(CN) — Seven GOP-dominated states filed a federal lawsuit in St. Louis against multiple Biden administration agencies Wednesday, in opposition to recent changes to the Affordable Care Act meant to protect transgender people from medical discrimination.
Missouri, Utah, both Dakotas, Iowa, Idaho and Arkansas, joined by a conservative medical professional organization known as the American College of Pediatricians, filed four claims against the Biden administration over the changes. The complaint includes both procedural and substantive claims but is centered around ideological opposition to gender-affirming care, particularly for children.
“The U.S. Department of Health and Human Services, under Section 1557 of the Affordable Care Act forces doctors to perform, refer for, or affirm harmful gender-transition procedures and forces states to pay for these dangerous procedures in state health plans,” the plaintiff states claim. “This radical mandate will hurt children.”
The rule changes in question are based on the language of 1972 Title IX civil rights protections. They were scheduled to take effect last week, and bar insurers and medical providers from denying care “based upon the individual’s sex assigned at birth, gender identity, or gender otherwise recorded.” The new rule also specifically prohibits the denial of gender transition and gender-affirming care based on a person’s assigned sex or gender identity.
The plaintiff states claim these changes violate their free speech protections and subvert the legislative authority of Congress. They want a federal judge to block enforcement on those grounds.
“The rule is an overbroad restriction on speech, and it sweeps within its ambit a substantial amount of First-Amendment protected speech and expression,” the states say in the complaint. “This overbreadth chills the speech of health care entities that engage in private speech through statements, notices, and other means in healthcare on the basis of sex.”
Their complaint also includes nods to what have become typical conservative culture war grievances, such as transgender people using the bathroom of their preferred gender, or asking others to refer to them by their preferred pronouns. As part of their prayer for relief, the plaintiffs ask the court to block enforcement of any federal rule requiring them to “allow members of one sex into the private spaces or sex-specific programs of the other sex in their facilities,” “speak in ways that the entities contend inaccurately refers to a patient’s sex, such as in pronoun usage, coding, charting, or conversation,” or “affirm ‘gender-transition’ efforts, or refrain from providing criticism or their full opinions to patients on these subjects,” among other requests.
The lawsuit is the latest in a string of legal challenges to the Biden administration’s efforts to expand protections for LGBTQ people. Last week U.S. District Judge Louis Guirola Jr. in Mississippi, a George W. Bush appointee, placed a temporary hold on the same rule changes challenged in Wednesday’s suit. The judge found the language of Title IX extends to biological sex but not gender identity.
Before that, three separate federal judges ruled — in as many weeks — against separate expanded Title IX protections for LGBTQ students, ultimately enjoining the protections in 14 red states and at an Oklahoma middle school. Two of the federal judges who made those rulings, Kansas’ John Broomes and Louisiana’s Terry Doughty, are Donald Trump appointees. The third, Kentucky’s Danny Reeves, is a George W. Bush appointee.