Federoff v. Geisinger Clinic, 571 F.Supp.3d 376

~100 Geisinger health employees with conditional religious exemptions to vaccination refused the vaccine; Geisinger required twice-weekly COVID-19 testing for unvaccinated staff starting Nov. 9, 2021 and threatened termination for noncompliance.
Plaintiffs sought a preliminary injunction: either exempt them from testing or require that vaccinated employees be tested as well.
Complaints (amended) asserted claims under Title VII, the Pennsylvania Human Relations Act (PHRA), the Pennsylvania Free Exercise Clause, and federal Free Exercise/Equal Protection (later pared back); plaintiffs did not allege Geisinger was a state actor.
Court heard briefing and oral argument on whether Geisinger is a state actor, whether administrative exhaustion (EEOC/PHRC) bars relief, and plaintiffs’ likelihood of success and irreparable harm.
Court denied the preliminary injunction: plaintiffs failed to show likelihood of success (constitutional claims require state action; Title VII/PHRA claims lack exhaustion and fail to allege sincere religious beliefs) and failed to show irreparable harm; court also found Geisinger met the low “undue hardship” burden to deny an accommodation.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether Geisinger (private hospital) is a state actor for Free Exercise/Equal Protection	Plaintiffs treated employer action as subject to constitutional scrutiny	Geisinger is private; no state action alleged	Court: No state action; constitutional claims fail
Whether court can grant preliminary injunction before EEOC/PHRC exhaustion	Seek immediate relief; pause to file with agencies	Administrative filing required first; agencies may seek injunction	Court: Even if pre-filing relief were allowed, plaintiffs fail other injunctive prerequisites
Whether plaintiffs pleaded a sincere religious belief under Title VII/PHRA	Plaintiffs claim religious objections to testing (various, vague)	Plaintiffs provided no coherent, systemic religious belief; many objections appear secular/medical	Court: Plaintiffs did not allege sincere religious beliefs; prima facie Title VII/PHRA case fails
Whether accommodation (exempting unvaccinated from testing or testing everyone) would be an undue hardship	Plaintiffs: alternative (test all) is feasible and nonburdensome	Geisinger: exempting unvaccinated or expanding testing to all would impose more-than-de-minimis burden and public-health risk	Court: Geisinger showed undue hardship under de minimis standard; plaintiffs’ alternative would impose significant cost/risk

AT&T v. Winback and Conserve Program, Inc., 42 F.3d 1421 (3d Cir. 1994) (preliminary injunction is extraordinary relief; four-factor test applies)
Reilly v. City of Harrisburg, 858 F.3d 173 (3d Cir. 2017) (gateway requirements: likelihood on merits and probable irreparable harm)
Sampson v. Murray, 415 U.S. 61 (U.S. 1974) (loss of job generally not irreparable for injunction purposes)
Trans World Airlines, Inc. v. Hardison, 432 U.S. 63 (U.S. 1977) (Title VII undue-hardship test is more-than-de-minimis cost)
Webb v. City of Philadelphia, 562 F.3d 256 (3d Cir. 2009) (applies de minimis undue-hardship standard)
Wallace v. Jaffree, 472 U.S. 38 (U.S. 1985) (First Amendment protects against governmental, not private, action)
Civil Rights Cases, 109 U.S. 3 (U.S. 1883) (Fourteenth Amendment limits state action)
Fort Bend County v. Davis, 139 S. Ct. 1843 (U.S. 2019) (EEOC right-to-sue/administrative exhaustion framework)