Texas sues to block new Biden administration rule protecting access to some gender transition care

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Texas Attorney General Ken Paxton has sued the Biden administration over a new federal rule that he says would require states to pay for gender care procedures for transgender people through their Medicaid programs and require health care providers to perform them.

“This is yet another example of Joe Biden trying to sidestep the Constitution and use agency rulemaking to advance unpopular, unlawful, and destructive policies,” Paxton wrote in a press release.

At issue is a new Biden administration rule regarding a section of the Affordable Care Act that pertains to nondiscrimination. The section particularly bans discrimination based on gender.

In 2016, the Obama Administration interpreted it to protect against gender identity and sex stereotyping but not sexual orientation. Four years later, the Trump administration didn’t change the section but suggested it would interpret sex to mean only sex assigned at birth.

But the Biden administration in March issued rules that said the protections apply to gender identity and sexual orientation.The administration, through the U.S. Department of Health and Human Services, included specific protections for transgender people, including saying that providers can’t deny transition care that would be provided to other people for other purposes. It does, however, allow for some providers to make religious freedom claims.

Paxton’s office argued in a press release that the rule “is a plainly unconstitutional attempt to override state law." He claims the health care law also doesn’t “authorize—and has never authorized—the federal government to compel anyone to perform or pay for these procedures.”

Paxton has asked the federal court for injunctive relief, which would pause the rule from being implemented.

The state of Montana is also suing the Biden administration over this rule.

The lawsuit drew immediate outrage from one LGBTQ rights group, Equality Texas, which said that transgender people have traditionally been denied care by Medicaid for care related to gender dysphoria. The Biden administration rule, the group estimated, would help tens of thousands of Texans.

“Health care for transgender adults remains legal in the state of Texas," said Ricardo Martinez, CEO of the group. "And while Ken Paxton seems to have little regard for medical freedom, it’s essential that trans adults who use Medicaid have access to vital care."

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