Trump Administration Reverses Course on Obamacare’s Civil Rights Protections

The latest move heightens the Trump administration's stealth campaign against LGTBQ people and regulatory power against health-care benefits for vulnerable populations.

Trump administration officials have attacked legal protections for transgender people. Shutterstock

The Trump administration plans to roll back sweeping federal nondiscrimination provisions enacted under the Affordable Care Act (ACA) that protect transgender people and pregnant people.

The U.S. Department of Justice (DOJ) filed a motion for what’s known as a voluntary remand and stay. Doing so will pause ongoing litigation in a conservative Texas federal district court that had temporarily blocked the Section 1557 regulations and send the regulations back to the U.S. Department of Health and Human Services (HHS)—presumably to gut them.

DOJ officials in March decided not to challenge District Court Judge Reed O’Connor’s injunction, which will remain in place while the regulations are remanded back to HHS.

Section 1557 of the ACA prohibits entities receiving federal funds from discrimination on the basis of race, skin color, national origin, sex, age, or disability. A person’s sex includes discrimination based on pregnancy, gender identity, and sex stereotyping in all such health-care programs and activities. That means even religious and religiously affiliated providers that accept money from the federal government can’t deny patients health care or health coverage. If they do, Section 1557 provides a legal vehicle to sue for, say, people seeking sterilization, those seeking abortion care, or transgender patients seeking any health-care services. Connor’s ruling blocked enforcement of Section 1557 broadly, though people can still sue for discrimination under the provision.

President Obama signed the ACA, including Section 1557, in 2010. It wasn’t until 2016 that Obama’s HHS finalized the rule to enforce Section 1557 regulations.

“The Section 1557 regulation has been literally life-saving for transgender people all across the country, who are routinely turned away from emergency rooms and doctors’ offices and refused coverage for critical medical care. Now, the Trump administration is going after transgender people yet again and trying to take away these basic protections,” National Center for Transgender Equality Executive Director Mara Keisling said in a statement.

“The administration is rejecting the views of every major medical associations, most courts, and most Americans, who believe that people should not be denied health care because of who they are. That’s not just bad science and bad law—it’s a dangerous attack on transgender people’s ability to survive.”

The latest move heightens the Trump administration’s stealth campaign against LGTBQ people and regulatory power against health-care benefits for vulnerable populations. Administration officials in February withdrew Obama-era guidance protecting transgender students in public schools. Rewire‘s Jessica Mason Pieklo explained that Title IX continues to protect their right to use restrooms and facilities consistent with their gender identities.