Judge blocks rule that would add gender identity protections to health care

Brendan Pierson
| Reuters Agency

A U.S. judge on Wednesday blocked the Biden administration from implementing a new rule banning discrimination based on gender identity in health care while it considers a lawsuit challenging it filed by 15 Republican-majority states.

The rule was finalized in May by the U.S. Department of Health and Human Services (HHS) and was set to go into effect Friday. It says the federal ban on sex discrimination, part of the Affordable Care Act, includes discrimination against transgender people.

States opposing the new rules said in their lawsuit that they would require Medicaid programs covering low-income residents to pay for treatments such as hormones and surgeries for transgender people, including minors. Many Republican states have passed laws banning such treatments, often called gender-affirming care, for minors.

The rule applies to recipients of federal funds, including Medicaid programs. It was put in place under executive orders issued by President Joe Biden in 2021 and 2022 directing agencies like HHS to take measures to protect transgender people from discrimination.

Senior U.S. District Judge Louis Guirola in Gulfport, Mississippi, said in a preliminary order Wednesday that Republican states will likely succeed in their challenge. He said the administration overstepped its authority by interpreting “sex” in federal law to include gender identity.

“Today, a federal court said no to the Biden administration’s attempt to illegally force every health care provider in America to adopt the most extreme version of gender ideology,” Tennessee Attorney General Jonathan Skrmetti, who led the lawsuit along with Mississippi Attorney General Lynn Fitch, said in a statement. States also opposing the rule include Georgia, Ohio and Virginia.

HHS did not respond to a request for comment.

“This ruling is not only morally wrong, it is bad policy,” Kelley Robinson, president of the Human Rights Campaign, an advocacy group that supports transgender rights, said in a statement. “Everyone deserves access to the health care they need to be healthy and thrive.”

In court papers, HHS said the states’ concerns were “speculative” and that the rule does not override doctors’ medical judgment. It said states have no right to an injunction blocking the rule because they face no direct enforcement.

But Guirola said in Wednesday’s ruling that the costs of complying with the rule would immediately be borne by the states.

Two other judges in Florida and Texas issued separate rulings Wednesday sided with Republican attorneys general in other states challenging the rule, though those rulings only barred its enforcement in those two states and Montana.

U.S. District Judge William Jung, appointed by Republican former President Donald Trump in Tampa, wrote that nationwide rulings by judges in a single federal district like Guiroli “should be the rare exception, not the routine.”

The decisions come a week after the U.S. Supreme Court curbed the power of federal agencies, ruling that courts could no longer rely on their interpretation of ambiguous laws. Guirola, who was appointed to the bench by Republican former President George W. Bush, noted the ruling, although he ultimately said the law was not ambiguous.

(Reporting by Brendan Pierson in New York; additional reporting by Nate Raymond; editing by Jonathan Oatis, Alexia Garamfalvi and Rosalba O’Brien)