Judge cites new Supreme Court ruling in blocking health care anti-discrimination protections for transgender Americans

By Devan Cole, CNN

Washington (CNN) — The Biden administration cannot enforce new anti-discrimination rules in health care for transgender Americans, a federal judge in Mississippi ruled Wednesday, citing a recent landmark Supreme Court ruling that weakened the power of federal agencies.

The preliminary injunction from US District Judge Louis Guirola comes just two days before the new protections were set to take effect. The George W. Bush appointee said his block on the federal protections will apply nationwide.

The new rules unveiled by the Department of Health and Human Services earlier this year were meant to bar health providers and insurers receiving federal funding from discriminating against those seeking care on the basis of gender identity or sexual orientation. The HHS rule restored Obama-era protections for transgender patients that the Trump administration rolled back in 2020.

But the rules were swiftly met with legal challenges, including from a group of Republican state attorneys general who argued that HHS overstepped its authority when it issued the new rules and that they would be harmed by a loss of federal funding for not complying with the changes.

Guirola agreed, ruling that HHS had wrongly leaned on a 2020 Supreme Court ruling that said federal civil rights law that bars sex discrimination protects LGBTQ workers when it issued the new rules. The Biden administration has in recent years used the court’s ruling in the case, Bostock v. Clayton County, to create protections for LGBTQ+ Americans.

In ruling against the Biden administration, the judge also pointed to a major Supreme Court ruling last week that overturned the decades-old “Chevron Deference” precedent that required courts to give deference to federal agencies that create regulations based on an ambiguous law.

“Plaintiffs have demonstrated a substantial likelihood of success on the merits of their claim that HHS exceeded its statutory authority by applying the Bostock holding to Section 1557’s incorporation of Title IX in its May 2024 Rule,” Guirola wrote, going on to quote from the high court’s ruling last week. “’And to the extent that Congress and the Executive Branch may disagree with how the courts have performed [their] job in a particular case, they are of course always free to act by revising the statute.’”

“HHS acted unreasonably when it relied on Bostock’s analysis in order to conflate the phrase ‘on the basis of sex’ with the phrase ‘on the basis of gender identity,’” Guirola wrote. “Specifically, the Bostock holding did not ‘sweep beyond Title VII to other federal or state laws that prohibit sex discrimination.’”

The blocked rules stem from Section 1557 of the Affordable Care Act, which bars “discrimination on the basis of race, color, national origin, sex, age or disability in specified health programs or activities.” The new HHS guidelines stipulate that while Section 1557’s prohibition on sex discrimination includes LGBTQ+ patients — and bans limiting access to care based on a patient’s sex assigned at birth or gender identity — exemptions based on health care providers’ religious beliefs still apply.

CNN has reached out to HHS for comment on the ruling.

Tennessee Attorney General Jonathan Skrmetti, a Republican who is part of the lawsuit challenging the new protections, applauded Wednesday’s ruling.

“The administration has over and over again issued regulations that mangle the law to advance an ideological agenda,” he said. “This case is just one of many examples of Tennessee working with other states to block the unlawful abuse of regulatory power.”

CNN’s Avery Lotz contributed to this report.

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