CHARLESTON — A federal judge has struck down the Biden administration's attempt to impose gender-identity mandates on healthcare providers and state Medicaid programs through regulations implementing Section 1557 of the Affordable Care Act.
The gender-identity provisions of the rule, which were still on the books until the October 23 ruling, would have forced doctors to perform controversial gender-transition procedures and have taxpayers to fund them. The judgment eliminates those provisions and makes it more difficult for future administrations to revive them.
The court ordered universal vacatur, applying to all states, not just the plaintiff-states
The U.S. District Court for the Southern District of Mississippi agreed with the coalition that the U.S. Department of Health and Human Services had exceeded its authority in the matter by redefining unlawful “sex” discrimination under the Affordable Care Act to include discrimination on the basis of “sexual orientation” and “gender identity.”
“Congress only contemplated biological sex when it enacted Title IX in 1972,” U.S. District Judge Louis Guirola Jr. wrote. “Therefore, the court finds that HHS exceeded its authority by implementing regulations redefining sex discrimination and prohibiting gender-identity discrimination.”
McCuskey
West Virginia Attorney General J.B. McCuskey joined a 15-state coalition led by the AGs of Mississippi and Tennessee.
“We have again successfully fought back federal overreach,” McCuskey said. “Agencies do not have the authority to rewrite sex discrimination laws — only Congress does. This is a reasonable and right decision, and we are glad the court agreed with our coalition.”
Mississippi AG Lynn Fitch agreed.
“The Biden Administration attempted to import its radical theories on gender identity into ObamaCare, forcing healthcare providers to perform surgeries or prescribe drugs even if it violated their best medical judgment,” Fitch said. “I am proud to stand with my colleagues from across the country as we fight to undo the Biden administration’s extremist political agenda.”
So did Tennesseee AG Jonathan Skrmetti.
“When Biden-era bureaucrats tried to illegally rewrite our laws to force radical gender ideology into every corner of American health care, Tennessee stood strong and stopped them,” Skrmetti said. “Our 15-state coalition worked together to protect the right of health care providers across America to make decisions based on evidence, reason, and conscience.
“This decision restores not just common sense but also constitutional limits on federal overreach, and I am proud of the team of excellent attorneys who fought this through to the finish.”
HHS issued a rule in May 2024 redefining Title IX’s prohibition against discrimination “on the basis of sex” — which Congress incorporated into the ACA through Section 1557 — to include gender identity. The coalition says HHS’s 2024 rule represented a “disturbing federal intrusion” into the states’ traditional authority to regulate healthcare and make decisions about their own Medicaid programs.
Specifically, the rule would have prohibited healthcare facilities from maintaining sex-segregated spaces, required certain healthcare providers to administer procedures for gender dysphoria and forced states to subsidize those treatments through their Medicaid programs.
In vacating the rule, Guirola said when Congress passed Title IX in 1972, “sex” meant biological sex and that federal agencies cannot unilaterally rewrite laws decades later to advance political agendas.
Along with West Virginia, Tennessee and Mississippi, others who were part of the coalition are the AGs from Alabama, Georgia, Indiana, Kansas, Kentucky, Louisiana, Nebraska, Ohio, Oklahoma, South Carolina, South Dakota and Virginia.
