A federal judge on Wednesday struck down a new rule, not yet in effect, that allowed health care providers to refuse participation in abortions and other services on moral or religious grounds.
U.S. District Judge Paul A. Engelmayer in New York said he was tossing out the rule in its entirety.
The decision came after 19 states, the District of Columbia, three local governments, health organizations and others sued the U.S. Department of Health and Human Services.
The rule let clinicians object to providing abortions and other services that conflict with their moral and religious beliefs.
Engelmayer said his ruling came in three consolidated lawsuits.
Health and Human Services and the Justice Department are reviewing the ruling but "will not comment on the pending litigation at this time," said Caitlin Oakley, a Health and Human Services spokeswoman.
Plaintiffs had argued that the rule was unconstitutional because it would be discriminatory and stall access to health care for populations nationwide.
"The court heard clear and compelling arguments about the harm communities face when our health care system is distorted to the point in which a patient's health care needs are not paramount," said Clare Coleman, president of the National Family Planning & Reproductive Health Association, one of the plaintiffs.
New York Attorney General Letitia James said the state sued in part because the rule "was an unlawful attempt to allow health care providers to openly discriminate and refuse to provide necessary health care to patients based on providers' 'religious beliefs or moral objections.'"
The rule emerged after President Donald Trump in May 2017 signed an executive order instructing the attorney general to issue guidance interpreting religious liberty protections in federal law.
In May, the Department of Health and Human Services published a rule applying more than 30 "Conscience Provisions" that must be complied with for an entity to receive federal funding.
Lawsuits challenging the rule argued that the department exceeded its authority in establishing the rule, violated the Constitution and acted in an arbitrary and capricious manner in creating it.
Engelmayer, who was appointed by Democratic President Barack Obama, wrote that existing laws already define the duties of employers with respect to religious objections.
The 2019 rule, which had been set to take effect late this month, would effectively supersede existing law in the health care field, he said.
The judge rejected arguments that the rule was "mere housekeeping." Rather, he said, it relocates "the who, what, when, where, and how — of conscience protection under federal law."
The Department of Health and Human Services lacked authority to create major portions of its rule, including to terminate an entity's federal health funding if it violates one of the provisions.
At the time the rule was issued, Engelmayer noted, the president said it conferred "new protections."
The rule, for the first time, put limits on an employer's ability to inquire about conscience objections, the judge said.
"These limits have clear potential to inhibit the employer's ability to organize workplace arrangements to avoid inefficiencies and dislocations," he said.
Associated Press writers Ricardo Alonso-Zaldivar in Washington and Jennifer Peltz in New York contributed to this report.