New Law Allows Clergy to Opt Back Into Social Security and Medicare

On Oct. 20, President Trump signed into law H.R. 227, the Clergy Act. The new law (P.L. 119-125) (full text) is summarized by the Congressional Research Service in part as follows:

This act establishes a two-year window for members of the clergy who have opted out of Social Security and Medicare taxes (and are thus ineligible for benefits under those programs) to opt back in.

Under current law, certain ministers, members of religious orders, and Christian Science practitioners who object to participation in public insurance programs on religious or conscientious grounds may apply to the Internal Revenue Service (IRS) for an exemption from Social Security and Medicare taxes on ministerial earnings. Individuals who are approved for the exemption do not receive Social Security or Medicare benefits in retirement unless they have qualifying credits from other employment. The exemption is irrevocable.

Under the act, clergy members may choose to revoke their exemption by filing an application with the IRS by ...  April 15, 2031.... A revocation under the act is permanent.

Clergy members who opt back in will generally need 10 years of covered employment ... to be eligible for .. benefits ....

HHS Proposes Rules to Bar Hospitals from Performing Gender Affirming Care to Minors

The Department of Health and Human Services today published in the Federal Register two Releases proposing rule changes that would effectively ban almost all U.S. hospitals from providing pharmaceutical or surgical gender-affirming care to children and adolescents under 18 years of age. One Release is titled Prohibition on Federal Medicaid and Children’s Health Insurance Program Funding for Sex-Rejecting Procedures Furnished to Children. The second Release is titled Medicare and Medicaid Programs; Hospital Condition of Participation: Prohibiting Sex-Rejecting Procedures for Children. Health and Human Services Secretary Robert F. Kennedy, Jr. announced the Proposed Rules yesterday in a Press Release and in a "Declaration" titled Safety, Effectiveness, and Professional Standards of Care for Sex Rejecting Procedures on Children and Adolescents.  According to the Press Release:

The U.S. Department of Health and Human Services (HHS) today announced a series of proposed regulatory actions to carry out President Trump’s Executive Order directing HHS to end the practice of sex-rejecting procedures on children that expose young people to irreversible harm. These procedures include pharmaceutical or surgical interventions of specified types that attempt to align a child’s physical appearance or body with an asserted identity different from their sex.

The Centers for Medicare & Medicaid Services (CMS) will release a notice of proposed rulemaking to bar hospitals from performing sex-rejecting procedures on children under age 18 as a condition of participation in Medicare and Medicaid programs. Nearly all U.S. hospitals participate in Medicare and Medicaid and this action is designed to ensure that the U.S. government will not be in business with organizations that intentionally or unintentionally inflict permanent harm on children....

CMS will release an additional notice of proposed rulemaking to prohibit federal Medicaid funding for sex-rejecting procedures on children under age 18. The same prohibition would apply to federal Children’s Health Insurance Program (CHIP) funding for these procedures on individuals under age 19. Currently, 27 states do not provide Medicaid coverage of sex-rejecting procedures on children....

Supreme Court Hears Arguments on Whether Federal Emergency Treatment Law Preempts State Abortion Ban

The U.S. Supreme Court on Wednesday heard oral arguments in Moyle v. United States, (Docket No. 23-726) and Idaho v. United States, (Docket No. 23-727). (Audio and Transcript of full oral arguments). The case poses the question of whether the federal Emergency Medical Treatment and Labor Act that requires hospitals accepting Medicare to provide stabilizing emergency treatment to patients preempts state abortion bans when such treatment would involve pregnancy termination. The Court took the case without waiting for 9th Circuit review. (See prior posting.) SCOTUSblog reports on the oral arguments.

District Court Upholds Denial of Medicare Reimbursement To Christian Science Nursing Training Programs

In Chestnut Hill Benevolent Association v. Burwell, (D DC, Nov. 3, 2015), the D.C. federal district court upheld a ruling by the Center for Medicare Services that four Christian Science nursing facilities were not entitled to Medicare reimbursement for furnishing "approved educational activities."  The court concluded that while the Christian Science Nursing Arts Training Programs offered by these facilities are accredited by the Commission for Accreditation of Christian Science Nursing Organizations/Facilities, the Commission's standards do not meet those required by Medicare regulations.