State Officials and Members of Congress to Trump Administration: Stop Promoting Discrimination
Members of Congress, state attorneys general, and state departments of health are not impressed with the White House’s discriminatory health care proposal.
by Luc Athayde-Rizzaro
Earlier this year, the Department of Health and Human Services proposed a regulation that would promote discrimination by health care providers. For 60 days, HHS accepted comments from the public about the proposed regulation.
In addition to gathering thousands of comments from individuals, NCTE submitted our own comments urging HHS in the strongest terms to reject this proposed regulation — and medical associations and faith groups spoke up as well.
State officials and Members of Congress also came out in support of transgender people.
In joint letters, 18 U.S. Senators, 103 U.S. House Representatives, and 19 State Attorneys General urged HHS to withdraw the rule and highlighted how it would promote discrimination against transgender people and other vulnerable groups. And state and local officials from around the country pointed out in their comments that this rule can make it harder for state to enforce their own laws and protect their residents.
Joint Letter by 103 U.S. House Representatives
The proposed rule reflects a fundamental misunderstanding of the mission of HHS to protect the health and well-being of all individuals. OCR was established with the express purpose of furthering HHS’s mission by enforcing federal laws that protect patients, prohibit discrimination, and address health disparities …
The proposed rule seeks to allow providers and health care institutions to refuse care to LGBTQ patients. This is particularly harmful given that LGBTQ individuals already face significant discrimination in health care settings.
Joint Letter by 18 U.S. Senators
By attempting to allow hospitals, providers, and anyone loosely involved in the provision of health care to determine a patient’s care based on their personal beliefs — not based on what is best for the patient — the proposed rule will harm those who already face barriers to care and prevent them from accessing the care and coverage they need …
The proposed rule’s sweeping language, and its troubling reliance on a case involving discrimination against a transgender patient, signal an attempt to expand refusal laws to transition-related care — ignoring not only the well-established consensus in the medical community that transition-related care is medically necessary, but also Congress’ clear intent to apply those laws to a limited set of procedures. We are also troubled by indications the Department intends the proposed rule to be interpreted even more broadly. For example, the proposed rule’s vague and sweeping language can encourage providers to refuse any care to an LGBTQ patient simply because of the provider’s personal disapproval of his or her patient’s sexuality or gender identity.
Joint Letter by 19 State Attorneys General
The Proposed Rule also risks having a chilling effect upon health care providers in a manner that will likely harm patients and vulnerable populations.
The States have serious concerns, for example, that an expanded universe of potential conscience objectors may seek to use the statutory tether of a “sterilization procedure” to deny care to transgender patients. Transgender people regularly experience discrimination within the health care industry, resulting in substantial health disparities with the non-transgender population. This discrimination includes both denials of care related to gender transition as well as denials of care for routine medical issues. Any regulatory expansion of statutory conscience exceptions that results in status-based discrimination would fundamentally undermine patient health and the interest of the States in preserving that health within their borders.
National Association of County and City Health Officials
As proposed, the rule will give health care providers a license based on religious beliefs to opt out of evidence-based care that the medical community endorses …
NACCHO calls on HHS to include explicit language making clear that religious beliefs will not be used to deny access to health services or to discriminate against people based on reproductive health decisions, gender identity or sexual orientation …
Refusals to treat individuals according to medical standards of care put patients’ health at risk, particularly for women and LGBT individuals …
Given the broadly-written and unclear language of the proposed rule, if implemented, some providers may misuse this rule to deny services to LGBT individuals on the basis of perceived or actual sexual orientation and gender identity. Allowing providers to flout established medical guidelines and deny medically accurate, evidence-based care impairs the ability of patients to make a health decision that expresses their self-determination.
Commonwealth of Pennsylvania Departments of Aging, Health, Human Services, Drug and Alcohol Programs, and Insurance
Not only does this proposed rule put at risk positive health care outcomes and access to health care for tens of thousands of people, it treads on states’ efforts to protect patients and constituents and puts millions of federal funds in jeopardy …
Pennsylvania agencies are concerned that this rule will hinder their efforts to address negative and disparate patient health care outcomes and access to health care especially for LGBTQ people, women, and other vulnerable groups that already face enormous barriers to getting competent and affirming care…
If finalized, the rule … will put thousands of people at risk of facing negative health consequences simply from the increased barriers or steps to acquiring care …
It will invite health and human services professionals to ignore existing law and medical standards, and it will go against person-centered approaches and evidence-based practices that have been at the core of social service and public health delivery for decades.
Washington State Department of Health
It is also our expectation these expanded definitions would create substantial gaps in access to preventive services and limit referrals to services that are provided elsewhere. These gaps could be especially harmful for vulnerable populations such as women and families with low incomes; people who are lesbian, gay, bisexual, or transgender (LGBT); people of color; and people living in rural or otherwise underserved areas …
These groups already face barriers to care and experience health inequities. The proposed rule could further decrease their access to necessary health care and worsen health outcomes and disparities. This clearly runs counter to the mission of HHS “to enhance and protect the health and well-being of all Americans,” and it neglects the responsibility of our public health system to ensure access to quality health services.
NCTE will continue to keep a close watch on what HHS does with this proposed regulation — along with other HHS efforts to promote anti-trans discrimination — and will continue to fight these attacks on trans people’s healthcare access.
To find out more about your health care rights and how you can stop the Trump Administration’s efforts to promote discrimination, visit NCTE’s Health Care Action Center.
Luc Athayde-Rizzaro is a policy counsel at NCTE.
