The Trump Administration has told a federal court in Texas that it plans to modify an Obama-era rule aimed at preventing transgender health care discrimination from medical professionals and insurers. This comes in response to a federal court declaring that rule as beyond the scope of what’s covered in the 2016 Affordable Care Act, better known as Obamacare.
The Affordable Care Act clearly forbids “sex discrimination,” and during the Obama presidency the Department of Health and Human Services issued a rule stating that includes any decisions based on a person’s gender identity and gender expression.
The rule forbade health insurers from placing arbitrary limits or restrictions on health services that help a person undergo gender transition. These services include counseling, hormone therapy and various surgeries related to gender transitions.
Insurers used to be deny these services as “cosmetic” or “experimental,” limiting trans people’s access to care, but the Obama administration said such denial criteria were “outdated and not based on current standards of care.”
The rule applied to “all hospitals that accept Medicare, doctors who receive Medicaid payments [and] insurers that participate in government health insurance marketplaces.” It specified that any medical provider found guilty of discrimination against trans people could risk losing their government funding.
Eight states, however — including Texas, Wisconsin, Nebraska, Kentucky and Kansas — challenged that rule in federal court alongside a Catholic medical network and a Christian medical and dental group representing 19,000 doctors.
Their lawsuit argued that the rule forced clinicians to provide services against their religious beliefs and that medical providers would “suffer massive financial liability” for refusing to comply.
Federal Judge Reed O’Connor said of the rule that when passing the Affordable Care Act “Congress did not understand ‘sex’ to include ‘gender identity,'” saying rather that Congress “adopted the binary definition of sex.”
But the very question of whether sex discrimination includes prejudice against LGBTQ individuals is being weighed in several civil rights lawsuits across the United States.
This isn’t the first time the Trump administration has voiced its desire to rollback transgender health care protections. In January 2018, the Trump Administration set up the Conscience and Religious Freedom Division within the U.S. Department of Health and Human Services’ Office of Human Rights as a way to provide legal protection to medical providers who don’t want to perform abortions, treat transgender patients trying to transition or provide other services to which they might have religious or moral objections.