A U.S. judge on Wednesday blocked the Biden administration from enforcing a new rule against discrimination based on gender identity in healthcare while he hears a lawsuit challenging it by 15 Republican-led states.
The U.S. Department of Health and Human Services (HHS) finalized the rule in May, and it was set to take effect on Friday. The rule states that a federal prohibition on sex discrimination, part of the Affordable Care Act health insurance law, extends to discrimination against transgender people.
States opposing the new rule claimed in their lawsuit that it would require their Medicaid programs to cover treatments like hormones and surgeries for transgender people, including minors. Many Republican states have passed laws banning such treatments, often called gender-affirming care, for minors.
The rule applies to recipients of federal funds, including Medicaid programs. It followed executive orders from President Joe Biden in 2021 and 2022 instructing agencies like HHS to take measures protecting transgender people from discrimination.
Senior U.S. District Judge Louis Guirola in Gulfport, Mississippi, in his preliminary order on Wednesday, said the Republican states were likely to succeed in their challenge. He stated that the administration had overstepped its authority by interpreting “sex” in the federal law to include gender identity.
“Today a federal court said no to the Biden administration’s attempt to illegally force every health care provider in America to adopt the most extreme version of gender ideology,” Tennessee Attorney General Jonathan Skrmetti, who led the lawsuit alongside Mississippi Attorney General Lynn Fitch, said in a statement. The states opposing the rule also include Georgia, Ohio, and Virginia.
HHS did not respond to a request for comment.
“This ruling is not only morally wrong, it’s also bad policy,” Kelley Robinson, president of Human Rights Campaign, an advocacy group supporting transgender rights, said in a statement. “Everyone deserves access to the medical care they need to be healthy and thrive.”
In a court filing, HHS argued that states’ fears were “speculative” and that the rule did not override doctors’ medical judgment. It claimed that the states were not entitled to an order blocking the rule because they did not face any imminent enforcement.
However, Guirola ruled on Wednesday that the cost of ensuring compliance with the rule would be an immediate harm to the states.
Later on Wednesday, two other judges in Florida and Texas issued separate rulings siding with other Republican state attorneys general challenging the rule. Those orders only prevented the rule from being enforced in those two states plus Montana.
U.S. District Judge William Jung, an appointee of Republican former President Donald Trump in Tampa, wrote that nationwide rulings by judges in a single federal district, like Guirola’s, “ought to be the rare exception, not routine.”
The decisions came the week after the U.S. Supreme Court curbed federal agencies’ power by ruling that courts must no longer defer to their interpretation of ambiguous laws. Guirola, appointed to the bench by Republican former President George W. Bush, noted that ruling, though he ultimately concluded that the law was not ambiguous.
