The Hand Writing Is On The Wall

And it is not good. It looks like the Trump administration is on the verge of ignoring Section 1557 of the Affordable Care Act (ACA) also known as Obamacare. That section mandates health coverage for us.

Trump Health Officials Prepare to Promote Anti-Trans Discrimination
Medium
By Harper Jean Tobin
August 17, 2017

The U.S. Department of Health and Human Services (HHS) is the latest federal agency to make moves against the transgender community under the Trump administration.

Last month, the agency removed web pages that contained frequently asked questions about a law ensuring that trans people are covered by non-discrimination laws when seeking health care.

As if that wasn’t enough, HHS also announced preparations last week to rewrite a non-discrimination regulation so that it no longer recognizes transgender people. The regulation makes it clear that Section 1557 of the Affordable Care Act (ACA) — Obamacare — prohibits discrimination against transgender people by health care providers or insurance companies.

Like other federal agencies, HHS has demonstrated a desire to roll back policies that are aimed at improving health care for LGBTQ people.

Hey if you don’t like a law ignore it! That seems to be the philosophy of the Trump administration. Section 1557 prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in certain health programs and activities. Notice that it doesn’t include gender identity or sexual orientation.

The Obama administration used a history of court cases to find that sex does cover gender identity but the Trump administration used bigotry to declare that sex means just sex.

Section 1557 is part of federal law, and the regulation interprets and enforces that law. The regulation was first published in 2016 after six years of development, and was accompanied by frequently asked questions that summarized parts of the regulation about unlawful insurance exclusions that target transgender people, harassment in health care settings, and the need to treat patients in a manner consistent with their gender identity — among many other issues.

And the Obama administration had in their FAQ that Section 1557 also included gender identity well the Trump Administration removed all of the references from the FAQ claiming a Bush appointed federal judge ruled that sex does not mean anything but sex.

A single federal judge in Texas — ignoring case law from around the country — temporarily stopped HHS from enforcing Section 1557 to protect trans people. Shortly thereafter, the HHS Office of Civil Rights (OCR) updated its FAQs to include a note about this judge’s decision, clarifying that it would still enforce non-discrimination protections based on race, color, national origin, age, or disability, but that it would only cover some sex discrimination cases.
Specifically, the note said:

Areas of sex discrimination that HHS OCR may continue to enforce include: harassment based on sex and allegations related to sex stereotyping that do not involve gender identity claims, as well as other forms of discrimination based on sex other than gender identity or termination of pregnancy. (Emphasis added.)

The FAQs further noted that, “More than 25 years ago, the U.S. Supreme Court held that discrimination based on stereotypical ideas about gender is unlawful sex discrimination.”

So what does that mean for us?

It means we are screwed!

My guess that the Trump administration will attack the CMS* ruling that we are covered under Medicare.

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*CMS = Centers for Medicare & Medicaid Services, the governing body that controls Medicare.
From Wikipedia

The Centers for Medicare & Medicaid Services (CMS), previously known as the Health Care Financing Administration (HCFA), is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the State Children's Health Insurance Program (SCHIP), and health insurance portability standards. In addition to these programs, CMS has other responsibilities, including the administrative simplification standards from the Health Insurance Portability and Accountability Act of 1996 (HIPAA), quality standards in long-term care facilities (more commonly referred to as nursing homes) through its survey and certification process, clinical laboratory quality standards under the Clinical Laboratory Improvement Amendments, and oversight of HealthCare.gov.