| | | | |  | | By Chelsea Cirruzzo and Ben Leonard | With help from Carmen Paun
| | |  Florida has filed a lawsuit against HHS to overturn an Obamacare rule that prohibits health care providers from discriminating against patients because of their gender or sex. | Getty Images | ACTION AGAINST 1557 — The state of Florida and others have sued the Biden administration over its rule to strengthen nondiscrimination protections for LGBTQ+ patients and also patients seeking abortions. It’s the first lawsuit filed against the administration after it reversed a Trump-era regulation that it said weakened nondiscrimination protections in health care settings. The Biden administration rule clarifies that 1557, a provision of the Affordable Care Act, forbids providers from discriminating against patients based on their gender identity or sexuality. What Florida is arguing: The lawsuit, filed Monday by Florida, its health insurance agency and the Catholic Medical Association, an organization of Catholic providers, argues that the rules go beyond nondiscrimination and would force providers to administer and insurers to cover gender-affirming care or face penalties. “In other words, HHS has already determined that ‘gender transition’ is medically necessary and that disagreeing with HHS is a pretext for discriminating on the basis of sex,” the lawsuit claims. Florida also argues that the rule would go against state law that prevents such care for minors. A separate lawsuit, Neese v. Becerra, is before the U.S. Court of Appeals for the Fifth Circuit. The suit, filed by two Texas providers, also argues that — based on an earlier HHS notice that outlined nondiscrimination guidance — providers would be forced to perform gender-affirming treatment against their medical judgment. But during arguments earlier this year, the judges on the case seemed skeptical that providers would be penalized. What HHS says: HHS declined to comment on Tuesday, citing the pending litigation, but the administration has maintained that the rule is critical in preventing LGBTQ+ patients from being denied care. In the rule and the Neese lawsuit, HHS has leaned on a 2020 Supreme Court ruling in Bostock v. Clayton County, which maintained that employers cannot discriminate based on someone’s gender identity or sexuality. What happens if Florida wins: If a judge rules in Florida’s favor, the rule would be blocked from being enforced, potentially opening the doors for providers to refuse care to people based on their gender identity or sexuality. Florida’s argument that the rule is “arbitrary and capricious” is similar to the argument made by opponents of the former Trump administration’s attempts to narrow 1557 civil rights protections in 2020. Courts in New York and Washington blocked that rule from taking effect, citing Bostock. WELCOME TO WEDNESDAY PULSE. HHS will host a mental health awareness event today that will feature a livestream of puppies starting at 10:30 a.m. Send your tips, scoops and feedback to ccirruzzo@politico.com and bleonard@politico.com and follow along @ChelseaCirruzzo and @_BenLeonard_.
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A new HHS rule helps better protect older adults and adults with disabilities who have been abused. | Jacqueline Larma/AP | MINIMUM STANDARDS FOR ADULTS IN NEED — HHS finalized a rule on Tuesday that creates federal regulations for adults in the Adult Protective Services program, including a more robust way to report neglect and abuse. The rule, finalized through HHS’ Administration for Community Living, requires states to create minimum standards to operate programs that work with older adults and adults with disabilities who have been abused. The rule emphasizes that service providers must ensure that the adults in the program can make their own decisions and their decisions are prioritized. It also requires service providers to respond more quickly to adults if their cases are life-threatening or could cause irreparable damage. It also offers two ways, including an online reporting system, to report maltreatment or self-neglect of adults 24/7. The action comes as HHS races to finalize certain proposed rules ahead of a deadline at the end of the month: The Congressional Review Act allows Congress to overturn any rules finalized after the deadline if a new administration takes office. Tuesday’s rule follows other recently finalized regulations that the administration says strengthened nondiscrimination protections in health care for people with disabilities, LGBTQ+ people and people seeking abortions.
| | | | INSIDE THE TELEHEALTH PACKAGE — The House Ways and Means Committee will mark up a sweeping telehealth package today, which might indicate what could ultimately be signed into law later this year, Ben reports. Why it matters: A plethora of telehealth rules eased during the pandemic’s height will expire at the end of the year, affecting Medicare patients, commercial insurers, acute hospital care at-home programs and more. Here’s what’s included in the package: Telehealth: The bill would extend the Medicare rules through the end of 2026, but not permanently, as many telehealth advocates and lawmakers have pushed for. Hospital at home: The legislation would extend the program through 2029, which would let hospitals treat some emergency department and inpatient hospital patients from their homes. Pay-fors: The package would add reporting requirements for the pharmacy benefit managers that negotiate drug prices, delay phasing in of Medicare laboratory test payment changes and extend hospice caps under Medicare. What’s not included: Eased rules allowing high-deductible health plans to cover telehealth before customers hit their deductibles will expire at the end of 2024. The package doesn’t address those provisions, though Ways and Means marked up legislation on the issue last year.
| | | | LISTEN TO POLITICO'S ENERGY PODCAST: Check out our daily five-minute brief on the latest energy and environmental politics and policy news. Don't miss out on the must-know stories, candid insights, and analysis from POLITICO's energy team. Listen today. | | | | | | | | NEW YORK BALLOT MEASURE DENIED — A conservative New York judge rejected a measure Tuesday that would codify abortion rights in the New York constitution, tossing it off the ballot, POLITICO’s Bill Mahoney reports. Democrats have hoped the measure would drive turnout in a critical election year where New York will have a half dozen battleground House seats that could determine control of the chamber next year. But for now, the decision in the lawsuit brought by Assembly Republican Marjorie Byrnes handed Republicans some momentum on the issue. “Once again the legislature and Governor Hochul are found to have violated the state constitution,” state GOP Chair Ed Cox said in a statement. “In their rush to pass this amendment, the Legislature never held a single hearing on the proposal, never consulted with outside constitutional experts, and falsely asserted this amendment was necessary to protect abortion rights in the state.” What’s next: Democrats plan to appeal with the assumption that Democratic-dominated higher courts will eventually let the Equal Rights Amendment stay on the November ballot — one of several states with abortion-rights measures on the ballot.
| | ELIMINATING STI PERINATAL TRANSMISSION — Belize, Jamaica and St. Vincent and the Grenadines are the latest countries to eliminate transmission of HIV and syphilis from mothers to their children either during pregnancy, birth or breastfeeding, the World Health Organization said Tuesday, Carmen reports. That means the nations brought perinatal HIV transmission to under 5 percent; provided prenatal care and antiretroviral treatment to more than 90 percent of pregnant women; reported fewer than 50 new cases of congenital syphilis for every 100,000 newborn babies and achieved an HIV case rate of fewer than 500 births per 100,000 live births. The three countries achieved the milestone by strengthening prevention and treatment services through primary health care and maternal and child health, screening pregnant people, monitoring cases and following up with infants exposed to HIV and syphilis, according to the WHO. Nineteen countries have achieved this milestone, 11 of them in the Americas, the WHO said. Cuba was the first country in the world to eliminate perinatal transmission of both HIV and syphilis, in 2015, according to the WHO.
| | Jeanne Lambrew is now The Century Foundation’s director of health care reform. She previously was commissioner of the Maine Department of Health and Human Services. She is an Obama administration alum. Taylor West is now executive director of the Healing Advocacy Fund, which advocates for legal and regulated psychedelic treatments. She previously worked in drug policy reform advocacy.
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