The Trump administration on Friday finalized its rollback of protections against gender identity discrimination in health care regulated by the Affordable Care Act.
The U.S. Department of Health and Human Services said in a statement it would recognize "sex discrimination according to the plain meaning of the word 'sex' as male or female and as determined by biology."
The move means insurance policies and health care regulated under the Obama-era Affordable Care Act can deny services to transgender people. HHS said it is reverting to a time when the government "declined to recognize sexual orientation as a protected category under the ACA."
A number of organizations strongly criticized the move, with the Human Rights Campaign vowing to sue in an attempt to block the new rule.
“We cannot and will not allow Donald Trump to continue attacking us," the group's president, Alphonso David, said in a statement. "LGBTQ people get sick. LGBTQ people need health care. LGBTQ people should not live in fear that they cannot get the care they need simply because of who they are."
New York Gov. Andrew Cuomo tweeted, "At a time when there is so much violence against trans people, it is abhorrent that the Trump admin is stripping away critical health protections."
Critics say the move will impact LGBTQ people and others with HIV while allowing health care providers opposed to abortion to deny services.
Health and Human Services argues the rule will save taxpayers "$2.9 billion in undue and ineffective regulatory burdens over five years," according to its statement.
The department said the rule change is consistent with a 2016 federal court ruling saying the protections weren't consistent with civil rights and religious freedom precedent and law. Health and Human Services effectively vacated the protections last year.
The National LGBTQ Task Force said more than 134,000 Americans have opposed the changes on the record during the mandated public comment period.
Candace Bond-Theriault, the group's senior policy counsel, said in a statement, "Whether it be from the COVID-19 pandemic or as a result of the police brutality we’ve seen on full display over the last few weeks, people across the country are suffering and in pain.
"That’s why it’s particularly despicable that the Trump administration would choose this moment to continue with its assault on the rights of LGBTQ people and members of other marginalized communities."
Mara Keisling, executive director of the National Center for Transgender Equality, said in a statement, "Even as the death toll and catastrophe of the COVID-19 pandemic grows and people take to the streets, the Trump administration remains focused on denying equal access to health care to transgender people."
Louise Melling, deputy legal director for the American Civil Liberties Union, called the move "beyond heartless."
“The Trump administration has made a mission out of putting politicians and religious beliefs above a patient’s health care," she said in a statement. "This is deadly and all of us should be outraged."
The conservative, anti-LGBTQ Family Research Council hailed the Trump administration change.
Mary Beth Waddell, senior legislative assistant for the organization, said in a statement that the Obama-era rule would have protected gender confirmation surgeries, as well as abortions.
"The rule finalized today helps protect health care providers from being forced to participate in and perform services that substantially violate their consciences and help protect their patients," she said. "Family Research Council fully supports these revisions to ensure Obamacare isn't used as a vehicle to advance transgender or abortion politics."
