Show-Me State Times

JEFFERSON CITY, Mo. – Missouri Attorney General Andrew Bailey led a coalition of seven states in filing a lawsuit against the Biden Administration’s Department of Health and Human Services (HHS) over a rule that mandates healthcare providers to perform gender-transition procedures and requires states to fund these interventions. The coalition argues that this rule, which they claim Congress did not authorize, misinterprets Section 1557 of the Affordable Care Act.

"Joe Biden is once again exceeding his legal authority in order to force his radical transgender ideology onto the American people," said Attorney General Bailey. "His Administration is threatening to hold federal funding hostage from any healthcare provider that refuses to perform or affirm harmful and irreversible transgender procedures."

The States demand the withdrawal of the rule on several grounds:

- It was created without legal authority and is considered arbitrary and capricious.

- It exceeds Congress's enumerated powers and infringes upon states' rights under federalism principles and the Tenth Amendment.

- It violates First and Fifth Amendment rights of healthcare providers.

- It employs unconstitutional coercion by threatening removal of federal healthcare funding.

- It attempts to preempt state powers without clear federal statutory authorization.

General Bailey stated in the lawsuit, "Doctors should not be compelled to harm children. But a new final rule from the U.S. Department of Health and Human Services (HHS) 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 lawsuit claims that HHS threatens severe financial penalties on non-compliant doctors and states, potentially excluding them from programs like Medicare, Medicaid, and CHIP. This exclusion could significantly impact vulnerable children in low-income communities.

The plaintiffs argue that this rule violates multiple statutes including the Affordable Care Act (ACA), Administrative Procedure Act (APA), structural principles of federalism, and freedom of speech. They assert there is no mandate for gender-transition procedures within Section 1557 or Title IX of the Education Amendments of 1972.

As HHS continues its stance despite previous court judgments, the States seek judicial relief to declare this fourth attempt at enforcing such a mandate permanently unlawful.

Joining General Bailey are attorneys general from Arkansas, Idaho, Iowa, North Dakota, South Dakota, Utah, as well as the American College of Pediatricians.