The Trump administration is expected to gut nondiscrimination protections within the Affordable Care Act that allow for transgender patients to obtain coverage for their medically necessary transition-related health care.
According to The Hill, the Department of Health and Human Services is planning on issuing a proposed rule that would allow doctors and hospitals to deny treatment to transgender patients and women who have had abortions based on a provider’s individual beliefs.
The provision in the Affordable Care Act that is being rolled back, which was was passed in 2016, prohibited healthcare providers and insurers who receive federal money from denying treatment or coverage to a patient based on their sex, gender identity, or termination or pregnancy, among other conditions.
Under the Obama-era rule, doctors and hospitals were also required to provide “medically necessary” services to transgender individuals, as long as they would have provided similar services to cisgender patients.
A group of Christian health providers known as the Franciscan Alliance sued over the rule, arguing it violated their religious beliefs by forcing insurers to pay for abortions and forcing doctors to perform gender confirmation surgeries. The Franciscan Alliance won the case, and a federal judge in Texas issued a nationwide injunction blocking the rule from taking effect.
The Trump administration has decided not to appeal the ruling, choosing instead to move forward with its own guidance. On Aug. 4, the Department of Justice, which is represents Health and Human Services in its lawsuit, said it was reviewing a draft of that proposed rule.
Once DOJ finishes reviewing the rule, the Office of Management and Budget will undertake its own review, before making the draft available for public comment.
The move doesn’t come as a surprise, particularly given the Trump administration’s elevation of figures like Roger Severino, the director of the Office for Civil Rights at HHS. Severino and other conservatives have previously opposed the Obama nondiscrimination rule, known as Section 1557, believing it to infringe upon health care providers’ sincerely held religious beliefs.
LGBTQ groups, wary of what they view as a hostility towards their community on the part of the Trump administration, are now preparing for legal action should the Obama-era rule be rescinded.
“I don’t think they are going to have an easy time,” Joshua Block, a senior staff attorney with the ACLU’s LGBT and HIV Project, said of HHS’ efforts to change the rule, “and we’ll make sure they hear every objection and justify what they’re doing.”