Federal govt aims to roll back transgender health protection

Henrietta Brewer
May 26, 2019

President Donald Trump's administration has proposed drastically changing language in the Affordable Care Act that affects transgender people. The regulation, if finalized, would remove all references to gender identity, sex stereotyping and termination of pregnancy in the regulation and would broadly increase the authority of health care providers to refuse service based on religious objection. There is a separate state rule that requires insurance coverage for transgender health services.

The change by the Department of Health and Human Services specifies that existing laws that bar sex-based discrimination no longer apply to a patient's gender identity.

The proposed rule will now go through a 60-day public comment period, as the original Obama-era rule did in 2013 and 2015.

"The action we are taking today conforms with the court injunction, as well as the position of the DOJ, but most importantly it conforms with the text of the law itself", Severino told reporters.

"This landmark provision is the first of its kind to include protections from discrimination on the basis of sex in the context of healthcare", the campaign said in a statement. The Trump administration says the notice requirement has become a needless burden on health care providers, requiring billions of paper notices to be mailed annually at an estimated five-year cost of $3.2 billion. He issued a nationwide preliminary injunction blocking enforcement of the rule.

Louise Melling, deputy legal director with the American Civil Liberties Union, said: "This move by the Trump administration is nothing less than an act of violence against those whose healthcare needs have historically been ignored, neglected and dismissed".

"By prohibiting differential treatment on the basis of 'gender identity" in health services, these regulations propose to penalize medical professionals and health care organizations that, as a matter of faith, moral conviction, or professional medical judgment, believe that maleness and femaleness are biological realities to be respected and affirmed, not altered or treated as diseases", said the article from Severino, a Harvard Law graduate, and his co-author. "This proposed rule is a backdoor way to undercut this important federal law and weaponize "religious freedom" to the detriment of other peoples' health and rights". Court challenges are expected.

"As a child of Hispanic immigrants, I know how vitally important it is that people receive quality healthcare services regardless of the language they speak, and this proposal grants providers the needed flexibility for achieving that goal", Severino's statement says, adding, "The American people are exhausted of unnecessary regulations getting in the way of access to affordable healthcare". If the administration is successful, LGBT people would be at particular risk. Trump's religious conservative base has argued that the Obama administration stretched the meaning of "sex discrimination" when it included gender identity as a protected class.

That decision was released December 31, 2016, and wasn't appealed by the Trump administration when it took over the following month. The proposed changes also eliminate protections from discrimination on the basis of pregnancy termination.

"Predicated on little more than prejudice, this proposal will abandon 2 million Americans who already face significant barriers to accessing adequate and life-saving health care", said Mara Keisling, the executive director for NCTE.

Sen. Patty Murray, D-Wash., the highest ranking Democrat on the Senate Health, Education, Labor and Pensions Committee, called the change "blatantly harmful, discriminatory, and wrong".

"I'm going to keep fighting back against efforts to turn back the clock on people's rights, and making sure everyone in this country is able to get the health care they need without interference from politicians who think their personal beliefs are more important than patients' lives", she said in a statement.

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