Using a recent historic Supreme Court decision that diminished the authority of federal agencies, a district court in Mississippi decided on Wednesday that the Biden administration cannot implement new anti-discrimination regulations in health care for transgender Americans.
Just two days before the new safeguards were supposed to go into force, US District Judge Louis Guirola issued a preliminary injunction. His veto of the federal safeguards will be nationwide, according to the Bush appointee.
Health care providers and insurers that get federal financing cannot discriminate against patients based on their gender identity or sexual orientation, according to new regulations announced earlier this year by the Department of Health and Human Services. After the Trump administration repealed transgender patients’ protections in 2020, the HHS rule brought them back.
But the regulations were immediately challenged in court, with one such lawsuit coming from a coalition of Republican state attorneys general who claimed that the new rules were an overreach of HHS’s authority and that their states would suffer financially if they did not comply.
As a result, Guirola sided with the LGBTQ workers and found that HHS had erred in issuing the new regulations based on a 2020 Supreme Court decision that stated federal civil rights legislation that prohibits sex discrimination protects LGBTQ employees. In light of the Supreme Court’s decision in Bostock v. Clayton County, the Biden administration has been working to expand legal safeguards for the LGBTQ+ community in recent years.
In his decision against the Biden administration, the judge cited a recent landmark Supreme Court decision that nullified the “Chevron Deference” precedent, which had been in place for decades and had mandated that courts respect federal agencies’ authority to issue regulations based on vague legislation.
Based on the high court’s decision last week, “Plaintiffs have demonstrated a substantial likelihood of success on the merits of their claim that HHS exceeded its statutory authority by applying the Bostock holding to Section 1557’s incorporation of Title IX in its May 2024 Rule,” according to Guirola’s report. “Obviously, Congress and the Executive Branch can always take action by changing the statute if they disagree with the courts’ decision in a specific case.”
The use of Bostock’s analysis by HHS to confuse “on the basis of sex” with “on the basis of gender identity” was deemed unreasonable, according to Guirola’s critique. “To be more precise, the Bostock decision did not ‘persist beyond Title VII to other federal or state statutes that forbid sex discrimination.'”
A portion of the Affordable Care Act, Section 1557, prohibits “discrimination on the basis of race, color, national origin, sex, age or disability in specified health programs or activities.” This provision is the source of the blocked regulations. According to the new HHS guidelines, there are still exceptions for health care providers’ religious convictions, even if Section 1557 prohibits sex discrimination (which covers LGBTQ+ patients) and limits access to care based on a patient’s given sex at birth or gender identity.
The decision handed down on Wednesday was enthusiastically received by Republican Tennessee Attorney General Jonathan Skrmetti, who is involved in the lawsuit contesting the extra safeguards.
“The government has repeatedly promulgated rules that distort the legislation in order to further an ideological goal,” he stated. “Tennessee is collaborating with other states to prevent the illegal misuse of regulatory authority, and this case is only one of numerous instances of that.”