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Analysis

AHA, AMA Oppose HHS Final Rule Reversing Obama-era Discrimination Protections

By Jack O'Brien  
   June 13, 2020

HHS said the final rule, which rolls back Obama-era regulations prohibiting discrimination based on gender identity and the termination of a pregnancy, would result in savings of nearly $3 billion over five years.

The American Hospital Association (AHA) and the American Medical Association (AMA) issued statements pushing back on the Trump administration's planned rollback of regulations prohibiting discrimination based on gender identity and the termination of a pregnancy.

The Department of Health and Human Services (HHS) finalized a rule to revise Section 1557 of the Affordable Care Act (ACA) Friday afternoon, focusing on "certain provisions that go beyond the plain meaning of the law as enacted by Congress."

In 2016, the Obama administration issued a regulation that redefined sex discrimination as part Section 1557, prohibiting healthcare providers that receive federal funding from discriminating against patients on the basis of sex, which was expanded to include the "termination of pregnancy and gender identity."

A federal court preliminarily enjoined the regulation in late 2016 and in October 2019, U.S. District Judge Reed O'Connor ruled that the Obama-era regulation violated both the Administrative Procedure Act and the federal Religious Freedom Restoration Act.

Related: Judge Vacates 2016 Rule That Banned Healthcare Discrimination Against Transgender Patients

In a press release announcing the final rule, HHS stated that it will enforce Section 1557 based on the "plain meaning of the word 'sex' as male or female and as determined by biology."

HHS added that the 2016 rule issued by the Obama administration did not recognize sexual orientation as a protected category under the ACA and that the Trump administration will "leave that judgment undisturbed."

HHS said the final rule would result in savings of nearly $3 billion over five years.

"HHS respects the dignity of every human being, and as we have shown in our response to the pandemic, we vigorously protect and enforce the civil rights of all to the fullest extent permitted by our laws as passed by Congress," Roger Severino, director of the Office for Civil Rights at HHS, said in a statement. "We are unwavering in our commitment to enforcing civil rights in healthcare."

Related: Trump Administration Rule Would Undo Healthcare Protections For LGBTQ Patients

The AHA responded after the rule was released, criticizing the regulation as a move that "weakens important protections for patients."

"Hospitals and health systems value every individual we have the privilege of serving, regardless of race, religion, national origin, sexual orientation or gender identity," Rick Pollack, CEO of AHA, said in a statement. "That is why we urged the administration to not move forward with changes to non-discrimination protections. We are deeply disappointed that this rule weakens important protections for patients and could limit coverage. Treating all with dignity and respect will continue to guide us in everything we do."

Related: AHA, AHIP, & U.S. Chamber of Commerce Call on Congress to Expand Coverage Options During Pandemic

Similarly, Susan R. Bailey, M.D., president of the AMA, said in a statement that the federal government "should never make it more difficult for individuals to access healthcare—during a pandemic or any other time." 

"Respect for the diversity of patients is a fundamental value of the medical profession and is reflected in long-standing AMA policy opposing discrimination based on race, gender, sexual orientation, gender identity or a woman's decisions about pregnancy, including termination," Bailey said.

Related: Hospital Groups Speak Out About George Floyd Killing, Nationwide Protests

Jack O'Brien is the finance editor at HealthLeaders, a Simplify Compliance brand.


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