the filing that the result has been that the OCR “has turned this legacy on its head. "

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“This is a perversion of OCR’s mission, it is unlawful, and San Francisco will not abide it,” Herrera wrote.

The new rule is scheduled to take effect 60 days from its publication in the Federal Register. It has received widespread support from conservative groups such as the Family Research Council, March for Life and the Catholic Medical Association. But the American Civil Liberties Union, Planned Parenthood, Lambda Legal and other groups that support abortion and LGBTQ rights have opposed it, saying it will make it more difficult for hundreds of thousands of Americans to get the health care they need.

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