Tuesday, May 01, 2018

Basic Human Needs

Healthcare is a basic human right.

Back in the colonial times healthcare was not an issue because there was no such thing as doctors as we know them today. When I was growing up you visited the doctor’s office in their house or the doctor came to your house and if you couldn’t pay it didn’t matter. Then healthcare became big business.
Transgender patients sue Wisconsin for not covering their surgeries
The Hill
By Avery Anapol
April 30, 2018

Two transgender Wisconsin residents are suing the state’s health department, alleging discrimination because their desired gender reassignment surgery is not covered by Wisconsin Medicaid.

In the complaint, plaintiffs Cody Flack and Sara Ann Makenzie challenge a 1997 Wisconsin regulation that prohibits the state’s Medicaid program from covering what it refers to as “transsexual surgery.”

The regulation, which is similar to provisions in nine other states, says such surgery is medically unnecessary. The plaintiffs say the regulation “flies in the face” of the medical consensus on gender dysphoria, the “clinically significant distress associated with having a gender identity ... that conflicts with the sex one was assigned at birth.”
Flack, a transgender man, and Makenzie, a transgender woman, are asking a federal judge to declare the provision unconstitutional under the Affordable Care Act and to block the state from denying them coverage. They are also seeking damages for related “economic and non-economic injuries” and legal fees.
It will all boil down to the judge. Hopefully it will not be a Trump appointee.

The state is going to have a hard uphill fight on their hands.
Trump’s War on Trans Americans Is About to Face a Counterattack
The administration is preparing to gut health care protections for transgender people, but civil rights advocates are ready.
By Mark Joseph Stern
April 30, 2018

To an extent rarely discussed by the media, Donald Trump’s presidency has been defined by an overwhelming, unrelenting hostility toward the rights of transgender Americans. In just 15 months, the Trump administration has withdrawn federal guidance protecting transgender schoolchildren, employees, and homeless people. It has attempted to outlaw transgender military service and painted trans individuals as disordered deviants who are too mentally unstable to serve. One-third of Trump’s judicial nominees have anti-LGBTQ records, including one who described transgender children as part of “Satan’s plan.”

In the coming weeks, the administration will launch its next attack on trans rights by announcing the revocation of a landmark regulation that protects transgender people from discrimination in health care. The Department of Health and Human Services will argue that the Affordable Care Act does not prohibit doctors and hospitals from turning away transgender patients, or insurance companies from refusing to cover gender-related treatment. This time around, however, civil rights advocates are prepared to fight back. In fact, they’ve already laid the groundwork for a two-pronged legal attack to maintain the ban on anti-trans health care discrimination.

The ACA’s protections for LGBTQ people lie in Section 1557 of the law, which forbids medical providers and insurance companies from discriminating on the basis of race, color, national origin, sex, age, or disability. Like many federal courts, the Obama administration interpreted sex discrimination to encompass discrimination against transgender people on account of their transition from one gender to another. If a medical provider refuses to provide hormone therapy to a transgender man, for instance, it has declined treatment based on his sex, concluding that an individual assigned female at birth should not receive the recommended care. Thus, in May 2016, HHS issued a regulation interpreting Section 1557 to bar discrimination in health care on the basis of transgender status.
But it’s also not at all clear that HHS can actually get away with gutting Section 1557. The lower courts have developed a sizable body of case law establishing that sex discrimination encompasses anti-trans discrimination. And the Supreme Court itself has ruled that “sex stereotyping”—punishing an individual for not complying with gender norms—constitutes discrimination on the basis of sex. When a medical provider declines to treat a transgender patient because it feels he should comport with the sex assigned to him at birth, it’s denying treatment on the basis of a stereotype. The ACA was designed to strike at the entire spectrum of medical discrimination; it would be rather odd to exclude this clear-cut form of gender-based discrimination from the law’s ambit.
The roots of the court rulings go back to the Price Waterhouse v. Hopkins 1989 ruling by the Supreme Court where the court said as the article points out sex discrimination also includes “sex stereotyping” and in Schroer v. Billington the federal district of the District of Columbia said,
There, the court noted that an employer who fires an employee because the employee converted from Christianity to Judaism has discriminated against the employee “because of religion,” ... because “[d]iscrimination ‘because of religion’ easily encompasses discrimination because of change of religion.  By the same token, discrimination “because of sex” inherently includes discrimination against employees because of a change in their sex.
Another court has ruled that religious freedom does not apply when it comes to discrimination.
However, based on the funeral home’s defense that the application of Title VII would force it to violate its sincerely-held religious beliefs, the district court found the funeral home was exempt from Title VII pursuant to the Religious Freedom Restoration Act of 1993 (RFRA).  In so finding, the district court relied on RFRA’s provision that “[a] person whose religious exercise has been burdened in violation in this section may assert that violation as a claim or defense in a judicial proceeding.”
It is going to be very hard for the administration to justify any attempts to cut us out of the ACA (Obamacare). But it is going to be a long drawn out fight all the way to the Supreme Court.

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