WASHINGTON — The Trump administration says it plans to roll back a rule issued by President Barack Obama that prevents doctors, hospitals and health insurance companies from discriminating against transgender people, the New York Times reports.
Advocates said the change could jeopardize the significant gains that transgender people have seen in access to medical care, including gender reassignment procedures — treatments for which many insurers denied coverage in the past.
The rule was adopted in 2016 to carry out a major civil rights law embedded in the Affordable Care Act. The law prohibits discrimination based on race, color, national origin, sex, age or disability in “any health program or activity” that receives federal financial assistance.
The Obama administration said the rule covered “almost all practicing physicians in the United States” because they accept some form of federal remuneration or reimbursement. It applies, for example, to hospitals that accept Medicare and doctors who receive Medicaid payments, as well as to insurers that participate in health insurance marketplaces, the New York Times reports.
Trump administration officials said they believed they had to modify the rule because a federal judge in Texas had found that parts of it were unlawful.
“The Department of Health and Human Services has submitted a draft of a proposed rule” to the White House for clearance, the Justice Department told the judge two weeks ago. And the White House confirmed that it was reviewing the proposed rule on “nondiscrimination in health programs,” the Times reports.
The Trump administration has been scaling back protections for transgender people on several fronts. Attorney General Jeff Sessions, reversing an Obama administration policy, said the main federal job discrimination law “does not encompass discrimination based on gender identity per se,” the Times reports. And Trump’s effort to bar transgender people from serving in the military is tied up in several federal courts. The Education Department has rescinded Obama administration guidelines on how schools should accommodate transgender students.
Eight states, a network of Roman Catholic hospitals and the Christian Medical and Dental Associations, representing 19,000 doctors, challenged the Obama-era rule. A federal district judge in Texas temporarily stopped enforcement of the protections for transgender patients, saying that Congress had outlawed discrimination based on sex — “the biological differences between males and females” — but not transgender status, the New York Times reports.
“Congress did not understand ‘sex’ to include ‘gender identity, ’” said the judge, Reed O’Connor, in Fort Worth. In the Affordable Care Act, he said, Congress “adopted the binary definition of sex.”
But Jennifer C. Pizer, the law and policy director at Lambda Legal, a gay rights group, said, “That is an excruciatingly narrow and legally incorrect definition of the term ‘sex’ that would jeopardize legal protections for (LGBT) people,” the New York Times quoted her as having said.