A federal court of appealsย blocked the Department of Health and Human Services (HHS) from enforcing specific Section 1557 nondiscrimination rules under the Affordable Care Act (ACA) against some faith-based providers on August 26, 2022. The court upheld a permanent injunction prohibiting HHS from requiring the providers to perform or provide insurance coverage for gender transition procedures or abortions.
ACA Section 1557
Section 1557 forbids discrimination based on sex in any health program or activity that is administered by a federal agency orย receives federal funds. An HHS rule from 2016 defined โsexโ to include sex stereotypes and gender identity, alongside pregnancy termination and other conditions related to pregnancy.
HHS issued a proposed rule intended to strengthen protections against discrimination on the basis of sex, including gender identity, sexual orientation andย pregnancy terminationย onย July 25, 2022. Then, on March 2, 2022, HHS issued a notice highlighting theย health privacy lawsย and federal civil rights protections that apply to gender-affirming care for transgender and gender nonconforming youth.
Federal Courtโs Ruling
HHS was sued by a group of faith-based health care providers who challenged the Section 1557 prohibition against discrimination based on gender identity or termination of pregnancy. A trial court relinquished the Section 1557 provisions related to gender identity and termination of pregnancy, concluding that the provisions violated the Religious Freedom Restoration Act and permanently blocked HHS from imposing these requirements with respect toย abortionsย or gender transition procedures upon the plaintiffs in the case.
The federal appellate court upheld this permanent injunction. According to the court, the 2022 proposed rule and the agency notice on gender-affirming care shows that the agency intends to enforce Section 1557 to prohibit discrimination based on gender identity and termination of pregnancy. Therefore, the permanent injunction was necessary.
Recap
- Termination of Pregnancy –ย The 2022 proposed rule defines discrimination โon the basis of sexโ to include discrimination on the basis of pregnancy, termination ofย pregnancy or recovery therefrom, false pregnancy, childbirth or related medical conditions.
- Gender Identity Defined –ย Oneโs internal sense of gender, which may be different from the sex one is assigned at birth.
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