A slew of states, hospitals and thousands of medical professionals sued HHS on Tuesday to challenge its controversial gender transition care rule for violating religious and states' rights.
Texas and four other states joined forces with the Franciscan Alliance, a Roman Catholic hospital system headquartered in Mishawaka, Ind., and 17,000 medical professionals to allege HHS is forcing them to ignore their medical judgment and sovereign rights to determine medical care coverage. A May rule from HHS prohibited the denial of health services or coverage based on sex or gender identity.
The latest lawsuit alleges the rule is solely based on redefining the word "sex" to include internal gender identity, a move that neither Congress nor the courts have approved despite several opportunities to do so.
"With a single stroke of the pen, HHS has created a massive new liability for thousands of healthcare professionals unless they cast aside their medical judgment and perform controversial and even harmful medical transition procedures," the complaint said.
Texas stands to lose more than $42.4 billion per year in federal funding if it refuses to comply with the rule. The other states involved—Wisconsin, Nebraska, Kentucky and Kansas—would face similar "significant financial liability," the suit said.
The states, the Franciscan Alliance and the Christian Medical & Dental Associations have banded together in the lawsuit with help from the Becket Fund for Religious Liberty, which served as counsel in several high-profile challenges to the Affordable Care Act, including two major U.S. Supreme Court cases involving Hobby Lobby and Little Sisters of the Poor that challenged the contraception mandate.
“This regulation is blatantly hypocritical: The government exempts coverage of gender transition procedures from Medicare or Medicaid because it admits that they may be harmful; but it then tries to force private doctors to perform the same procedures on young children,” said Lori Windham, senior counsel of the Becket Fund.
CMS determined shortly after the HHS rule was finalized that it wouldn't cover sex change operations on a national basis. Local Medicare administrative contractors are still able to determine coverage on individual claims.
HHS' rule has also sparked a lawsuit against Dignity Health after a nurse alleged the system refused to cover gender-transition care.
