Suit was filed yesterday in a Missouri federal district court by six states and a national organization of pediatricians challenging new rules adopted in May by the Department of Health and Human Services barring discrimination on the basis of gender identity in federally funded health care programs. The complaint (full text) in State of Missouri v. Becerra, (ED MO, filed 7/10/2024), alleges in part:
1. ... [The] new final rule ... forces doctors to perform, refer for, or affirm harmful gender-transition procedures and forces States to pay for these dangerous procedures in state health plans....
2. HHS threatens to punish doctors and States who do not comply with the mandate by imposing huge financial penalties and excluding them from federally funded healthcare programs like Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). This punishment would effectively preclude doctors and States from providing healthcare for the most vulnerable children in low-income communities.
3. This harmful rule violates the Affordable Care Act (ACA), the Administrative Procedure Act (APA), the structural principles of federalism, and the freedom of speech.
4. Congress did not authorize any of this. The rule purports to implement the sex-discrimination prohibition in Section 1557 of the ACA, but there is no gender-transition mandate in that statute, nor in Title IX of the Education Amendments of 1972 from which it is derived. Nor did the rule (or the ACA) satisfy the constitutional requirements of clear notice for such a mandate: the States and healthcare providers did not agree to provide, pay for, or affirm gender-transition procedures when they began Medicaid, Medicare, and CHIP.
States bringing the lawsuit are Missouri, Utah, Arkansas, Iowa, North Dakota, South Dakota and Idaho. ADF issued a press release announcing the filing of the lawsuit.
