Florida sues to block HHS rule on sex-based discrimination in healthcare

Photo: Alvaro Medina Jurado/Getty Images

Florida Attorney General Ashley Moody, along with the Catholic Medical Association, is suing the Department of Health and Human Services over a new rule under Section 1557 of the Affordable Care Act meant to protect against discrimination against LGBTQI+ patients in healthcare.

Published on May 6, the rule outlines bans on sex-based discrimination in healthcare, including discrimination based on stereotypes, sexual orientation, gender identity, and pregnancy or related conditions.

But in the lawsuit, Moody and the Catholic Medical Association claim the new rule would effectively force Florida to violate state laws prohibiting hormone treatment and surgery for minors, and argue it would pave the way toward funding children's gender transition surgeries.

"These rules trample states' power to protect their own citizens," Moody said.

WHAT'S THE IMPACT?

The plaintiffs – including the state of Florida, Catholic Medical Association, Florida Agency for Health Care Administration and Florida Department of Management Services – are pressing the U.S. District Court of the Middle District of Florida in Tampa to block enforcement of the rule.

Florida is one of 21 states that prohibit hormone treatment and surgery for minors. Moody argued that these medical interventions are dangerous and could render patients infertile. The complaint seeks to block these surgeries and also contends the rule would "unlawfully limit states' power to set protective standards of care for healthcare professionals" and "compel states to cover these gender-transition interventions in state-administered healthcare programs and employee insurance plans."

The plaintiffs cite former President Barack Obama's HHS, which concluded that there was a lack of evidence that gender-reassignment surgeries improve health outcomes – a sentiment shared by President Trump's HHS during his term.

The Biden administration has so far declined to comment on the complaint, but in a 2022 HHS document, "Gender-Affirming Care and Young People," the administration cited research demonstrating that "gender-affirming care improves the mental health and overall well-being of gender diverse children and adolescents.

"Because gender-affirming care encompasses many facets of healthcare needs and support, it has been shown to increase positive outcomes for transgender and nonbinary children and adolescents," the document states. "Gender-affirming care is patient-centered and treats individuals holistically, aligning their outward, physical traits with their gender identity."

For transgender and nonbinary children and adolescents, HHS maintains that early gender-affirming care is crucial to overall health and well-being, as it allows the child to focus on social transitions and can increase their confidence while navigating the healthcare system.

The agency cited research suggesting that "medical and psychosocial gender affirming healthcare practices have been demonstrated to yield lower rates of adverse mental health outcomes, build self-esteem, and improve overall quality of life for transgender and gender diverse youth."

Politico reported that HHS has been guided by a 2020 Supreme Court Ruling, Bostock v. Clayton County, which held that employers are not allowed to discriminate based on someone's gender identity or sexuality.

Moody remained unmoved, and the plaintiffs are asking the court to vacate the 2024 rules, issue preliminary and permanent injunctive relief enjoining enforcement, and declare that the 2024 rules are "contrary to law and arbitrary and capricious."

THE LARGER TREND

HHS under Biden has consistently sought to shore up protections for LGTBQI+ individuals. Just last week the administration finalized a rule codifying protections for youth in foster care by clarifying how states should meet their statutory requirements to appropriately serve LGBTQI+ children.

The reason HHS honed in on LGBTQI+ youth in particular is that such children, according to the agency, are overrepresented in foster care and face significantly higher levels of bullying and harassment in care than other children.
 

Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.