Trump admin aims to roll back transgender health protection

WASHINGTON (AP) — The Trump administration proposed Friday to roll back Obama-era discrimination protections for transgender people in health care, a move LGBT groups warn will unleash a wave of discrimination.

The Health and Human Services Department released a proposed regulation that in effect says "gender identity" is not protected under federal laws that prohibit discrimination in health care.

It is part of a backdrop of administration actions to limit or move back some of the new recognition for LGBT people, in areas ranging from military service to housing.

RELATED: Protests against President Trump's proposed transgender military ban

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Protests against President Trump's proposed transgender military ban
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Protests against President Trump's proposed transgender military ban
People protest U.S. President Donald Trump's announcement that he plans to reinstate a ban on transgender individuals from serving in any capacity in the U.S. military, in Times Square, in New York City, New York, U.S., July 26, 2017. REUTERS/Carlo Allegri
A participant cries during a protest against U.S. President Donald Trump's announcement that he plans to reinstate a ban on transgender individuals from serving in any capacity in the U.S. military, in Times Square, in New York City, New York, U.S., July 26, 2017. REUTERS/Carlo Allegri
People protest U.S. President Donald Trump's announcement that he plans to reinstate a ban on transgender individuals from serving in any capacity in the U.S. military, in Times Square, in New York City, New York, U.S., July 26, 2017. REUTERS/Carlo Allegri
Transgender activist Tanya Walker speaks at a protest against U.S. President Donald Trump's announcement that he plans to reinstate a ban on transgender individuals from serving in any capacity in the U.S. military, in Times Square, in New York City, New York, U.S., July 26, 2017. REUTERS/Carlo Allegri
People protest U.S. President Donald Trump's announcement that he plans to reinstate a ban on transgender individuals from serving in any capacity in the U.S. military, in Times Square, in New York City, New York, U.S., July 26, 2017. REUTERS/Carlo Allegri
Demonstrators gather to protest U.S. President Donald Trump's announcement that he plans to reinstate a ban on transgender individuals from serving in any capacity in the U.S. military, at the White House in Washington, U.S. July 26, 2017. REUTERS/Jonathan Ernst
A participant dressed as both Russia's President Vladimir Putin and U.S. President Donald Trump attends a protest against Trump's announcement that he plans to reinstate a ban on transgender individuals from serving in any capacity in the U.S. military, in Times Square, in New York City, New York, U.S., July 26, 2017. REUTERS/Carlo Allegri
Demonstrators gather to protest U.S. President Donald Trump's announcement that he plans to reinstate a ban on transgender individuals from serving in any capacity in the U.S. military, at the White House in Washington, U.S. July 26, 2017. REUTERS/Jonathan Ernst
COLUMBUS CIRCLE, NEW YORK, UNITED STATES - 2017/07/29: A group of New Yorkers gathered at Columbus Circle across the Trump International Hotel and Tower New York in Central Park to raise their voices in protest against discrimination towards the LGBT community, in the aftermath of the Trump/Pence regime decision to ban transgender people from serving in the U.S. military. (Photo by Erik McGregor/Pacific Press/LightRocket via Getty Images)
TIMES SQUARE NYC, NEW YORK CITY, NEW YORK, UNITED STATES - 2017/07/26: On July 26, 2017, after a series of tweets by President Donald Trump, which proposed to ban transgender people from military service, thousands of New Yorkers took the streets of in opposition. Thousands of transgender soldiers are currently serving in all branches of the United States Armed forces. (Photo by Michael Nigro/Pacific Press/LightRocket via Getty Images)
TIMES SQUARE NYC, NEW YORK CITY, NEW YORK, UNITED STATES - 2017/07/26: On July 26, 2017, after a series of tweets by President Donald Trump, which proposed to ban transgender people from military service, thousands of New Yorkers took the streets of in opposition. Thousands of transgender soldiers are currently serving in all branches of the United States Armed forces. (Photo by Michael Nigro/Pacific Press/LightRocket via Getty Images)
TIMES SQUARE NYC, NEW YORK CITY, NEW YORK, UNITED STATES - 2017/07/26: On July 26, 2017, after a series of tweets by President Donald Trump, which proposed to ban transgender people from military service, thousands of New Yorkers took the streets of in opposition. Thousands of transgender soldiers are currently serving in all branches of the United States Armed forces. (Photo by Michael Nigro/Pacific Press/LightRocket via Getty Images)
Protesters gather in front of the White House on July 26, 2017, in Washington, DC. Trump announced on July 26 that transgender people may not serve 'in any capacity' in the US military, citing the 'tremendous medical costs and disruption' their presence would cause. / AFP PHOTO / PAUL J. RICHARDS (Photo credit should read PAUL J. RICHARDS/AFP/Getty Images)
NEW YORK, NY - JULY 26: Dozens of protesters gather in Times Square near a military recruitment center to show their anger at President Donald Trump's decision to reinstate a ban on transgender individuals from serving in the military on July 26, 2017 in New York City. Trump citied the 'tremendous medical costs and disruption' for his decision. (Photo by Spencer Platt/Getty Images)
UNITED STATES - JULY 26: Human Rights Campaign supporters hold up signs as the House Democrats along with the LGBT Equality Caucus' Transgender Equality Task Force members hold a press conference outside of the Capitol to call on President Trump to reverse his ban on transgender Americans from serving in the military on Tuesday, July 25, 2017. (Photo By Bill Clark/CQ Roll Call)
Protesters display placards against US President Donald Trump during a demonstration in front of the US Army career center in Times Square, New York, on July 26, 2017. Trump announced on July 26 that transgender people may not serve 'in any capacity' in the US military, citing the 'tremendous medical costs and disruption' their presence would cause. / AFP PHOTO / Jewel SAMAD (Photo credit should read JEWEL SAMAD/AFP/Getty Images)
TIMES SQUARE NYC, NEW YORK CITY, NEW YORK, UNITED STATES - 2017/07/26: On July 26, 2017, after a series of tweets by President Donald Trump, which proposed to ban transgender people from military service, thousands of New Yorkers took the streets of in opposition. Thousands of transgender soldiers are currently serving in all branches of the United States Armed forces. (Photo by Michael Nigro/Pacific Press/LightRocket via Getty Images)
TIMES SQUARE NYC, NEW YORK CITY, NEW YORK, UNITED STATES - 2017/07/26: On July 26, 2017, after a series of tweets by President Donald Trump, which proposed to ban transgender people from military service, thousands of New Yorkers took the streets of in opposition. Thousands of transgender soldiers are currently serving in all branches of the United States Armed forces. (Photo by Michael Nigro/Pacific Press/LightRocket via Getty Images)
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The proposed rule from HHS reverses the Obama administration, which found that the Affordable Care Act's anti-discrimination section does indeed protect transgender people seeking health care services.

Friday's action had been long-expected by activists on both sides of the nation's social issues divide. Trump's religious conservative base has argued that the Obama administration stretched the meaning of "sex discrimination" when it included gender identity as a protected class. Civil rights and LGBT groups say that view is logically and legally flawed.

The rule is unlikely to have immediate consequences beyond the realm of political debate. It faces a 60-comment period and another layer of review before it can be finalized. Court challenges are expected.

"Despite the goals of this White House...courts have been clear for decades that prohibitions on sex discrimination encompass discrimination against transgender individuals," said Louise Melling, deputy legal director with the American Civil Liberties Union. Her organization, she added, will see the administration in court.

Melling said the impact of the proposed rule goes beyond transgender people and could also subject women to discrimination for seeking an abortion. The proposal would remove "termination of pregnancy" as grounds for making a legal claim of discrimination.

HHS official Roger Severino told reporters that the administration is going back to the literal text of the ACA's anti-discrimination law to correct what it sees as an overly broad interpretation. Severino heads the HHS Office for Civil Rights, which is charged with enforcing anti-discrimination protections.

He pushed back on the charge that the rule would open the door to widespread discrimination, for example, when a transgender person seeks emergency room care after an auto accident. He said other laws protect individuals in such situations, adding that the administration is committed to making sure health care services are provided fairly to all.

Severino also said that the proposed rule does not come with a new definition of sex discrimination. Earlier, a leaked internal document suggested the administration was debating whether to issue an immutable definition of sex, as based on a person's genital organs at birth.

The Obama-era rule dates to a time when LGBT people gained political and social recognition. But a federal judge in Texas said the rule went too far by concluding that discrimination on the basis of gender identity is a form of sex discrimination, which is forbidden by civil rights laws.

Under the original rule, a hospital could be required to perform gender-transition procedures such as hysterectomies if the facility provided that kind of treatment for other medical conditions. The rule was meant to carry out the anti-discrimination section of the Affordable Care Act, which bars sex discrimination in health care but does not use the term "gender identity."

In the Texas case, a Catholic hospital system, several states and a Christian medical association argued that the rule went beyond the law as written and would coerce providers to act against their medical judgment and religious beliefs.

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