The Trump Administration has shown it will stop at nothing to undermine access to health care for marginalized communities. Most recently, the Administration has proposed to undermine critical protections against sex discrimination in Section 1557 of the Affordable Care Act, the Health Care Rights Law. Instead of combatting discrimination in accessing health care and insurance coverage, the Administration is looking for any opportunity to weaken the Health Care Rights Law’s protections, which have been life saving for many transgender and non-binary people.
Under the Trump Administration, the Department of Health and Human Services (HHS) has its duty to fight against discrimination in health care. It stopped defending existing regulations in a lawsuit attacking protections for transgender individuals and people who have obtained abortions. HHS then turned around and cited that very lawsuit as a reason for changing the regulations. But HHS cannot use its failure to defend current protections as a reason to gut them.
The proposed rule removes explicit protections for transgender, non-binary, and gender nonconforming people, as well as for people seeking, or who have obtained, services related to pregnancy, childbirth, and abortion. The Administration has made clear that a central goal of the proposed changes is to excise transgender people from the protections of the Health Care Rights Law. Though their intent has been to “erase” transgender people, the Administration can neither erase transgender people from existing statutory protections nor exclude them from society.
Case after case has confirmed that transgender people are protected under the Health Care Rights Law—and that is something the Administration cannot change even if this rule is finalized.
This isn’t just about definitions, though. This rule is yet another attempt by the Trump administration to undermine our nation’s antidiscrimination laws. The proposed rule would also: eliminate protections ensuring that people who have limited English proficiency are aware of their health care rights; narrow the list of health insurance providers covered by the Health Care Rights Law and prohibited from discriminating based on race, national origin, age, disability, or sex; and give religiously-affiliated health care institutions a broad license to discriminate on the basis of sex.
Even though one in six hospital beds in the United States is in a Catholic hospital, and the number of religious health care providers is only growing, the Administration wants to lift prohibitions on religious health care institutions discriminating based on a patient’s sex.
The proposed rule continues the Trump Administration’s mission to undermine access to health care for marginalized communities. So far they want to deprive people of coverage for contraceptives, decimate family planning services, dramatically expand the ability of health care institutions and workers to refuse to provide medical services, and penalize access to health care by immigrant women and children.
Transgender people already face threats of violence and discrimination in all aspects of their lives and the Trump Administration is inviting more. The Administration is intent on emboldening discriminatory and dangerous denials of care for transgender individuals. They have already banned transgender members of the military from openly serving and accessing certain critical medical procedures, reversed positions as to whether federal law protects transgender people from workplace discrimination, and proposed allowing taxpayer-funded shelters to turn away transgender people experiencing homelessness.
Despite these attacks by the Trump Administration we will continue to fight to ensure equal access to health care and coverage, free from discriminatory treatment or denials. For all these reasons, tens of thousands of people are telling HHS to abandon the proposed rule, and to keep the current Health Care Rights Law regulations in place – and I hope you join us in doing so.
Learn More About the Issues on This Page
-
Press ReleaseDec 2024
LGBTQ Rights
President Biden Must Veto Defense Bill Attacking Military Families with Transgender YouthPresident Biden Must Veto Defense Bill Attacking Military Families with Transgender Youth
WASHINGTON — The U.S. Senate today passed a version of the National Defense Authorization Act that would ban coverage for gender-affirming care for transgender youth whose parents are active-duty military personnel. The American Civil Liberties Union is opposing final passage of the defense bill over the inclusion of this health care ban and calling on President Joe Biden to veto the bill. Section 708 of the NDAA would prohibit insurance coverage for “medical interventions for the treatment of gender dysphoria” such as hormone therapy and puberty-suppressant medications, which Speaker Mike Johnson says would “permanently ban transgender medical treatment for minors.” The same treatments would be covered by TRICARE for any medical purpose other than treating gender dysphoria, the clinical diagnosis for the psychological distress experienced by transgender people related to their gender identity. “By passing this bill, the House and Senate are forcing thousands of active-duty service members to choose between their careers in the military and the future of their transgender children,” said Mike Zamore, national director of policy & government affairs at the ACLU. “This unconscionable and unjustifiable attack on those families stands in direct contrast to President Joe Biden’s legacy of defending the civil rights of transgender Americans — including when few in his own party showed the courage to do so. President Biden should cement his legacy by vetoing this bill and sending it back to Congress to pass without Speaker Johnson’s last minute health care ban for servicemembers’ kids.” If signed by President Biden, this health care ban would be the first new anti-LGBTQ provision enacted by Congress and signed into law by the president since the enactment of the military’s since-repealed “Don’t Ask, Don’t Tell” policy for LGBTQ servicemembers and the since-repealed federal law barring recognition of same-sex marriages known as the Defense of Marriage Act. It is unknown how many transgender youth are currently enrolled in TRICARE or how many of those enrolled are currently receiving coverage for gender-affirming care. In one 2022 analysis, 2,500 minor patients sought care for gender dysphoria through TRICARE Prime insurance at military or civilian treatment facilities in 2017, and 900 received puberty suppressants or gender-affirming hormones. Earlier this month, the Supreme Court heard oral arguments in a landmark case brought by the ACLU, the ACLU of Tennessee, Lambda Legal, and Akin Gump on behalf of three families and a medical provider challenging a Tennessee ban on gender-affirming hormonal therapies for transgender youth on the grounds the ban violates the Equal Protection Clause of the U.S. Constitution. -
Press ReleaseDec 2024
LGBTQ Rights
Montana Court Blocks State From Refusing to Correct Sex Markers on Transgender People's Birth Certificates and Driver's LicensesMontana Court Blocks State From Refusing to Correct Sex Markers on Transgender People's Birth Certificates and Driver's Licenses
HELENA, Mont. – A Montana court has granted a preliminary injunction preventing the state of Montana from enforcing policies that bar transgender people from obtaining accurate sex designations on their birth certificates and driver’s licenses. After a prior restriction on amendments of birth certificates was struck down by the courts, in early 2024 the state of Montana enacted a new rule that categorically bars transgender Montanans from correcting the sex designation on their birth certificates. Around the same time, the Montana Department of Justice adopted a policy similarly restricting amendment of driver’s licenses. The plaintiffs challenged these policies in state district court, arguing that they violate various constitutional provisions, including the right to equal protection of the law. In a recent Montana Supreme Court decision, two justices concluded that discrimination on the basis of transgender status – as the state is engaging in here – is a form of sex discrimination that violates the Montana Constitution’s equal protection clause. The plaintiffs, two transgender women, are represented by the American Civil Liberties Union, the ACLU of Montana, and Nixon Peabody LLP. Plaintiff Jessica Kalarchik, a veteran who served in the United States Army for 31 years, said: “After finally being able to live my life openly as the woman I know myself to be, I am frustrated that my birth state, Montana, wants me to carry around a birth certificate that incorrectly lists my sex as male. I live my life openly as a woman, I am treated as a woman in my daily life, and there is no reason I should be forced to carry a birth certificate that incorrectly identifies me as male. Fortunately, the court agrees that this ridiculous policy should not be in effect.” “Once again the State of Montana chose to adopt a draconian policy that is clearly intended to marginalize transgender Montanans, only for that discriminatory action to be blocked by the courts,” said Akilah Deernose, executive director for the ACLU of Montana. “Here in Montana we treasure our right to privacy and to live our lives free from governmental intrusion. The State of Montana clearly has not learned any lessons from the past few years, where courts have repeatedly struck down unconstitutional laws targeting transgender Montanans.” “Forcing anyone to carry documents that contradict their identity unjustly violates their rights to privacy, equal treatment, and not being compelled to convey a government message about their sex that they disagree with,” said Malita Picasso, staff attorney for the ACLU’s LGBTQ & HIV Project. “Such a policy marks transgender people for further mistreatment and discrimination, essentially requiring them to carry papers that out them as transgender any time they need to provide identity documents. Fortunately, the court has refused to allow the state of Montana to subvert the freedom of transgender Montanans to control their own identity as this case goes forward.” In granting the plaintiffs’ motion for a preliminary injunction, the court held, “[i]f the challenged state actions discriminate against transgender individuals on the basis of their transgender status, they also necessarily discriminate the basis of sex.” The state has the option of appealing the district court’s ruling to the Montana Supreme Court, but the underlying case will proceed in district court. A trial has not yet been scheduled. -
FloridaDec 2024
LGBTQ Rights
Keohane v. DixonKeohane v. Dixon
On September 30, 2024, the Florida Department of Corrections rescinded its policy regarding treatment of gender dysphoria, which allowed for hormone therapy when deemed medically necessary, as well as access to clothing and grooming standards that accord with one’s gender identity. Under this new policy, grooming and clothing accommodations have been stripped away, and hormone therapy is not permitted unless an exception is deemed constitutionally required. The ACLU brought a class action challenging the policy. -
IdahoDec 2024
LGBTQ Rights
Robinson v. LabradorRobinson v. Labrador
Two incarcerated transgender women have sued the state of Idaho alleging that HB 688, a 2024 law barring state funding for gender-affirming medical care for transgender people, denies them access to the health care their doctors have prescribed for them and is a violation of their Eighth Amendment right to be free from cruel and unusual punishment. They represent a class of all incarcerated folks within the state of Idaho who face the loss of hormone therapy due to HB 668.