The attorneys general of Montana and Texas on Tuesday filed a lawsuit against Xavier Becerra, Secretary of the Department of Health and Human Services (HHS), over a rule that says states must pay for “gender transition” procedures through their Medicaid programs and requires health care providers who receive federal funding to perform such procedures even in violation of state law.
The complaint, filed on June 11 with the U.S. District Court for the Eastern District of Texas, Tyler Division, asks the court to block a new rule recently published by HHS in the Federal Register that modifies non-discrimination protections of the Affordable Care Act (ACA) in a way that expands the definition of “sex” discrimination to include discrimination based on “gender identity.”
The final rule, called “Nondiscrimination in Health Programs and Activities,” implements Section 1557 of the ACA in a way that reinstates and expands on many of the 2016 regulations from the administration of then President Barack Obama while reversing much of the 2020 version of the rule adopted under then President Donald Trump.
The rule, which applies to health programs and activities that receive federal financing, has staggered effective dates starting on July 5, 2024. It provides nondiscrimination health care protections to individuals in protected groups, including prohibiting denial of benefits, coverage, and program participation based on factors like race, age, disability, and sex—which has been expanded to include the concept of “gender identity.”
The rule explicitly provides nondiscrimination protections based on “gender identity” and sexual orientation, and categorically prohibits the denial of “gender-affirming” care.
More Details
The attorneys general of Montana and Texas object to what they call in their complaint a “devastatingly drastic social change” under Section 1557. They argue that the change effectively forces taxpayers in those states to pay for controversial drugs and experimental surgeries for people seeking “gender transition,” which they label as procedures that “inflict permanent harm.”
“We are suing to stop the Biden Administration from withholding federal healthcare funds to force medical professionals to perform these experimental and dangerous procedures,” Texas Attorney General Ken Paxton said in a statement.
The two attorneys general argue in the complaint that the final rule is unlawful and an unconstitutional attempt to override state law. They’re seeking injunctive relief to prevent the rule from being enforced.
“States should not be compelled to foot the bill for treatments that are leaving people, even children, with irreversible damage,” Montana Attorney General Austin Knudsen said in a statement.
Mr. Knudsen said that in some states, Montana included, health care providers may be forced to choose between violating state law or losing federal funding. He cited Montana’s Senate Bill 99, which bans the provision of surgical procedures to address a minor’s perception that their “gender” differs from their biological sex.
HHS did not respond to a request for comment on the lawsuit.
However, in announcing the new final rule on April 26, 2024, HHS said in a statement that it amounted to “bold action” to bolster protections against discrimination.
“Today’s rule is a giant step forward for this country toward a more equitable and inclusive health care system, and means that Americans across the country now have a clear way to act on their rights against discrimination when they go to the doctor, talk with their health plan, or engage with health programs run by HHS,” Mr. Becerra said in a statement.
HHS also stated that the new final rule adds protections against discrimination by codifying that Section 1557’s prohibition against discrimination based on sex “includes LGBTQI+ patients.”
Transgender Agenda in Focus
Transgenderism has become a prominent issue in America’s social and political landscape in recent years.
Nearly half of America’s states have passed legislation banning medical sex-change procedures for minors, according to data compiled by Movement Advance Project.
Conservatives have backed laws that give parents more authority to prevent their children from undergoing transgender procedures or impose penalties on doctors who perform them without parental consent.
Progressives, by contrast, have tended to support “gender-affirming care” and laws that protect access to transgender procedures, which in some cases limit the ability of parents to have a say in their children’s decisions to seek sex-reassignment procedures and medications.
President Joe Biden has advanced various policies that promote gender ideology and special protections for individuals who identify as something different from their birth sex.
For instance, on his first day in office, President Biden signed an executive order calling for the heads of government agencies to consult with the U.S. Attorney General to eliminate discriminatory rules or regulations in any “existing orders, regulations, guidance documents, policies, programs, or other agency actions” that were based on “gender identity or sexual orientation.”
“Transgender Black Americans face unconscionably high levels of workplace discrimination, homelessness, and violence, including fatal violence,” says the order.
Also, in a move that sparked controversy and triggered multiple lawsuits, the Department of Education (DOE) expanded the decades-old Title IX law that prohibits sex discrimination in schools to now include sexual orientation and “gender identity.”
The changes, which stop short of prohibiting schools from banning female-identifying male athletes from competing against females, are slated to go into effect on Aug. 1, 2024.
By contrast, former President Trump has opposed the pro-transgender agenda and related policy moves. For instance, he has vowed to reverse the Biden administration’s expansion of Title IX protections for transgender students.
A recent declaration by a coalition of doctors and medical groups, including the American College of Pediatricians, sounded the alarm on the long-term risks of subjecting children to so-called “gender-affirming” procedures. Rather than backing gender transition in children experiencing confusion or distress about their sex, medical professionals should instead focus on psychotherapy for underlying mental health issues such as depression, autism, or anxiety, per the declaration.
Bonnie Gasper, vice chair of the Child Protection League Action, told The Epoch Times in an interview that the declaration gives “a lot more weight,” to their arguement. “They’re calling for a halt to all this stuff, because obviously, the data is out there” on interventions like puberty blockers and cross-sex hormones, Ms. Gasper said.
