HHS released a proposed rule on Friday that would strip protections for transgender people from discrimination under the Affordable Care Act.
The Trump administration's proposal would get rid of a 2016 rule that implemented Section 1557 of the ACA, which prohibits discrimination based on race, color, nationality, sex, age or disability. The 2016 rule said that healthcare providers cannot discriminate against transgender individuals, and the new proposal would strip that section.
HHS' Office for Civil Rights said that the 2016 rule's definition of sex was too broad, noting it included the termination of a pregnancy and gender identity.
"When Congress prohibited sex discrimination, it did so according to the plain meaning of the term, and we are making our regulations conform," OCR Director Roger Severino said in a statement.
HHS said that the proposal preserves certain protections from the 2016 rule, namely ensuring physical access to persons with disabilities to healthcare facilities and technology to assist visually or hearing-impaired individuals.
The new rule would affect any ACA health plan, any health program or activity that HHS administers or any program that gets funding from the department.
HHS also notes that the proposed rule, which is open for comment for 60 days, will comply with federal law.
Kansas, Kentucky, Nebraska, Texas and Wisconsin, along with three providers, sued HHS in 2016 to challenge the original transgender rule. They alleged that HHS created a "massive new liability" for providers and could force them to go against their medical judgment.
A federal judge issued a preliminary injunction in December 2016, noting that the Obama administration's definition of sex under federal statute was incorrect. That ruling was stayed in 2017 when the Trump administration's HHS considered pulling the regulation.
Congressional Democrats slammed the proposed rule as targeting transgender individuals.
"This inhumane proposal is yet another attempt by the Trump administration to sabotage the ACA's critical patient protections and turn back the clock on Americans' healthcare rights," Reps. Frank Pallone (D-N.J.), Robert Scott (D-Va.) and Richard Neal (D-Mass.) said.
Pallone is chairman of the House Energy and Commerce Committee, Neal chairs Ways and Means, and Scott leads Education and Labor.