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WASHINGTON — A federal judge in Baltimore on Friday struck down a Trump administration rule that abortion rights advocates called a manoeuvr to restrict access but officials defended as merely following the law.

The decision by U.S. District Judge Catherine C. Blake affects women covered under the Obama-era Affordable Care Act, not the majority with workplace insurance. The ruling hinged on the arcane question of whether a congressional requirement that insurers collect a “separate payment” for abortion coverage meant the companies also have to send their policyholders an additional, different bill, as the Trump administration wanted to require.

The judge’s ruling means insurers can continue to make the charge for abortion coverage a line item on their monthly bill, or just give policyholders notice that it’s included.

Although abortion is a legal medical procedure, federal law has long barred the use of taxpayer funds to pay for it in most cases. To secure the support of Democratic lawmakers opposed to abortion for his health law, former President Barack Obama agreed that insurers who covered the procedure would have to collect a separate payment and strictly segregate those funds from taxpayer subsidies for medical coverage.

But the law did not spell out the billing method insurers had to follow, and the Obama administration left it up to the companies to decide whether to list the relatively small cost of covering abortions on the main bill, or bill separately.

Abortion opponents cried foul, saying separate bills should be mandatory because that would clearly reflect the intent of the law. The Trump administration, which takes its lead on social issues from religious conservatives, agreed. Last year the Department of Health and Human Services proposed that separate bills would be required.

Planned Parenthood of Maryland sued on behalf of several women, supported by the American Civil Liberties Union. They argued that the requirement to send separate bills could prompt insurers to drop coverage for abortions and would create confusion for policyholders. Insurers argued that they were already complying with the law’s requirement to keep premiums for abortion coverage strictly separate, and that mandating separate bills would only increase health care costs and complicate their business operations.

Judge Blake sided with the plaintiffs, underlining that the health care law itself called for “separate payments” but did not address how to collect.

“HHS has simply stated that it believes that (its) interpretation is reasonable and more appropriate, without explaining why,” the judge wrote.

It was the second setback in recent weeks for abortion opponents. In a much bigger case, a divided Supreme Court struck down a Louisiana law that doctors who perform abortions must have admitting privileges at nearby hospitals.

If upheld, the Louisiana law could have led to clinics closing and directly reduced access. Blake’s decision was much narrower, dealing with interpretations of administrative law.

HHS said it is reviewing the ruling and would have no comment.

Planned Parenthood celebrated. “Today is a huge victory for the people who need and deserve access to safe, legal abortion,” Alexis McGill Johnson, the group’s president, said in a statement.

Blake was nominated by former President Bill Clinton.

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