A federal appeals court delivered a major victory to religious liberty advocates Friday by ruling that the Biden administration cannot force religious doctors and hospitals to perform abortions and gender-affirming procedures under Obamacare.

The issue was the much-debated "Section 1557" of the 2010 Affordable Care Act (Obamacare), which prohibits discrimination on the basis of race, color, national origin, sex, age, and disability by medical professionals.

The Biden Department of Health and Human Services (HHS) — like that of the Obama administration — interprets Section 1557 to also prohibit discrimination on the basis of sexual orientation and gender identity. Further, Biden's HHS says discrimination on the basis of sex encompasses "pregnancy termination" — that is, abortion.

But the U.S. Fifth Circuit Court of Appeals on Friday sided with a coalition of religious groups, including the Christian Medical and Dental Associations (CMDA) and the Franciscan Alliance. The case is Franciscan Alliance v. Becerra.

The appeals court, in a 3-0 decision, affirmed a lower court decision that had permanently blocked the Biden rule. The case dates back to 2016 and has seen multiple stages, with the Trump administration dropping the Obama rule. The Biden administration then mostly reinstated the Obama rule.

The judges noted that the Biden rule would "require that hospitals perform gender-reassignment surgeries and abortions."

Critics have dubbed the rule the "transgender mandate."

The Fifth Circuit said it was affirming the lower court ruling "permanently enjoining the United States Department of Health and Human Services (HHS) from requiring Franciscan Alliance to perform gender-reassignment surgeries or abortions in violation of its sincerely held religious beliefs."

Religious groups applauded the ruling.

"We have been fighting in the courts against this transgender mandate since 2016, and Friday's unanimous ruling only further protects the rights of healthcare professionals across this country," said CMDA CEO Mike Chupp. "This victory against government coercion means healthcare professionals can continue to exercise medical judgment and ethical care based upon sound medical evidence and Hippocratic standards of patient care instead of any ideology."

Becket, a legal organization that supports religious liberty, battled the Biden rule in court.

"This ruling is a major victory for conscience rights and compassionate medical care in America," said Joseph Davis, an attorney at Becket. "Doctors cannot do their jobs and comply with the Hippocratic Oath if the government requires them to perform harmful, irreversible procedures against their conscience and medical expertise."

The decision was written by Trump nominee Don R. Willett and joined by Jennifer Walker Elrod (George W. Bush) and Kurt D. Engelhardt (Trump).

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