The Biden administration's recent move to reinstate regulatory protections against discrimination in healthcare is under siege from the state of Florida and a nationwide Catholic medical group.
In a lawsuit filed early this week in district court, state agencies and the Catholic Medical Association wrote that the Department of Health and Human Services "seeks to redefine the practice of medicine" with a final rule published Monday.
It specified that a portion of the Affordable Care Act prohibiting discrimination on the basis of sex, race, color, national origin, age and disability for certain health activities extends to LGBTQI+ patients.
Those protections, the plaintiffs wrote, "threaten the livelihood" of practitioners who refuse to deliver gender transition services and gender-affirming care, which they wrote could include puberty blockers, hormones and surgeries. The complaint notes that these providers would be punished for their clinical judgment that such services are not beneficial to the patient and that decisions based on clinical need are not discriminatory.
"Refusing to provide interventions to anyone because of doubts about medical efficacy or ethical misgivings is not treating transgender individuals differently at all, much less on the basis of sex," they wrote in the complaint, which also noted that the rule violates doctors' right to free speech and freedom of religion.
Further, the plaintiffs wrote that the administration's policy risks federal funding for payers and states that refuse to cover these services and "overrides" state law banning certain gender-affirming care services for minors.
Florida and the medical group are asking the court to issue a preliminary injunction against, and subsequently toss, the recently published final rule. They are also seeking a declaration specifying that the Affordable Care Act and Title IX's discrimination protections do not require covered entities to support various areas of transgender care, language and policy.
Florida has been among the vanguard of conservative states passing laws to restrict gender-affirming care services for minors.
Proponents of the restrictions say the legislative and administrative bans are intended to limit harm from unproven care decisions, though gender-affirming care is generally supported by medical professional organizations such as the American Academy of Pediatrics and the American Medical Association.
The Biden administration has previously quarreled with these states when the restrictions inch into the territory of established federal policies—for instance, when Tennessee law enforcement sought protected medical records from gender-affirming care providers.
The latest final rule took that stance a step further by reinstating transgender protections that had been stripped during the Trump administration. The rule also includes clarifications that nondiscrimination applies to technologies used to deliver care like telehealth and artificial intelligence.