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Tipsheet

Judge Blocks Obamacare Requirement for Doctors to Perform Transgender Surgeries

AP Photo/Carolyn Kaster

A federal judge in Texas has permanently blocked the federal government from penalizing healthcare providers and insurance companies who refuse to perform gender reassignment surgeries.

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The judge, Reed O’Connor of the United States District Court for the Northern District of Texas, ruled in favor of the Obama-era initiative in 2019, but cited the “substantial burden” on the providers’ freedom of religion in his ruling on Monday, Aug. 9.

“Plaintiffs identified the substantial burden on their religious exercise as resulting from HHS’s attempt to ‘force them to choose between federal funding and their livelihood as healthcare providers and their exercise of religion,’” O’Connor wrote in his opinion.

Under President Barack Obama in 2016, the U.S. Department of Health and Human Services (HHS) had altered a pair of statutes under Section 1557 of the Affordable Care Act (ACA), colloquially known as Obamacare. Denying care to patients seeking abortions or gender reassignment surgeries, Obama’s HHS argued, constituted a violation of the federal ban on sex discrimination under the Civil Rights Act of 1964.

This so-called “transgender mandate” was suspended by the HHS in 2020, as the administration of former President Donald Trump sought to comply with the 1993 Religious Freedom Restoration Act (RFRA) — oddly enough sponsored by then-Rep. Chuck Schumer (D-NY). The HHS revived the transgender mandate under President Joe Biden back in May.

The lawsuit, formally known as Franciscan Alliance v. Becerra, was first filed in November 2016. It pitted the Franciscan Health Christian hospitals, a coalition of 20,000 health care professionals, and nine states against Biden administration HHS Secretary Xavier Becerra. 

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O’Connor’s ruling will invalidate Biden’s Day 1 executive order returning to the Obama-era transgender mandate. It will also prohibit Becerra’s HHS from interpreting the current sex discrimination laws  “in a manner that would require [doctors] to perform or provide insurance coverage for gender-transition procedures or abortions, including by denying Federal financial assistance because of their failure to perform or provide insurance coverage for such procedures or by otherwise pursuing, charging, or assessing any penalties, fines, assessments, investigations, or other enforcement actions.”

Religious conservatives, like Becket Law Vice President and Senior Counsel Luke Goodrich, cheered O’Connor’s ruling.

“Today’s ruling is a victory for compassion, conscience, and common sense,” Goodrich said. “No doctor should be forced to perform controversial, medically unsupported procedures that are contrary to their conscience and could be deeply harmful to their patients.”

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