Government proposes discriminatory anti-trans regulations, weaponizing health insurance
In December, the Trump administration released three proposed rules that would target transgender people in ways that harm communities, ignore the law and interfere with the practice of medicine. Medicare Rights opposes all three proposed rules.
Ignoring legal precedent and exceeding authority
The first proposal was to try to amend the statute by statute, which was beyond the authority of the administrative agency. Section 504 of the Rehabilitation Act prohibits discrimination on the basis of disability in federally assisted and federally operated programs and activities. In 2022, a federal appeals court for the Fourth Circuit ruled that gender dysphoria was not excluded from the definition of disability. The Supreme Court declined to hear the case, leaving the Fourth Circuit's ruling in place.
The proposed rule rejects the Fourth Circuit's findings, a move that exceeds the authority of the Department of Homeland Security.
In the proposed rule, the Department of Health and Human Services' Office for Civil Rights rejected the Fourth Circuit's finding by proposing to add gender dysphoria to a list of conditions that cannot be used to prove a disability — a move that exceeds the agency's authority.
Intrusion into medical decision-making
Other proposals seek to use regulations to prevent gender-affirming care for transgender youth by penalizing practitioners who provide such care. The second proposal would deny Medicaid reimbursement for medically necessary gender-affirming care for transgender youth. Title III would prohibit hospitals from participating in Medicare or Medicaid if they provide such care.
The proposals seek to disrupt the practice of medicine, which has historically been regulated at the state level.
Weaponizing Medicare and Medicaid
By leveraging the market power of Medicare and Medicaid to force hospitals to limit the care they provide, Proposition 3 weaponizes these programs and sets a dangerous precedent for interfering with medical practice. There is nothing to stop a government from banning any medical service for adults or children it chooses.
There is nothing to stop a government from banning any medical service for adults or children it chooses.
Medicare Rights Opposes These Proposals
This week, Medicare rights groups submitted comments opposing the first proposal and urging the agency to withdraw it altogether. In the coming weeks, we will also submit comments opposing the second and third proposals. Medicare, Medicaid, and the health system must be the vehicle to provide safe, high-quality, and affordable health care to all enrollees. Policymakers should look for ways to protect and support marginalized individuals and communities, promote well-being, allow physicians to operate within the scope of their license, and embrace science rather than political interests.
Read the first, second, and third proposed rules.
Read our comments on the first proposed rule.
Read more about the second and third proposed rules.
