The Trump administration wants to roll back protections for transgender patients, frightening LGBT activists who fear a loss of care while enthusing conservatives who say an Obama-era rewrite stretched existing law.
The previous administration issued 2016 regulations that said laws barring health care discrimination on the basis of sex should include gender identity. Religious groups sued over those rules — an outgrowth of Obamacare — and federal courts in Texas and North Dakota enjoined them from taking effect.
The Trump administration says they’re taking a position that comports with those decisions, adheres to existing law and slashes billions of dollars in unnecessary paperwork.
“When Congress prohibited sex discrimination, it did so according to the plain meaning of the term, and we are making our regulations conform,” said Roger Severino, director of HHS’s Office of Civil Rights. “The American people want vigorous protection of civil rights and faithfulness to the text of the laws passed by their representatives.”
The proposal will escalate a simmering fight between LGBT advocates and President Trump, who earlier this month issued a “conscience” protection rule to shield health workers who object to participating in certain procedures.
Also, the Department of Housing and Urban Development (HUD) issued rules on homeless shelters this week that defer to local and state law in considering how a person’s sex should impact accommodations. Advocates fear that transgender people will be turned away or forced to use a bathroom that doesn’t comport with their identity.
The National Center for Transgender Equality vowed to ramp up their fight, saying the latest rule will imperil Obamacare’s progress in getting transition-related care and other services.
“Predicated on little more than prejudice, this proposal will abandon 2 million Americans who already face significant barriers to accessing adequate and life-saving health care,” Executive Director Mara Keisling said. “This is not about free health care or special treatment. It’s about the right of every American to be treated with dignity when they walk into an emergency room, meet a new doctor, or find the right insurance plan.”
Democrats vowed to fight the changes, which will be open for comment before taking effect.
“Patients don’t need the ideological judgment of President Trump, Vice President Pence, or anyone else for that matter — they need to know that when they seek the health care they need, they won’t be turned away because of who they are,” said Sen. Patty Murray, the senior Democrat on the Senate Health Committee.
Mr. Severino downplayed the idea that doctors will refuse to treat transgender patients in an emergency.
“I have not heard of such a hypothetical happening in real life,” he told reporters.
Conservative groups cheered the rule as a win for medical workers who want to exercise their religious freedoms protections, or worry that sex-reassignment surgeries would violate their best judgment. The rule also deletes “termination of pregnancy” as grounds for citing discrimination.
“It would have forced physicians to offer sex-reassignment procedures and abortions despite strong ethical and medical concerns,” said Emilie Kao, director of the DeVos Center for Religion and Civil Society at the Heritage Foundation. “No American should be forced to violate deeply held beliefs, especially in hotly debated issues in health care.”
At the White House, Mr. Trump punted when he was asked if doctors should be forced to performed “transgender-reassignment surgeries.”
“We’re gonna see, we’ll see,” Mr. Trump told reporters as he departed for a trip to Japan.
In a conference call, HHS mainly focused on the drier, legal aspects of the changes.
“The action we are taking today conforms with the court injunction as well as the position of the Department of Justice,” Mr. Severino said. “Most importantly it conforms with the text of the law itself.”
The administration says the move will reduce paperwork and save $3.6 billion in “unnecessary regulatory costs” over five years.
Mr. Severino said the money saved on English-only paperwork could be used to provide access for translators and interpreters for non-English speakers.
“As a child of Hispanic immigrants, I know how vitally important it is that people receive quality healthcare services regardless of the language they speak, and this proposal grants providers the needed flexibility for achieving that goal,” he said.
• Tom Howell Jr. can be reached at thowell@washingtontimes.com.
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