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White House won’t comment on HHS proposal to nix rule for trans health

Obama-era provision barred discrimination based on gender identity

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transgender, caduceus, medicare, gay news, Washington Blade, health, gender reassignment
Transgender Center of Excellence, gender dysphoria, transgender, caduceus, medicare, gay news, Washington Blade, health

The White House won’t comment on a proposed HHS plan to nix a rule for trans health.

The White House has declined to comment on recent indications the Trump administration is set to undo an Obama-era rule barring medical providers from refusing service to transgender people, including gender reassignment surgery.

The Washington Blade sought to ask White House Press Secretary Sarah Huckabee Sanders about the proposed reversal Monday during the daily briefing, but the spokesperson didn’t call on the Blade for a question, nor did any other reporter ask about the issue following a report on the development in the New York Times.

In response to an email request for more information, the White House referred the Washington Blade to HHS, which didn’t respond to a request for comment. OMB also didn’t respond to the Blade’s request for information.

The Obama-era rule interpreted Section 1557 of the Affordable Care Act, which bars discrimination in health care on the basis of sex, to bar refusal of service to transgender people based on their gender identity, including the denial of transition-related care such as gender reassignment surgery.

As the Times first reported, the U.S. Justice Department noted in a filing last week in a lawsuit challenging the rule the Department of Health & Human Services “had submitted a draft of a proposed rule” for review to the White House Office of Management & Budget. The OMB website reveals it’s considering a proposed rule related to “non-discrimination in health programs and activities.”

Although the Justice Department filing doesn’t explicitly say the pending proposal would undo the Obama-era rule, that seems likely based on the decision to file it in a lawsuit challenging the provision and the history of the Trump administration.

The Trump administration has already declared federal law barring discrimination on the basis of sex doesn’t apply to cases of transgender discrimination in education and employment. The Education and Justice Departments rolled back Obama-era guidance requiring schools to allow transgender kids to use the restrooms consistent with their gender identity. Additionally, the Justice Department reversed a memo from former U.S. Attorney General Eric Holder finding Title VII of Civil Rights of 1964 prohibits anti-trans discrimination in the workforce.

The Justice Department filing indicates the proposed rule change will be published in the Federal Register and made available for public comment — but says nothing about timing for when that will happen.

The Obama-era rule is currently moot in any event. Last last year, U.S. District Judge Reed O’Connor issued an injunction barring the U.S. government from enforcing the rule as a result of litigation filed by Texas Attorney General Ken Paxton.

Roger Severino, an anti-trans scholar at the Heritage Foundation-turned-director of the Office for Civil Rights at HHS, cited the court ruling in an interview with the New York Times as evidence it’s time to re-examine the rule.

“The court held that the regulation’s coverage of gender identity and termination of pregnancy was contrary to law and exceeded statutory authority, and that the rule’s harm was felt by health care providers in states across the country, so a nationwide injunction was appropriate,” Severino is quoted as saying. “The court order is binding on HHS, and we are abiding by it.”

Despite this court order — and even if the Trump administration were to reverse the underlying rule — transgender people could still sue medical providers in court based on the underlying law in the Affordable Care Act that prohibits discrimination in health care on the basis of sex. A growing number of courts are interpreting laws against sex discrimination to apply to LGBT people regardless of the views of the Trump administration.

David Stacy, government affairs director for the Human Rights Campaign, criticized the Trump administration in a statement.

“No health care provider should be able to turn someone away because of their gender identity,” Stacy said. “[Trump’s] plans to eliminate the regulations spelling out these crucial non-discrimination protections is unconscionable.”

 

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Federal Government

HHS reverses Trump-era anti-LGBTQ rule

Section 1557 of the Affordable Care Act now protects LGBTQ people

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U.S. Department of Health and Human Services Secretary Xavier Becerra (Public domain photo)

The U.S. Department of Health and Human Services Office for Civil Rights has issued a final rule on Friday under Section 1557 of the Affordable Care Act advancing protections against discrimination in health care prohibiting discrimination on the basis of race, color, national origin, age, disability, or sex (including pregnancy, sexual orientation, gender identity, and sex characteristics), in covered health programs or activities. 

The updated rule does not force medical professionals to provide certain types of health care, but rather ensures nondiscrimination protections so that providers cannot turn away patients based on individual characteristics such as being lesbian, gay, bisexual, transgender, queer, intersex, or pregnant.

“This rule ensures that people nationwide can access health care free from discrimination,” said HHS Secretary Xavier Becerra. “Standing with communities in need is critical, particularly given increased attacks on women, trans youth, and health care providers. Health care should be a right not dependent on looks, location, love, language, or the type of care someone needs.”

The new rule restores and clarifies important regulatory protections for LGBTQ people and other vulnerable populations under Section 1557, also known as the health care nondiscrimination law, that were previously rescinded by the Trump administration.

“Healthcare is a fundamental human right. The rule released today restores critical regulatory nondiscrimination protections for those who need them most and ensures a legally proper reading of the Affordable Care Act’s healthcare nondiscrimination law,” said Omar Gonzalez-Pagan, counsel and health care strategist for Lambda Legal.

“The Biden administration today reversed the harmful, discriminatory, and unlawful effort by the previous administration to eliminate critical regulatory protections for LGBTQ+ people and other vulnerable populations, such as people with limited English proficiency, by carving them out from the rule and limiting the scope of entities to which the rule applied,” Gonzalez-Pagan added. “The rule released today has reinstated many of these important protections, as well as clarifying the broad, intended scope of the rule to cover all health programs and activities and health insurers receiving federal funds. While we evaluate the new rule in detail, it is important to highlight that this rule will help members of the LGBTQ+ community — especially transgender people, non-English speakers, immigrants, people of color, and people living with disabilities — to access the care they need and deserve, saving lives and making sure healthcare professionals serve patients with essential care no matter who they are.”

In addition to rescinding critical regulatory protections for LGBTQ people, the Trump administration’s rule also limited the remedies available to people who face health disparities, limited access to health care for people with Limited English Proficiency, and dramatically reduced the number of healthcare entities and health plans subject to the rule.

Lambda Legal, along with a broad coalition of LGBTQ advocacy groups, filed a lawsuit challenging the Trump administration rule, Whitman-Walker Clinic v. HHS, and secured a preliminary injunction preventing key aspects of the Trump rule from taking effect.

These included the elimination of regulatory protections for LGBTQ people and the unlawful expansion of religious exemptions, which the new rule corrects. The preliminary injunction in Whitman-Walker Clinic v. HHS remains in place. Any next steps in the case will be determined at a later time, after a fulsome review of the new rule.

GLAAD President Sarah Kate Ellis released the following statement in response to the news:

“The Biden administration’s updates to rules regarding Section 1557 of the ACA will ensure that no one who is LGBTQI or pregnant can face discrimination in accessing essential health care. This reversal of Trump-era discriminatory rules that sought to single out Americans based on who they are and make it difficult or impossible for them to access necessary medical care will have a direct, positive impact on the day to day lives of millions of people. Today’s move marks the 334th action from the Biden-Harris White House in support of LGBTQ people. Health care is a human right that should be accessible to all Americans equally without unfair and discriminatory restrictions. LGBTQ Americans are grateful for this step forward to combat discrimination in health care so no one is barred from lifesaving treatment.”

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Maryland

Md. governor signs Freedom to Read Act

Law seeks to combat book bans

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Maryland Gov. Wes Moore (Public domain photo/Twitter)

Maryland Gov. Wes Moore on Thursday signed a bill that seeks to combat efforts to ban books from state libraries.

House Bill 785, also known as the Freedom to Read Act, would establish a state policy “that local school systems operate their school library media programs consistent with certain standards; requiring each local school system to develop a policy and procedures to review objections to materials in a school library media program; prohibiting a county board of education from dismissing, demoting, suspending, disciplining, reassigning, transferring, or otherwise retaliating against certain school library media program personnel for performing their job duties consistent with certain standards.”

Moore on Thursday also signed House Bill 1386, which GLSEN notes will “develop guidelines for an anti-bias training program for school employees.”

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Mexico

Mexican Senate approves bill to ban conversion therapy

Measure passed by 77-4 vote margin

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(Washington Blade photo by Michael K. Lavers)

The Mexican Senate on Thursday approved a bill that would ban so-called conversion therapy in the country.

Yaaj México, a Mexican LGBTQ rights group, on X noted the measure passed by a 77-4 vote margin with 15 abstentions.  The Chamber of Deputies, the lower house of Mexico’s congress, approved the bill last month that, among other things, would subject conversion therapy practitioners to between two and six years in prison and fines.

The Senate on its X account described conversion therapy as “practices that have incentivized the violation of human rights of the LGBTTTIQ+ community.”

“The Senate moved (to) sanction therapies that impede or annul a person’s orientation or gender identity,” it said. “There are aggravating factors when the practices are done to minors, older adults and people with disabilities.”

Mexico City and the states of Oaxaca, Quintana Roo, Jalisco and Sonora are among the Mexican jurisdictions that have banned the discredited practice. 

The Senate in 2022 passed a conversion therapy ban bill, but the House of Deputies did not approve it. It is not immediately clear whether President Andrés Manuel López Obrador supports the ban.

Canada, Brazil, Belgium, Germany, France, and New Zealand are among the countries that ban conversion therapy. Virginia, California, and D.C. are among the U.S. jurisdictions that prohibit the practice for minors.  

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