Officials from Montana and Texas filed a federal complaint against the Biden administration this week, challenging a new provision to enforce the Affordable Care Act warning violation of its nondiscrimination policies could result in loss of federal funding.
In a complaint filed this week in Texas federal court, Attorneys General Austin Knudsen of Montana and Ken Paxton of Texas argue the nondiscrimination law forces “radical gender ideology” upon the states through agency rulemaking and does so without proper authority.
They ask a judge to block the U.S. Department of Health and Human Services from enforcing the new nondiscrimination rules, which go into effect next month.
The complaint argues Montana health care providers would be forced to violate the state’s would-be ban on gender-affirming care in order to comply with the federal rule and maintain its funding. Montana’s law is currently blocked while a legal challenge there plays out.
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Supporters of Rep. Zooey Zephyr, D-Missoula, rally on the steps of the Montana State Capitol during the 2023 Legislature.
The federal health rule change finalized last month is in Section 1557 of the ACA, which holds its nondiscrimination policies. KFF’s analysis of the rule change last month noted that provision has been subject to oscillations with succeeding presidential administrations, and the latest turn reverses much of what was implemented by the Trump administration.
In the latest change, the federal health department has implemented an interpretation President Joe Biden made early in his administration that prohibitions on sex discrimination extend to gender identity and sexual orientation.
The ACA section at hand applies to health care entities that receive federal financial assistance; the complaint filed this week asserts 98% of health care providers participate in Medicare and therefore would be impacted.
Montana Attorney General Austin Knudsen.
