Category: Healthcare

Trump erases health care protections for transgender patients during Pride Month

Leave a comment

Just two weeks into Pride Month — and on the anniversary of the Pulse nightclub shooting — the Trump administration announced that it is rolling back Obama-era health care protections for people who are transgender. The rule, announced Friday, will impact transgender patients’ ability to fight against discrimination by doctors, medical facilities and health insurance providers. 

Former president Barack Obama’s administration changed federal health care guidelines in 2016 to expand sex-based protections based to include protections based on gender identity, “which may be male, female, neither, or a combination of male and female.” His administration also pushed for discrimination protections for those who have had abortions. 

But the Department of Health and Human Services (HHS) released a statement on Friday saying the final rule is based on “the plain meaning of the word ‘sex’ as male or female and as determined by biology.”

“All of these are essentially legislative changes that the Department lacked the authority to make,” the administration said of the 2016 changes in the final rule. “They purported to impose additional legal requirements on covered entities that cannot be justified by the text of Title IX, and in fact are in conflict with express exemptions in Title IX.”

In the summary of the final rule, HHS responded to several comments that criticized the lack of protection for people who do not identify with the sex they were assigned at birth. In one response to the comments, HHS compared gender identity to political affiliation. 

“For example, in the unlikely event that a healthcare provider were to deny services to someone based solely on his or her political affiliation, the Department would not be able to address such denial of care under Section 1557,” HHS said. “Unlike other bases of discrimination, the categories of gender identity and sexual orientation (as well as political affiliation) are not set forth in those statutes.”

The rule summary also argued that health care based on sex assigned at birth, rather than gender identity, is necessary for health care, and insinuated that transgender health care may be confusing for providers.

“The 2016 Rule risked masking clinically relevant, and sometimes vitally important, information by requiring providers and insurers to switch from a scientifically valid and biologically based system of tracking sex to one based on subjective self-identification according to gender identity,” the summary said. “…The 2016 Rule’s mandate cannot answer, for example, how a provider is to determine whether or when a transgender individual is entitled by law to be referred to a women’s mental health support group, a men’s mental health support group, either group, or both at the same time.”

Roger Severino, director of the HHS Office for Civil Rights, maintained in the announcement that “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,” Severino said. “We are unwavering in our commitment to enforcing civil rights in healthcare.”

Transgender individuals have long faced discrimination in health care. A quarter of the 28,000 individuals who took the U.S. Transgender Survey reported that they have experienced an insurance issue because of their gender identity. Even more respondents reported that they have experienced verbal harassment, been refused treatment, or had a health care provider who did not know how to properly treat transgender individuals. 

Thousands of survey participants also reported they were denied routine health and sexual health screenings. Those who are transgender are more likely than the general U.S. population to be uninsured, according to the survey. 

The American Civil Liberties Union quickly responded to the administration’s announcement, writing on Twitter that the rule “will embolden health care discrimination against transgender people, those seeking reproductive health care, and many other individuals who need health care — all while a global pandemic is occurring.”

“Politicians have no business coming between us and our health care,” the organization added.

The announcement also came at the end of a week where two black transgender women were murdered. So far this year, at least 14 transgender or gender non-conforming individuals have been fatally shot or killed by other violent means in the U.S., according to the Human Rights Campaign. 

[CBS News]

Trump tells Fox News he’s going after Social Security and Medicare: ‘We’ll be cutting’

Leave a comment

At a town hall meeting on Fox News Thursday, President Donald Trump acknowledged that his administration intends to cut Social Security and Medicare.

“We — when these trade deals kick in, you know this economy is the best economy we’ve ever had. It’s nothing to what it’s going to be when the trade deals kick in,” said Trump.

“But if you don’t cut something in entitlements, you’ll never really deal with that,” said the questioner.

“We’ll be cutting, but we’re also going to have growth like you’ve never had before,” said Trump.

The president campaigned on protecting Social Security and Medicare in 2016. However, he has never shown any particular interest in doing so.

[Raw Story]

Media

Trump delivers bizarre speech in Baltimore during Democratic debate

Leave a comment

While the Democratic presidential candidates debated in Houston on Thursday night about environmental policy, the role of racism in American society, health care access, and other issues, President Donald Trump gave a speech to a House Republican retreat in Baltimore. The contrast between the president and the Democrats who are vying to take his job was remarkable.

Perhaps the clearest distinction came as Trump resurrected his fake middle-class tax cuts while Democrats had a detailed conversation about how to provide affordable health care to more people without dramatically raising taxes — within minutes of each other.

“We’re now working on a tax cut for middle-income people that is going to be very, very inspirational,” he told House Republicans, bringing up an idea he hyped just before last November’s midterm elections, only to forget about it as soon as it came and went. “It’s going to be something that I think it’s what everybody is looking for. We’ll be announcing it sometime in the next year.”

While one can pick holes in the tax plans offered by Democrats, at least they’re coherent plans. Trump, on the other hand, is offering soundbites that he thinks will play well with voters without seemingly having any intention of following through.

But Trump has a long history of this sort of thing. On Tuesday, for instance, he vowed that Republicans “will always protect patients with preexisting conditions,” despite the fact that two years ago he wholeheartedly embraced health care legislation that would’ve resulted in millions of people losing coverage. Trump even mocked the late Sen. John McCain during his speech for voting against it.

That was par for the course in Trump’s more than hour-long speech, during which he made a number of outlandish and self-refuting claims. He began by bragging about the move his administration made earlier in the day to repeal an Obama-era rule meant to limit pollution in America’s rivers, lakes, streams, and wetlands. But a short time later, he seemed to accidentally admit that rules of that sort have helped the country’s water remain relatively clean.

“The Clean Waters act didn’t give you clean waters — by the way, today we have the cleanest air, we have the cleanest water that we’ve ever had in the history of our country,” Trump said, falsely, combining two statements that directly contradict each other.

When he wasn’t contradicting himself or gaslighting, Trump offered hyperbolic commentary about MS-13 (“They take young women. They slice them up with a knife. They slice them up — beautiful, young.”), Democratic presidential candidates (“They’re gonna take your money, they’re gonna take — and very much hurt — your families.), and expressed his now-familiar ignorance about wind energy.

“If you happen to be watching the Democrat debate and the wind isn’t blowing, you’re not going to see the debate … ‘the goddamn windmill stopped!’” he said.

Trump even took aim at the city that was hosting the House Republican retreat, characterizing Baltimore as a city that has “been destroyed by decades of failed and corrupt rule.” He closed by promising some sort of major federal action unless Los Angeles and San Francisco take quick action to clean up homelessness.

The spectacle was dark, and at times brutal. Republicans, as they have mostly done since Trump became the Republican nominee for president in 2016, cheered.

Meanwhile, in Houston, Democratic presidential candidates took a few potshots at each other and, of course, at Trump — but they also got deep into the weeds of policy and outlined their respective visions of an America where immigrants are treated with respect, the climate crisis is taken seriously, and claims about health care proposals are backed up with actual plans.

The difference couldn’t have been clearer. Then again, it was just as clear in 2016.

[Vox]

Trump unleashes bizarre stream of gobbledygook when reporter asks him to describe his health care plan

Leave a comment

President Donald Trump has vowed multiple times over the past two-and-a-half years to unveil his own replacement plan for the Affordable Care Act, but so far no actual plan has come to light.

As noted by CNN fact checker Daniel Dale, Trump was asked by a reporter in New Hampshire this week to describe his health care plan, and the president responded with a stream of gobbledygook.

“So, we have a great plan coming out,” the president began when asked about his plan. “It’s going to be — if we can take back the House because we’re not going to get the Democrats to vote for it, because they’re doing Medicare for all, which is going to take away your freedom, take away your doctors, take away everything that you should be able to have, and most importantly, it’s going to take away — we have 180 million people right now that have private insurance and they love it, and all of that’s going to be taken away. It’s absolute craziness.”

Instead of talking about his own health care plan, the president then proceeded to make false statements about Medicare for All.

“On top of everything else, they’re looking at 80, 90, 95 percent tax, because there’s no — there’s no way they can afford it,” he said. “But people don’t want to go to a hospital, to go to a doctor. They don’t want to go. They want to have their own doctor, number one, and we went through this with Obamacare, which we got rid of the individual mandate, by the way, which is very important.”

After all this, the president finally pivoted back to talking about his own health care plan, but he offered zero details about what it would contain.

“But we have a great health care plan,” he said. “If we get the House, we hold the Senate, we keep the presidency, we’re going to have great health care, much better than Obamacare, at much less cost.”

[Raw Story]

Trump Claims Only Republicans Can Pull Off Preexisting Condition Protections Already Available in Obamacare

Leave a comment

Donald Trump told his rally-goers dozens of insane lies, but one lie really stood out, claiming, “The Democrats’ vision on healthcare is deception and disruption … patients with pre-existing conditions are protected by Republicans much more so than were protected by Democrats who can never pull it off.”

One problem. Obamacare, passed by Democrats, contains protections for people with preexisting medical conditions and this is the same law Republicans tried to repeal 70 times and Trump’s own DOJ is currently trying to dismantle in courts today.

Doctors Could Refuse to Treat People Based on Race and Age Under Trump’s New Rule

Leave a comment

A new Trump administration proposal would change the civil rights rules dictating whether providers must care for patients who are transgender or have had an abortion. News stories have mainly focused on how the proposal might affect LGBTQ rights and abortion rights, but the sweeping proposal has implications for all Americans, because the Department of Health and Human Services seeks to change how far civil rights protections extend and how those protections are enforced.

Roger Severino, the director of the HHS Office for Civil Rights, has been candid about his intentions to overturn an Obama-era rule that prohibited discrimination based on gender identity and termination of a pregnancy. In 2016, while at the conservative Heritage Foundation, he co-authored a paper arguing the restrictions threaten the independence of physicians to follow their religious or moral beliefs. Supporters of the approach say it protects the freedom of conscience, but opponents say it encourages discrimination.

His office unveiled the proposed rule on May 24, when many people were focused on the start of the long Memorial Day holiday weekend.

The rule is the latest Trump administration proposal to strip protections for transgender Americans, coming the same week another directive was proposed by the Department of Housing and Urban Development that would allow homeless shelters to turn away people based on their gender identity.

The public was given 60 days to comment on the HHS proposal. Here’s a rundown of what you need to know about it.

What would this proposal do?

Fundamentally, the proposed rule would overturn a previous rule that forbids health care providers who receive federal funding from discriminating against patients on the basis of their gender identity or whether they have terminated a pregnancy.

The Trump administration proposal would eliminate those protections, enabling providers to deny these groups care or insurance coverage without having to pay a fine or suffer other federal consequences.

That may mean refusing a transgender patient mental health care or gender-confirming surgery. But it may also mean denying patients care that has nothing to do with gender identity, such as a regular office visit for a bad cold or ongoing treatment for chronic conditions like diabetes.

“What it does, from a very practical point of view, is that it empowers bad actors to be bad actors,” Mara Keisling, executive director of the National Center for Transgender Equality, told reporters.

The proposal would also eliminate protections based on sexual orientation and gender identity from several other health care regulations, like non-discrimination guidelines for the health care insurance marketplaces.

Does it affect only LGBTQ people?

The proposal goes beyond removing protections for the LGBTQ community and those who have had an abortion.

It appears to weaken other protections, such as those based on race or age, by limiting who must abide by the rules. The Trump proposal would scrap the Obama-era rule’s broad definition of which providers can be punished by federal health officials for discrimination, a complicated change critics have said could ease requirements for insurance companies, for instance, as well as the agency itself.

And the proposal erases many of the enforcement procedures outlined in the earlier rule, including its explicit ban on intimidation or retaliation. It also delegates to Severino, as the office’s director, full enforcement authority when it comes to things like opening investigations into complaints lodged under the non-discrimination rule.

Why did HHS decide to change the rule?

The Obama and Trump administrations have different opinions about whether a health care provider should be able to refuse service to patients because they are transgender or have had an abortion.

It all goes back to a section in the Affordable Care Act barring discrimination on the basis of race, color, national origin, age, disability or sex. President Barack Obama’s health officials said it is discrimination to treat someone differently based on gender identity or stereotypes.

It was the first time Americans who are transgender were protected from discrimination in health care.

But President Donald Trump’s health officials said that definition of sex discrimination misinterprets civil rights laws, particularly a religious freedom law used to shield providers who object to performing certain procedures, such as abortions, or treating certain patients because they conflict with their religious convictions.

“When Congress prohibited sex discrimination, it did so according to the plain meaning of the term, and we are making our regulations conform,” Severino said in a statement. “The American people want vigorous protection of civil rights and faithfulness to the text of the laws passed by their representatives.”

Much of what the Office for Civil Rights has done under Severino’s leadership is to emphasize and strengthen so-called conscience protections for health care providers, many of which existed well before Trump was sworn in. Last year, Severino unveiled a Conscience and Religious Freedom Division, and his office recently finalized another rule detailing those protections and their enforcement.

The office also said the proposed rule would save about $3.6 billion over five years. Most of that would come from eliminating requirements for providers to post notices about discrimination, as well as other measures that cater to those with disabilities and limited English proficiency.

The rule would also save providers money that might instead be spent handling grievances from those no longer protected.

The office “considers this a benefit of the rule,” said Katie Keith, co-founder of Out2Enroll, an organization that helps the LGBTQ community obtain health insurance. “Organizations will have lower labor costs and lower litigation costs because they will no longer have to process grievances or defend against lawsuits brought by transgender people.”

Why does this matter?

Research shows the LGBTQ community faces greater health challenges and higher rates of illness than other groups, making access to equitable treatment in health care all the more important.

Discrimination, from the misuse of pronouns to denials of care, is “commonplace” for transgender patients, according to a 2011 report by advocacy groups. The report found that 28 percent of the 6,450 transgender and gender non-conforming people interviewed said they had experienced verbal harassment in a health care setting, while 19 percent said they had been refused care due to their gender identity.

The report said 28 percent had postponed seeking medical attention when they were sick or injured because of discrimination.

Critics fear the rule would muddy the waters, giving patients less clarity on what is and is not permissible and how to get help when they have been the victims of discrimination.

Jocelyn Samuels, the Obama administration official who oversaw the implementation of the Obama-era rule, said that for now, even though the Trump administration’s HHS will not pursue complaints against those providers, Americans still have the right to challenge this treatment in court. Multiple courts have said the prohibition on sex discrimination includes gender identity.

“The administration should be in the business of expanding access to health care and health coverage,” Samuels told reporters on a conference call after the rule’s release. “And my fear is that this rule does just the opposite.”

[VICE]

Trump Knocks McCain Again for Saving Obamacare During NRA Convention Speech

Leave a comment

President Donald Trump made a dig at late Senator John McCain for voting against an Obamacare repeal bill, which ultimately killed Republican efforts to remove the ACA.

“We got the individual mandate, the absolute worst part of ObamaCare eliminated,” Trump said while bragging about his accomplishments to a raucous crowd gathered in Indianapolis for this year’s National Rifle Association convention. “Now we’re going for the rest.”

“And we had it [repealed] except for one vote,” he added, referencing the infamous McCain vote that saved Obamacare. “You know what I’m talking about.”

The crowd responded to Trump’s McCain jab with cheers and applause.

In nearly an hour long interview on Sean Hannity‘s Fox News show last night, Trump ripped McCain for doing the GOP “a tremendous disservice” and “the nation a tremendous disservice, tremendous, and it’s unfortunate.”

“He went thumbs-down at the very last moment and I thought it was a disgraceful thing to do and very, very bad for our country and bad for health care,” he added. “It was done and then John McCain, at the very last moment, late in the evening, went thumbs-down and everybody said, ‘What was that?’”

During his NRA speech, Trump also warned the audience that “socialists and far left Democrats want to destroy everything that we’ve done.” He went on to say that Democrats want to ban “new guns and confiscating existing guns from law-abiding citizens.”

“What they don’t tell you is, the bad guys aren’t giving up their guns and you’re not going to be giving up your guns either,” he added.

[Mediaite]

Trump goes off script at opioid summit: ‘I know about rigging the system because I had the system rigged on me’

Leave a comment

President Donald Trump alleged on Wednesday that the U.S. justice system had been “rigged” against him.

While speaking at an event on opioid abuse, the president argued that pharmaceutical companies are giving European countries better prices than they give U.S. customers.

Trump vowed to stop the practice and called his promise “a big deal.”

“At long last we’re stopping drug companies in foreign countries from rigging the system,” Trump said before straying from his prepared remarks.

“I know all about the rigging of the system because I had the system rigged on me,” the president said, likely referring to special counsel Robert Mueller’s Russia investigation.

“I think you know what I’m talking about,” Trump added. “Unfortunately, that will be your soundbite tonight but that’s okay. The system was rigged!”

[Raw Story]

Trump poised to roll back transgender health protections

Leave a comment


The Trump administration appears ready to roll back health care protections for transgender people, and advocates are gearing up for a fight.

A proposed rule from the Department of Health and Human Services (HHS) that’s expected in the coming days would make it easier for doctors, hospitals and insurance companies to deny care or coverage to transgender patients, as well as women who have had abortions.

Coming on the heels of the military transgender ban, there are fears the administration could go even further and use the proposal as an opportunity to narrow the definition of gender.

The administration hinted in a recent court filing that new health regulations could be published as soon as next week. The rule is expected to weaken or eliminate an anti-discrimination provision enshrined in ObamaCare.

The provision says patients cannot be turned away because they are transgender, nor can they be denied coverage if they need a service that’s related to their transgender status.

Religious providers say they expect the administration’s rule to reinforce their right not to provide treatment that is against their beliefs.

Advocates, meanwhile, say they are concerned that the proposal could jeopardize the gains made in making sure transgender individuals receive equal access to care.

The proposal is “likely to send an even stronger signal that the administration endorses discrimination in health care against transgender people,” said Harper Jean Tobin, director of policy at the National Center for Transgender Equality.

The rule “won’t mean that overnight transgender people can’t get health care, but it will be a steady drip of allowing more discrimination,” Tobin said.

Chase Strangio, an attorney at the American Civil Liberties Union (ACLU), said access to health care can be a life or death circumstance, and the rule could have “catastrophic effects” if it is finalized.

“To have the government take a stand in favor of discrimination is deeply upsetting, ” Strangio said.

Once the proposal is released, a public comment period will follow. After that, a final rule will be issued.

As for what comes next, Strangio said the ACLU has had two years to prepare for that.

“If the final rule looks like the proposal we are anticipating, we and our partners will file suit as soon as possible,” Strangio said. “We can expect many legal challenges to any final rule.”

President Trump repeatedly pledged support for the LGBTQ community on the campaign trail in 2016. But advocates say the president’s words increasingly ring hollow, and his administration has been steadily eroding protections for transgender individuals.

For example, the military’s transgender ban took effect earlier this month, despite objections from advocacy groups and medical experts. And the Supreme Court on Monday said it would hear arguments this year on three cases concerning whether federal law applies to transgender identity.

Additionally, the Justice Department has argued that the main federal civil rights law doesn’t protect employees from discrimination based on gender identity. Former Attorney General Jeff Sessions in 2017 wrote a memo saying the law “does not encompass discrimination based on gender identity per se.”

The existing health care rule was first issued in 2016, six years after the 2010 Affordable Care Act was signed into law. The rule prohibited providers and insurers who receive federal money from denying treatment or coverage to anyone based on sex, gender identity or termination of pregnancy.

It also required doctors and hospitals to provide “medically necessary” services to transgender individuals, as long as those services were the same ones provided to other patients.

That rule was challenged in court by a group of Christian providers called the Franciscan Alliance. They argued the rule forces insurers to pay for abortions and compels doctors to perform gender transition services, even if they disagree with those services on moral or medical grounds.

A federal judge in Texas agreed with that argument, issuing a nationwide injunction in late 2016 that is still in effect. The ruling said Congress had outlawed discrimination based on “the biological differences between males and females” but not transgender status.

The new proposed rule has been under review at the White House Office of Management and Budget for more than a year, something that experts say is highly unusual.

That delay is causing confusion in the health care industry: ObamaCare’s nondiscrimination statute is the law, even if a rule implementing it has been put on hold.

In a court filing earlier this month, the administration said it would be publishing the proposal soon, a move that would likely affect the lawsuit in Texas.

Luke Goodrich, senior counsel with the Becket Fund for Religious Liberty and a lead attorney for the plaintiffs, said providers would be better served by a ruling from the judge. He said they just want to make sure their religious protections are upheld.

Katie Keith, a health care consultant and professor at Georgetown Law, said, “It’s going to be really hard for people to understand their rights in health care” while the confusion continues.

Tobin, of the National Center for Transgender Equality, said the uncertainty is having a harmful effect.

“At a time when the administration is trying to overturn the entire Affordable Care Act, at a time when the transgender ban in military is taking effect, transgender people are scared for their ability to get the health care they need, and that their providers know they need,” Tobin said.

Goodrich argues that providers won’t turn away patients just because they are transgender, so long as the doctors aren’t giving transition-related care or “being pressured to perform abortions.”

He said the plaintiffs have been treating transgender people for years and “won’t stop doing that, because they provide care for everyone. That’s not what the lawsuit is about in our view.”

Transgender advocates are concerned the administration will use the lawsuit as an excuse to redefine gender.

The New York Times last year reported that HHS proposed in a memo that government agencies adopt a narrower definition of gender in a way that would essentially end federal recognition of transgender individuals.

No rules have been issued, but advocates say administration officials have been telegraphing their views.

The HHS memo is a “blueprint” for discrimination, and the nondiscrimination proposal is a major part of it, Tobin said.

[The Hill]

Trump says GOP senators are working on an Obamacare replacement and it will be ‘spectacular’

Leave a comment

President Donald Trump announced Thursday that a team of GOP senators is ready to give health care another shot after nearly a decade of promising and failing to repeal and replace the Affordable Care Act.

But he added the caveat that he’s in no rush to get it done.

Trump resurrected the issue this week after the Justice Department, in a court filing Monday, said it supported the full elimination of President Barack Obama‘s signature legislative achievement. The president’s assertion that Republicans would become “the party of health care” surprised some Republicans, who thought they’d missed their chance to replace the law.

Republicans experienced an embarrassing defeat during Trump’s first year in office when they failed to make good on their campaign promise to end Obamacare. The closest they got to dismantling it was to eliminate the penalty on people who didn’t purchase health care.

Instead, the White House used executive actions to chip away at the law, while 20 governors from red states challenged it in court.

Trump named Sens. John Barrasso of Wyoming, Bill Cassidy of Louisiana and Rick Scottof Florida as the point people on Capitol Hill crafting the legislation.

“They are going to come up with something really spectacular,” Trump told reporters before heading off to a political rally in Michigan.

Trump also claimed that Republicans “will take care of preexisting conditions better than they’re taken care of now.”

The law makes it illegal for health insurers to deny coverage or raise rates on anyone with a preexisting or current illness. Trump did not expand on how it would be improved.

Trump also sounded triumphant about a lawsuit brought by 20 red states to rule Obamacare unconstitutional. A federal judge in Texas ruled in December that the entire law hinged on the fee imposed on people without health insurance. Since Congress eliminated that mandate in its tax bill, the law is no longer constitutional, the judge ruled. An appeal on that case is pending.

According to Trump, those opposed to the ACA are “winning in the courts.”

Democrats campaigned on this issue in November, warning voters that if the courts invalidate the law, then all of its most popular provisions, like protections for people with preexisting conditions, would go down with it.

The law has become increasingly popular with the public, and Democrats credit voters’ concerns about health care for their winning back the House.

Cassidy, one of the three senators Trump named, was also the architect of a replacement bill in 2017 that would have provided block grants to states to allow them to set the guidelines for their insurers. The Senate never voted on it.

All three have been separately working on health care-related legislation, but Trump claims he has asked them to take on the larger endeavor.

Cassidy and Barrasso were both medical doctors. Scott ran a hospital company, which, notably, was fined $1.7 billion for Medicare fraud when he was at the helm.

Trump said he’s not in a rush to get to health care because he’s waiting to see what the courts will decide. Democrats, who are elated to be talking about health care, argue the exact opposite, and say there should be a replacement in place if the ACA is dismantled because otherwise people lose the consumer protections in the law.

[Chicago Tribune]

1 2 3 … 5